After the first story in 2010, a lengthy letter from Barnes-Jewish President Rich Liekweg was posted on the hospital's website and sent to clinicians highlighting the positive; for example, that the hospital has "significantly better" rates of 30-day mortality in two disease categories. The letter explained many of the initiatives being taken at the hospital to fix the problem.
"Our advice is not to run from it, and that has seemed to work well. To have your leadership out there and visible is really important for the community and our staff," Lynch says.
One lesson they learned is that it's wise to be proactive with the board of directors and employees before these disclosures become public. "Some of these stories are difficult to tell, and kind of complex. So I think it's important to have an early dialogue with community leaders, business partners, and the medical staff, and we're certainly having a much more open and timely dialogue with our board members around this."
Kenneth Sands, MD, senior vice president for quality at Beth Israel Deaconess Medical Center in Boston, which also shows up as "worse than" in 30-day readmissions for all three disease categories, agrees that just hoping the numbers will go away "is unlikely to be a good strategy."
"It's fair to say that there may be reasons why you think your hospital's performance is not fairly represented, but at the same time, it's best to acknowledge there's always the potential to do better," Sands says
Beth Israel has chosen to not be put in the defensive about such things the moment the data goes up on someone else's website, but to be transparent about its scores on its own website all the time so there are no surprises.
In a way, he's suggesting that if there's negative news out there, the hospital should scoop the media. "Don't wait for the news story to start communicating with all your important constituencies," he says.
Under "Quality and Safety," Beth Israel's website shows the latest available rates of adverse events such as falls, ventilator-associated pneumonia, or pressure ulcers. The rates are measured against comparable hospitals and against the hospital targets. It's clear that the hospital does not just reveal the positive. For example, the hospital's ICU central line–associated bloodstream infection rates are shown as double what it has targeted, and it offers information how the organization is addressing the issue.