TAILIEUCHUNG - Pursuing Excellence in Healthcare_8

Tham khảo tài liệu 'pursuing excellence in healthcare_8', khoa học xã hội, kinh tế chính trị phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | 196 Pursuing Excellence in Healthcare surgery programs and more recently has reported the outcomes for most of its other clinical departments as well 49 . Interestingly a 2005 survey of hospital administrators found that the vast majority were against public reporting of medical errors because of fears of increased lawsuits and the risk that less than expected results would result in the loss of patient volumes 50 . Thus hospital leaders must be convinced that their success in the increasingly competitive healthcare environment will come only through their ability to document and market their ability to provide outstanding care 46 . A novel model for enhancing professionalism in medicine is the adoption at Hopkins of an apology and disclosure program for physicians and staff. Designed by Dr. Michael A. Williams the program recognizes that all people are fallible that although errors occur a good-faith effort should be made to avoid them and that when a major error is made it should be disclosed to the patient and the family 51 . Unfortunately not all states preclude apologies from being included in medical malpractice cases 52 . Therefore it is not surprising that many health systems in the United States do not reward compensate or encourage physicians who disclose errors. Hospitals often assign risk management to administrative managers rather than to physician managers or physician leaders leading physicians to suspect that the health system has little or no interest in acknowledging or disclosing medical errors 53 . However it can be argued that the willingness of the Cleveland Clinic and Hopkins to disclose their faults and their successes publicly is representative of some of the elements that have allowed them to evolve a culture of excellence. Eliminate the Hidden Curriculum in AMCs One of the largest challenges for AMC leaders especially those with open staff models or who use affiliated hospitals to train medical students and residents has been to ensure a

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