Dr. Cutler's Advice to Users
Dr. Cutler’s General Advice to Users of This Web Site:
Dr. Cutler’s Advice on Specific Measures:
Measuring quality of health care (which includes safety), like health care itself can be easy or very complex. For example, careful attention to hand washing is the most effective method for preventing the infections often acquired in a hospital or doctor’s office. If you knew which providers of your health care were most careful, you could choose the most careful doctor and reduce your risk of catching an infection while receiving care.
The information on this Web site has been collected and presented with utmost care. It is not perfect, but it can help you. Before this, you had no information from a neutral source about health care quality in Maine. The information here will help you become better informed and make better decisions.
If you choose a hospital that rates better on the measures described in this Web site, you increase the chances that you will receive safer, more effective care.
Health care is complex. The sicker you are, the more complicated your health care becomes. Improve the chance that health care works for you by considering the information offered to you on this Web site.
If you live in a community where you do not have a choice about care, ask your provider about their rankings on these measures. Your hospital and your doctor are important to your community. There is no magic to doing better. Doing better does not require new inventions. Doing better requires more planning and effort to make sure that your hospital and doctor provide the care that is expected, as safely as possible.
Best practices (defined as doing the right thing at the right time, as agreed to by experts) for the care of heart disease improves outcomes. When every patient receives the care they should, when they should, fewer patients die. Doctors and nurses know what to do; the challenge is making sure every patient gets what they need when they need it. Hospitals that do well on these measures have built routines to make sure the right things happen. This information may not help Mainers choose a hospital. Few patients actually have a choice when time is critical. This information is useful when you discuss with your doctor their choice of hospital, and when you discuss with your hospital their own performance.
When you arrive at your hospital with pneumonia, it is important to receive the right antibiotics quickly. Early and correct treatment means better outcomes and shorter hospital stays. Achieving 100% is not possible on some of these measures because pneumonia is not always obvious. Some patients present a very complicated picture because of other medical problems they already have. Those hospitals that score well here may have simpler patients or better routines to get the drug to the patient quickly. If you have a lung or breathing problem, this is important information to know before you need care. If your hospital ranks below expectations here, encourage them to improve.
Preventing infections that a patient catches after entering the hospital is a huge problem. Giving the correct antibiotics to a patient prior to surgery can be very helpful in preventing infections after surgery for many types of surgical procedures. Careful attention to how medical devices are placed that pass through the skin makes a real difference in preventing infections. Paying attention to the simple things can help prevent infections for sick patients with breathing tubes and ventilators. Everyone knows what to do. Making sure it gets done can be difficult. Even doing all the right things cannot always prevent an infection in the hospital, but it sure helps. Hospitals doing well on these measures have made efforts to ensure that they are taking all the right precautions. You can use these results to help you and your physician choose a hospital when you need surgery.
It will surprise no one that having a skilled nurse at the bedside when you need one makes hospital care safer. Nurses must not be overworked, as that can make their care unsafe. Nurses must be constantly trained. Nurses with experience are essential to protect patients and train other nurses. A hospital that has more registered nurses with more experience (fewer turnovers) is likely to be better for patients. Experienced nurses know how their hospital works. Experienced nurses bring practical learning to your care. Look for a hospital with more RN hours for each patient (hours per patient day) and a lower rate of nurses leaving (voluntary turnover). Hospitals that care for simpler problems may need fewer nurses. Thus, when you compare nursing availability, try to compare similar hospitals.
Everyone works to protect their patients. Less use of restraints and fewer patient falls with and without injury are indicators of nursing success. Hospitals that score well here maintain an adequate number of skilled nurses to protect their patients. Experienced hospital managers should know how many nurses their types of patients need. Congratulate or encourage your hospital, depending on their numbers on these quality and performance measures.