Getting Used to Hospital Transparency

By Kate Fenner, RN, PhD

 Whether discussing the financial meltdown, governmental affairs or health care performance, the vogue word is TRANSPARENCY. The term is defined as the ability of “outsiders” (customers, citizens, patients) to peer into the inner workings of the subject and judge efficacy, equity, clarity and/or accountability.

 For many good reasons, healthcare has been particularly allergic to adopting transparency:

• Our necessity to maintain confidentiality
• Our fear of litigiousness
• Our aversion to bureaucracy that frequently accompanies external evaluation

These issues combine to create a culture loathe to disclosing even minimal performance data. We worry and quibble over the validity and objectivity of each proposed system of public measure.

But we need not only to overcome this aversion but to embrace the inevitable wave of open information descending upon the field. Even Zagat, the famous customer originated restaurant review system is getting into healthcare through their troubling plunge into patient ratings of physicians!

Successfully adapting to this unyielding wave of openness

A seismic shift in our culture of secrecy is required. Cultural norms that reinforce secrecy, “need to know information”, data dynasties and other barriers to open accountability for outcomes must be rooted out, evaluated and exterminated wherever possible. As in all significant organizational change, leadership must go first into the fray, or why else the term leader?

We must get comfortable with broadcasting performance dashboards to all audiences; publicizing clinical outcomes and financial results even when the results are suboptimal.

Paul Levy’s example at Beth Israel Deaconess stands as an exemplar for emulation.

Begin in small ways, but set an ambitious agenda for cultural change. Failure to do so just hastens the inevitable external inquiry, so we might as well control the process rather than to become a victim of the momentum!

Filed Under: Hospital Leadership

Tags: healthcare confidentiality, hospital management, hospital transparency