Rx Shortages and Their Impact on Care

     Many Americans rely on a steady supply of medication in order to maintain their health. Growing shortages of medications have caused great concern for those requiring the medication. “The shortages involve a wide range of medications: cancer chemotherapy agents, anesthetics, antibiotics, electrolytes needed for nutrient solutions, and dozens more” (Knox, 2011). These shortages have cause more than just delays. “Last week the Associated Press reported that at least 15 people have died as a result of drug shortages” (Knox, 2011). In recent years, there were a total of 211 national drug shortages. We are already at 213 shortages for this year, and it seems like the trend will only get worse (Knox, 2011).

     Faced with dwindling supplies, many hospitals have enacted rationing efforts in order to reserve these drugs for those who need it most. “… caregivers at other hospitals say they have had to divert scarce electrolytes from other children and adults to save the lives of fragile preemies" (Knox, 2011). Another drug shortage is labetalol. Intensive care doctors use labetalol to treat “patients whose blood pressure is going through the roof”. Labetalol is so scarce that the hospital recently decided to reserve it only for patients having a brain hemorrhage (Knox, 2011). Dr. Taylor Thompson, medical director of the Mass General’s medical ICU says “It's really no way to run an integrated health care delivery system, to take cornerstone drugs and have to do without and find alternatives monthly.  It would be a bit like a pilot coming to Logan Airport in the morning and (being told), 'We're out of Airbuses, you're going to have to fly a 727. And oh, by the way, you're taking off in 10 minutes.' "

     “Most drugs in short supply have been older generic drugs, which are generally less profitable. Hospitals are most affected, because many scarce drugs are intravenous forms, not pills dispensed in bottles” (Knox, 2011). On the contrary, officials at the Food and Drug Administration say that only 11 percent of shortages happen because companies cease production due to being unprofitable. Most occur when production halts, due to something going wrong during the manufacturing process. Whatever the cause may be, drug shortage may be the new normal in U.S. medical care (Knox, 2011).

     This is very alarming news. I am very grateful that I do not have to take any maintenance medication. I really feel for those affected by the shortages, having conditions requiring them to take drugs daily to preserve their health and well-being.  With rapidly rising trends in drug shortages, how will our medical care system cope when millions of more people become insured? These people will surely seek medical treatment which could possibly lead to more being put on these drugs. Does the solution lie in making more drugs or should we focus on making better drugs? How about laying the groundwork for living healthier lives to decrease drug dependence? These shortages will have a huge impact on the quality of care providers are able to deliver to their patients. There is a high level of reliance on drugs for maintaining comfortable living conditions. How will these shortages reflect on the ability of our healthcare system to deliver quality care?

Reference

Knox, R. (2011). Shortages Lead Doctors To Ration Critical Drugs. from NPR News Web site: http://www.npr.org/blogs/health/2011/10/04/140958404/shortages-lead-doctors-to-ration-critical-drugs

Patient’s Perspective - Adverse Events

Adverse events in healthcare are a touchy subject that can evoke strong emotions and opinions from people, especially those affected by them. Healthcare in itself is inherently full of risks but the majority of the general public does not view it that way or even acknowledge it. To most people, their thinking is “I get sick. I go to the doctor. The doctor makes me well again.” Perfect healthcare is an unrealistic expectation. They don’t realize all the risks associated with healthcare and with places like hospitals. There are so many adverse things (like nosocomial infections) that can happen to a person simply by being present at the hospital, let alone having a procedure done there. People can acquire methicillin-resistant Staphylococcus aureus (MRSA) visiting healthcare facilities or die from relatively routine procedures due to complications.

                The average patient does not have the knowledge and experience necessary to properly and objectively assess an adverse event. There could possibly be so many factors involved that would make it beyond the patient’s comprehension. Standard procedures in the operating room could have been improperly executed by staff members resulting in an adverse event. The most important people involved in determining an adverse event would be the healthcare providers present when the event allegedly occurred. Patients are often put under during their procedures and would be unaware if any adverse events occurred. The healthcare providers directly involved with the procedure would have first-hand knowledge to any such events. Patients could also easily mistake postoperative pain, swelling, and bruising as adverse events when in actuality, they are all part of the healing process. It should be left to the healthcare professionals to decide when an adverse event has or has not occurred.

                The patient’s perspective is most important from a customer service point of view for damage control. When an adverse event has not occurred but the patient believes otherwise, it could result in a less than desirable situation if not properly handled and addressed with the patient. The healthcare providers involved along with risk management needs to address the issue with the patient in order to properly diffuse the situation. This could involve speaking to the patient and their loved ones or working out some other arrangement to avoid any costly lawsuits. Involving patients and families in this process is essential (Ransom, 2008).

References

Ransom, E., Joshi, M., Nash, D., & Ransom, S. (2008). The Healthcare Quality Book Second Edition. Chicago, IL: Health Administration Press.

Health Care Consumer Satisfaction

The health care industry is quickly shifting its marketing strategies toward efforts designed to attract and appeal to its consumers. Patients have now become consumers of health care with hospitals and physicians all jockeying for position in order to provide their medical services. This shift from treating patients to providing services to health care consumers has greatly directed focus and attention toward customer service. Initiatives aimed at boosting customer service and experience include customer service training for staff, offering convenient services such as free valet parking, or even upgrading facilities with more luxurious amenities. Patients often have a choice in where to spend their health care dollars so health care providers are now advertising directly to them in order to capture this market (Ossoff & Thomason, 2012).

Increasing patient satisfaction will hopefully increase patient loyalty, which in turn should lead to repeat business from patients. Satisfied patients are more likely to positively market and recommend a physician or hospital to a friend or relative whereas an unsatisfied patient may negatively inform those around them to seek services elsewhere. Another reason to strive for high patient satisfaction could stem from financial pressure from the Centers for Medicare & Medicaid Services (CMS). CMS has realized that there is a correlation between patient satisfaction and positive clinical outcomes and will be putting in place initiatives to financially incentivize providers with high patient satisfaction rates and penalize those who are unable to meet the set levels for patient satisfaction(Ossoff & Thomason, 2012).

It is in the best interest for hospitals and medical facilities to invest in education and training programs designed to hone and strengthen patient interaction, communication, and customer service skills of physicians and staff. This will help to maintain and create long lasting relationships between health care providers and health care consumers while helping to ensure maximized reimbursement benefits and minimized reimbursement penalties.

References:

Ossoff, R. H., & Thomason, C. D. (2012). The Role of the Physician in Patient Satisfaction. Journal Of Health Care Compliance, 14(1), 57-72.

What does Quality mean to you?

I believe that quality is the perception of how well services and products are rendered and delivered to consumers. Quality is very subjective and can differ greatly between individuals. What one person views as high quality, another person may view it as low quality. The levels of quality itself can have a broad range as well. Quality levels can be classified as low, high, or anything in between. It often goes hand in hand with satisfaction levels.

When referring to the quality of products, quality is often affiliated with how well the product performs a certain function and/or its durability over a period of time. Having a nice car that continually breaks down could be considered to be low quality. Likewise, having a car that runs well but has no air conditioner, audio system or power features could also be considered low quality. Most will agree that having a reliable car with all the extra features and options would be considered high quality. High quality products generally carry a higher price tag.

Quality in healthcare is decided mostly by patients. Each patient has their own different views and opinions and so, quality varies greatly among patients. Quality in healthcare is often judged by treatment outcomes. Good outcomes will correlate with good quality and poor outcomes will often be correlated to poor quality. A high quality encounter at the hospital could be attributed to the cleanliness of the facility, a friendly and knowledgeable staff and timely appointments. Again, quality in healthcare goes hand in hand with patient satisfaction.

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