Needed: 'Consumer Revolution'

Re: "Making Patients Accountable for Their Care" by Haydn Bush, H&HN Daily, March 12

Engaging patients with the right information, awareness of their needs as opposed to our needs (to get "the numbers" right), and building trust is central to our biggest challenge, which is changing our cultures of care. Bringing the consumer into the discussion about health care needs to be a national initiative. Many try, but often are rejected as "problems" because they ask too many questions or bring information with them seeking our input on how this relates to their problems. It is impossible for clinicians to change the culture of acute care without a tidal wave of patient/family engagement in the processes of care. After decades of practice, I am convinced it will take a consumer revolution as the chief driver to decrease HAIs, stop medication errors, and prevent falls and pressure ulcers (to name a few).

Our hope lies in partnering with our families for improved outcomes … everyone wins!

— Lisa Sams

Untapped Opportunities

Re: "Strategies to Increase Market Share and Build Brand Loyalty" by Sebastien Gay, H&HN Daily, March 8

The largest pool of untapped opportunities for reducing hospital expenses is the volume of unnecessary, noncontributory, and wasteful medical spending. Period. Get that under control and you have a margin that allows you to innovate.

— Stefani Daniels

The Afterlife of Health Care

Re: "Understanding the Velocity of Change in Health Care" by Ian Morrison, H&HN Daily, March 6

Ian, you write as though technology and other factors are sitting still waiting for the health care industry to catch up. In fact, technology is accelerating away from health care at an exponential rate. Therefore, health care will be further behind in two years than it is today. It appears that, unless health care addresses the market drivers in a realistic manner, much of our health care system will become irrelevant within the next 10 or so years. Your "long half-life" is actually an "afterlife." The Affordable Care Act is not an accelerator. It is a "safe haven" to temporarily shield health care from real reform, just as the federal government shielded the auto industry to prevent the loss of unnecessary manufacturing jobs. 1930s socialism protects the status quo from the inevitable.

— Doug Elting

Attitude Matters Most

Re: "How Hospitals Can Rise to the Challenge," a video interview with Teri Fontenot, H&HN Daily, March 7

I wish every hospital employee could see this interview and Teri's key messages of optimism, confidence and resilience. We can't stop change from coming down the road, but we can face the challenges with courage and creativity. In one industry after another we've seen that the attitude with which we face our challenges is more important than the magnitude of the challenges themselves — the resurrection of Chrysler, the aplomb with which Southwest Airlines survived the post-9/11 slowdown, the way plowed through the dot-com bust. Each of these examples demonstrates that Nietzsche's aphorism applies to organizations as well as individuals — that which doesn't kill us can make us stronger. Teri makes it clear that we need to focus on the opportunities as well as the problems.

— Joe Tye

What About Doctors and ACOs?

Re: "Assessing Hospitals' Readiness to Participate in ACOs" by Kevin Kenward and Nathan Bostick, H&HN Daily, Feb. 28

Very interesting! But I am more intrigued by the prospect of physicians' creating their own ACOs using up-front funding from CMS. What ACO activities are emerging in this space? How will ACOs governed by physicians differ from ACOs governed by hospitals? In what way would these entities compete or cooperate? Could the emergence of physician ACOs create the potential for a revolt by doctors who feel that they became hospital employees too soon?

— Andy Innis