Pick up the PACE

Re: "Better Care after Hospital Discharge" by Shawn Bloom in H&HN Daily, Oct. 11

Having been a nursing home administrator for the past 10 years, I have seen firsthand the downsides related to institutional care; as hard as it tries to replicate a homelike environment, it simply falls short. Studies continue to show that when surveyed, seniors would rather die than move into a nursing home. PACE models seek to change that and they've demonstrated that they can. PACE often achieves consistently high satisfaction rates among participants.

We need more PACE sites around the country! I applaud Shawn for writing this article and for leading those who care for our most frail to a place where elders actually want to go … their home.

— Ryan J. Grace

For Seniors, a Third Sector of Care

Re: "Keeping Older Patients Out of the Hospital" by Bill Santamour in H&HN Daily, Oct. 9

The aging population makes this area of care even more important in seeking economic and quality support. In Scotland, we have a continuum of care which incorporates the third sector.

Luncheon clubs and befriending services are a huge support, acting to prevent loneliness [and] isolation, keeping an eye on the elderly to prevent deterioration in health and supporting families.

Dignity and respect are often given secondary importance in hospitals and nursing homes, as staff seek to improve health at all costs. Quality of life is equally as important as life itself and this can sometimes be forgotten.

— Janet Thompson

Better Data: A Carrot, Not a Stick

Re: "Preparing for the Growing Role of Analytics and Business Intelligence," John Glaser in H&HN Daily, Oct. 9

At best, hospitals are woefully behind the private sector in classic business intelligence.

The government seeks to improve quality by fining hospitals for not performing — has any government agency considered the reward side instead of beating hospitals into submission?

If I were the chief quality officer for a hospital, I would have a dashboard accessible from the home page with stats on death by infections, percentage of operations complete without error, percentage of patients returning with the same condition in fewer than 30 days and average length of stay trends.

— Larry Keller

If Car Insurance Is Mandatory …

Re: "The Ethics of Change: Making the Right Decisions in a Shifting System," by Emily Friedman in H&HN Daily, Oct. 2

Great synopsis. I don't think mandatory health care insurance coverage is so alarming, as long as it's open to all regardless of pre-existing conditions and affordable for all income levels; why not? I've been paying mandatory car insurance for years.

And discrimination is already present when considering who gets organ donations. A history of alcoholism will stop that patient from getting a liver transplant.

Most assuredly, if health care rationing does happen, age and every aspect of the medical record will be scrutinized to choose the "most deserving" — that is a very scary prospect.

— Jacqueline Speckin

Is CEO's the Right Voice in a Crisis?

Re: "Communication During Crisis" by Timothy Tinker and Bettina Gregory in H&HN Daily, Oct. 4

A very thoughtful and well-thought-out article. Of course, in many health care situations, the CEO may not be the most credible nor effective spokesperson. In clinical crises, a physician or nurse may be better able to give the public (internal and external) confidence and trust in what the organization is saying and doing. In cases where the crisis was created by an executive action, a board member may be the best person to do the job.

And remember, internal perception may be just as or more important than external ones.

— Rick Wade