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Looking for ways to improve basic care in hospitals--the government way

Lots of interesting stuff in this article from the New York Times, "Program Coaxes Hospitals to See Treatments Under Their Noses." The point is to get docs in hospitals to remember to give standard-of-care treatments in three non-controversial areas, like aspirin to heart attack patients.

    Doctors do know what works, said Dr. Steven M. Asch, a health care researcher at the V.A. Greater Los Angeles Health Care System and the RAND Corporation in Santa Monica. But, he found, Americans got just half the tests and treatments they should be getting...At least part of the answer, he and others say, is that doctors are unaware of their shortfalls and are rewarded no matter how well they do.

Enter the carrot--pay for performance--and the stick, which is the threat of public humiliation when Medicare posts the hospital ratings on the Internet.

What about those reminder sheets CME providers hand out as takeaways? Here's what the Times article said:

    "We tried to come up with a standardized order set," with all the measures that Medicare was asking about, Dr. Gross said. "But the doctors didn't want to use the sheet," insisting they would just remember those items. Then they forgot.

When they used nurses to remind the docs, success rates soared. Anyway, it's an interesting article.

Update: Shrinkette has a much better post on this--check it out.

Another update: AmedNews has an article on the AMA's new initiative to provide prompts that will, they believe, save 100,000 lives over the next 18 months by reducing errors.

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