tag:blogger.com,1999:blog-7476621888383604834.post2792408617476097678..comments2024-02-15T03:26:38.897-05:00Comments on Health Care Organizational Ethics: The Roar on the Other Side of SilenceJim Sabinhttp://www.blogger.com/profile/03087828142188534542noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-7476621888383604834.post-49977376606037734792007-10-12T09:42:00.000-04:002007-10-12T09:42:00.000-04:00Hi Eric --Thanks for this further helpful comment....Hi Eric --<BR/><BR/>Thanks for this further helpful comment. <BR/><BR/>I agree that a patient's global impression does not give focused guidance about what went right or wrong in their hospital experience. There is, however, an important upside for global scores. It encourages all of us to take more responsibility for what our colleagues are doing. I practice in a group setting, and when my patients report an unhappy experience elsewhere in the practice I always apologize that "we have disappointed you," and at least sometimes find I can do something about the problem.<BR/><BR/>I haven't yet done the research I promised on Press-Ganey scores, but I still plan to do it!<BR/><BR/>Best<BR/><BR/>JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-16758921813720577052007-10-11T22:41:00.000-04:002007-10-11T22:41:00.000-04:00Office-based practice lends itself to scoring indi...Office-based practice lends itself to scoring individual doctors' performance. Whereas current hospital practice provides a panoply of care-givers. It is often hard for patients to know who is a doctor, who is their primary doctor and who is the specialist. In a typical 3.5 day stay, a patient may be initially evaluated by an emergency department physician, admitted by a hospitalist, cared for by a second hospitalist during the day and by other hospitalists at night. In addition, specialists, PAs, students, therapists, case managers, etc. work with the patient. Most patients can at best give a global assessment, though certain care-givers may stand out as particularly good or particularly bad.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-16807089576364927352007-09-29T08:29:00.000-04:002007-09-29T08:29:00.000-04:00Hello Eric:Your thoughtful comments raise a host o...Hello Eric:<BR/><BR/>Your thoughtful comments raise a host of important questions. I will do some research about the validity of Press-Ganey scores and their correlation with other measures of quality. Some years ago I received satisfaction scores for my outpatient psychiatry practice along with the range of scores in my group and nationally. These were VERY meaningful to me --not because salary was tied to the measures - it wasn't - but because of personal ideals.<BR/><BR/>Re moral dilemmas -- validity is the key factor. IF Price-Ganey scores truly correlate with central objectives "pay for performance" (P4P) can in principle support ethical aims, but that hypothesis itself requires testing. Likewise with making the data public. <BR/><BR/>I will write at more length about this in coming weeks. <BR/><BR/>Thank you!Jim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-88083585668330054922007-09-28T22:02:00.000-04:002007-09-28T22:02:00.000-04:00Press-Ganey scores appear to be the way that hospi...Press-Ganey scores appear to be the way that hospitals are trying to demonstrate their level of customer satisfaction, which perhaps is a proxy measure for the organizational "listening to the roar on the other side of silence." Hospital administrators and physicians report that portions of their salaries are held at risk depending on these scores. Holding portions of salary at risk is believed to serve as a stimulus to improve these scores. Published comparisons of hospital scores are assumed to help patients choose a hospital. <BR/>What is the validity of Press-Ganey scores; how is the data gathered and processed; what is the correlation of patient satisfaction and good medical care; what are the moral dilemmas involved in tying salary to such measures; what are the moral dilemmas in presenting such data to the public?Anonymousnoreply@blogger.com