8. We Look Only Where the Light Is
Measures force hospital teams to put their resources into improving what is paid or penalized, and ignore other parts of their operations that may cry for attention.
According to Panzer and colleagues, "the total of the current and planned measures from different sources can be overwhelming, hence, the sense some organizations leaders have of excessive and potentially overwhelming measurement and reporting requirements."
Mandates may "crowd out" initiatives that would have more relevance for a particular institution's patients, staff and leadership, they add.
"For example, a hospital may internally detect problems with the safety of transitions in care and be unable to focus sufficient attention to this important patient safety issue, due to the volume of other measures to which they must direct their attention."
9. Variables are Inconsistent
I've learned from hospital leaders that healthcare quality measurement is a tower of Babel. The point at which one hospital reports an infection or a severe pressure ulcer, may vary depending on the organization.
I've heard that for some surgeons, a retained surgical object is not declared a serious adverse event if the patient is still under anesthesia when the lost object is identified and if the surgical wound can be reopened in the same surgical session without the patient being the wiser.
For others, the instance would be counted and reported.