Quality care requires open clinical transparency

Let’s face it. Health care is an odd field. Costs are unknown or indecipherable. Prices for the services offered are hidden from consumers. Likewise, the value (efficacy, quality, safety) of the services received is hidden from consumers. In no sense does it represent other markets, in which transparency of these elements reigns and which therefore have a better chance of reaching the “efficient market” described by economists.

In such an environment, growth in market share by one participant is usually solely at the expense of another: a zero sum game. But even in the dysfunctional world of hospitals and physician marketplaces, such transactions can add value to society. In that case, the result is a non-zero sum game. But only if the “winners” actually do add value.

The business strategy of our hospital is remarkably straightforward. We hope to be the high quality, low cost provider among academic medical centers in our region. We look for community-based partners — hospitals and physician practices — for whom we can respectfully help to deliver coordinated care. You have read numerous examples on this blog about how we are trying to do this.

But this is more than a business strategy. It is a matter of values and mission. You won’t find this mission statement written in our formal documents or in any strategic plan. Its strength lies in the fact that it is a deeply held belief.

I never told you this story, but when Gloria Martinez, one of our transporters, won our first caller-outer-of-the-month award, she first graciously accepted the award on behalf of herself and the other transporters. Then, with no coaching or prompting whatsoever, she said that she and her colleagues viewed their job as “trying to provide the kind of care we would want members of our own family to receive.”

I know I do not violate confidences when I tell you that this simple statement from Gloria left tears in the eyes of our Board members. That a person who pushes beds and wheelchairs and delivers specimens — who in another institution might be anonymous and ignored — could simply and elegantly express the community purpose of our hospital was a very moving moment.

We fully engage clinical transparency because we view openness in such matters as the best way to hold ourselves accountable to the standard of care we — the Board, the clinical leaders, and the administrative leaders — have set for ourselves. We do not do this for competitive purposes, but if the health care marketplace recognizes our progress and rewards us with a growing market share, we are happy to contribute to a non-zero sum result for society.

Paul Levy is the former President and CEO of Beth Israel Deaconess Medical Center in Boston and blogs at Not Running a Hospital. He is the author of Goal Play!: Leadership Lessons from the Soccer Field and How a Blog Held Off the Most Powerful Union in America.

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  • ChristineWithRegence

    Why is the cost of health care procedures and treatments so mysterious? How come I don’t know the cost of a test or an office visit? Check out this fun, short video. It makes you wonder!