Every month, we run a select group of comments from readers on recent items in H&HN Daily. This month's picks include takes on the role of patient education in reducing readmissions, the pace of adoption of best practices in quality and patient safety and the use of performance data to drive continuous improvement. Keep those comments coming in!

Gwenmarie Hilleary, Executive Director of the Hospital Association of San Diego and Imperial Counties, responded to Michael Abram's piece yesterday on strategies for reducing hospital readmissions. Hilleary argues that patient education is a key factor in that effort:

We also need to educate the public that there are alternatives to sending the patient back to hospital as well. Families need to learn when to go the ED versus urgent care. They need to call the physician sooner rather than too late, as they recognize the health status of the patient is in decline. Reimbursement is still not aligned with changes in care pathways. Ambulance services are only paid for if it results in a trip to the ED, for example. Providers need to educate families prior to patient discharge that a trip back to the hospital could be a unfortunate trip for the patient.

Last week, I blogged about a panel discussion, hosted by AHA President Rich Umbdenstock, that focused on promising results from several ongoing quality and patient safety initiatives. The blog drew this response from reader Waynergf:

"Promising results from the field suggest that health care's moment of improving quality and reducing costs may finally be arriving."
Finally? This "moment" in health care has been around for decades. The only thing lacking, apparently, is aware, engaged, and committed leaders.
"For years, advocates of quality and patient safety have argued that better adherence to best practices and standards of care can not only improve care, but reduce cost."
Argued? These "advocates" have been doing it for years…some for decades (go read about Brent James, Peter Pronovost, Paul Batalden, et al.).
Health care leaders have to get beyond the "discovering fire" stage (again and again it seems) and get on with the doing phase. I am continually amazed at health care's lethargic attitude toward the need for rapid change - in a industry that deals with people's health and lives — not things!

H&HN Daily Contributor Rachel Saxe recently took a look at one hospital's efforts to use real-time performance data to drive continuous improvement. Reader Vince Sonson responded:

Fantastic article Rachel and spot on. Continuous quality improvement requires access to real-time performance data across the health care environment and the tools to aggregate and interpret that data accurately and efficiently. This empowers leaders to intervene in a timely manner with fact-based insights where corrective actions are required, inspiring a culture of continuous improvement through positive behavioral change. Well said!

And finally, earlier this month, we ran a video interview I filmed with former CMS administrator and IHI co-founder Don Berwick, where he made an impassioned plea for health care quality advocates to become more engaged in national policy (a few weeks before, as it happens, he announced he was mulling a run for governor in Massachusetts). Reader Betty Noyes seconded his call to action:

A very clear and succinct overview. I really like the statement is that it is not just about medicine but it is about the health care of the community. Three cheers for this type of leadership. May we all find ways to contribute to the goal.