An extended interview with Dr. David Carlson, Chief Medical Officer, on HealthGrades and What It Means For You
Q. We’re talking about Health Grades. Some big news - what is your general reaction to it, and what do you think it means for the community?
A. great news because it really highlights what we do every day. It showcases quality in certain areas that, that our public sees and the services they use on a regular basis.
Q. It seems like in the future this (healthcare transparency) is going to be a really big issue. Do you think people are going to become more involved in their healthcare in this way?
A. More and more we see that sort of the concept of transparency where both the governable agencies, the insurance companies and the consumers are all asking for more information and wanting to understand not only that we believe we have quality but that we prove it. So this is one of those ways to really highlight and show consumers in a way that they can understand that, how we compare to other, other institutions and that we really do provide a high quality service based upon a comparison based upon a comparison as opposed to just what we believe.
Q. As a physician, would you encourage people that haven’t maybe thought about researching before, to use this tool?
A. I think it’s always important to talk to your physician as well but I think looking at, looking at the websites that are available and trying to understand the information is really also an important thing and something that’s going to become more and more common as the information gets better and easier to understand.
Q. The award puts us Distinguished Hospital Top 5 Percent in the Country. You’ve been in medicine a long time, is that an easy thing to do?
A. No, it’s not easy at all. In fact I think it’s really, it’s a challenge to get there. I know of a number of institutions who have really placed a lot of time and energy on really trying to get there so they can hold out that they’re, you know, in the Top Health Grades 10 percent or 5 percent and they struggle to get there. So we, of course, work every day to be as high quality as we can. This is just the fruit of that effort that we’ve made the top 5 percent and I think our challenge going forward is to get closer and closer to that top 1 percent.
Q. It’s a nice award. It’s a nice title and everything but I think what people might be surprised to hear some of the statistics that go along with it and what being a high performing top 5 percent hospital, what does it mean for the patients?
A. Well I think, you know, for the patients it really isn’t, it’s an endpoint measure. So they’re looking at how we do in terms of complications that occur and endpoint. So it’s not necessarily a measure of what you feel when you’re in the hospital but it’s really a measure of what you want to achieve from your hospitalization at the end. So we still have the obligation to provide all the benefits, the high touch, the caring that comes from being in a hospital. That’s not always in every hospital but I think we do a good job with that as well but this really measures how the technical part of your healthcare went as well.
Q. And really, I mean, it impacts your chances of surviving, I mean is that being too strong?
A. No. I mean we really do touch on that. That is exactly what a mortality rating is. So it measures how many people live at the end of a procedure or, you know, conversely, how many people might die if they have a certain procedure done and many of these procedures have a certain rate of people who have a complication or some factors that do lead to their demise when they, when they’re in the hospital.
Q. Critical Care is one of the areas that we did very well. What do you think is impacting that area? What do you think helps us shine in that area?
A. Well I think, you know, we have, first of all we have Critical Care Specialists who are always managing in our unit and because of that they pay attention to the patient as a whole when they’re in a situation where, where they need those intensive kind of services and I think that absolutely makes a difference as well as really, you know, we have a pretty robust Quality Improvement Program that, that, that has taken us down a path of really implementing things that are proven life savers and complication savers so things like we call them a Ventilator Bundle. It’s a certain set of things that you do for every patient who’s on a ventilator and if you do that you can reduce your, the numbers of people on a ventilator who get pneumonia just because they are on the ventilator so those are things that we do. We take a multidisciplinary approach by, you know, pulling our nurses and our respiratory therapists and our physicians together in rounds and I think we also benefit by having medical students and residents here who ask questions and kind of push us to be at the forefront of medical knowledge and I think that really is a help as well.
Q. You mentioned doing the same thing all the time and how that impacts, one of the things we talked about in Critical Care was the Hypothermia Protocol and the Traumatic Brain Injury Protocol where they obviously have a protocol in place so that every patient is getting the same treatment, why is that so important?
A. Well, I mean, I think it is for a couple of methods. One, if you’re doing that, if it really is the best practice, every patient unless there’s a reason not to give them one of those things, should get it and that doesn’t always happen in every institution. So that’s one element and I think the other element is the more we do things the same, the more are, all the people around, the nurses, the therapists, the doctors, everybody who helps care for that patient, the more they understand not only what they need to do but how they should do it and what to expect. So it creates a more consistent approach to what we do and I think that really does have significant benefits. So it’s really about the process and a very consistent one.
Q. Cardiac is another area where we earned significant recognitions, what are your thoughts on that program and where we’re going.
A. Well again I think that it speaks of a number of things. One, that we have really high quality physicians that work within a system that really does try to meet certain requirements that help us get to high performance. So we have protocols in place. We have things that we do in bundles that help improve care and we pay attention to it. So I think all those things together are kind of a recipe for really really good success.
Q. And what are you looking for moving forward? I mean what do you think it next on the horizon and what’s going to be really important to you and to the other physicians and staff moving forward?
A. Well I think that, you know, first we recognize that from this point, today, if we look at this as a starting point which it really isn’t but if we look at coming from today and going forward we’re really at a great place. So we’re constantly going to look at being better than we are, at improving our processes and defining how we can deliver healthcare in better ways and that translates into how healthcare’s delivered really not just here locally but anywhere. So because we are good at what we do now other people already look and say how can we replicate what you do and I think that we’ll continue that. So we’ll just keep, everyday, trying to implement more things and understand if there are better ways to practice or better processes we can use to get our endpoints and our outcomes that much better. So that’s our challenge.
Q. This is a nice award but what should the general public take home from this?
A. Well I think that what they really should understand is that we do this as well or almost as well as anybody in the Country and we do that because we have great physicians. We have great staff. We have great technology and we apply that all very well to take care of people.