I must have “you can’t manage what you don’t measure” on the brain – here’s a piece I wrote this week for AHRQ’s Guidelines/Quality Measures Clearinghouses called “Is the Measurement Mandate Diverting the Patient Safety Revolution?” Well, of course it is.
In it, I make the point that our hunger for measurable targets – generally a good thing – automatically diverts us from that which we don’t or can’t measure. In the quality and safety world, this means that we’re spending a lot of time documenting smoking cessation counseling and very little on avoiding transition errors; a huge amount of energy on preventing ventilator-associated pneumonia and precious little on improving teamwork; and, most perniciously, oodles of effort making sure that we complete a group of measurable processes, some of only marginal importance, and almost none on making correct diagnoses. As I wrote in the piece,
…as long as a system or doctor can look good on public reports by giving “pneumonia” patients pneumovax but remain unscrutinized if they misdiagnose half the pneumonia patients, diagnostic errors are likely, in the words of Rodney Dangerfield, to “get no respect.”
Anyway, happy National Patient Safety Week! We’ll get there…