Thursday, June 11, 2009

Throwing a "Metric" Wrench in the works

I really hate early morning meetings and I hope that soon those others in the meeting will hate me being there as well so I will be able to get out of them. I tend to ask the questions that throw a wrench in the works. This morning was a perfect example. It was a quality management review meeting. This is basically a group of clipboard nurses analysing things that are supposed to be about quality healthcare but are actually about JACHO compliance. Anyway, they present a "Quality Metric" which was the number of nosocomial urinary track infections. They presented a new form that they have spent weeks developing that the nurses are to fill out to follow each patient with a foley catheter. They then state that the JACHO determination of the rate of these infections was such and how they will follow their data to see how we keep up. In my sleep deprived stupor I asked what the criteria were to determine if these infections were really nosocomial. The answer I got was a positive UA after admission. Then I asked how did they know that the patient didn't have a positive UA before they got to the hospital?

The answer was of course, we dont know, it does not fit our JACHO mandated metric.

They then presented another "METRIC" which was time from pre-op to actual start of surgery and recoovery. They had data of turn around times in the OR, time of Anesthesia start, number of times instruments are flashed, time spent in each stage of recovery. Time it took to get the pre-op labs, etc. I raised my hand. Man did I get some leers. I asked who in the OR enters all the metric data? One of the clipboard nurses pipes in and explains that each pre-op nurse enters the data into a special program in the EMR and then data is entered by the circulating nurse and eventually the recovery room nurse. I said, Oh. Can I seen the graph of the metric that shows how much time is lost because all the nurses who are supposed to be taking care of the patients are actually entering all this stuff into the computer.

Lets just say, my question was not well received! Got another early morning meeting tomorrow! I cant wait!


SeaSpray said...

Good for you Throckmorton! :)

Someone's gotta make the point.

I's frustrating.

Chrysalis Angel said...