I graduated college during the emergence of Obama Care – where the healthcare system as we knew it was preparing for a massive overhaul. it was a dynamic time and it inspired my colleagues and I to be excited as we positioned ourselves to be the change we wanted to see in the world.
I started working for an accountable care organization and felt like I truly found what I was meant to be doing with my life. I was hyper focused on patient centered care and greater health outcomes for the patients in my community. I was immersed into chart audits evaluating quality of documentation and presence of preventative healthcare. I was working along side clinical staff to learn best practices and standard operating procedures that could be duplicated to create more efficiency in the health system, in turn creating cost savings that could be reinvested.
I was a new graduate that was bright eyed and bushy tailed – motivated to make impactful changes. more often than not i would be faced with individuals who weren’t as eager. over time i have become acclimated to a stagnant environment. one where quality improvement departments exist but only up until the point where they rock the boat. only up until the point of inconvenience. only up until the point where they need additional resources.
i have sat in meetings where client satisfaction scores were presented and largely skewed to make an organization look more appealing to the board or to the healthcare consumer. i have challenged those statistics and plainly agreed to disagree. i have brought up clinical audit indicators and encouraged quality improvement plans. but im going to tell you bluntly – the majority finds these topics unimportant unless it is costing them money or has the potential to generate revenue.
so I can bring up the importance of employee satisfaction and it’s direct correlation to patient satisfaction scores. i can aggressively encourage the immersion of the quality department into the clinical programs. I can motion to involve clinicians and administrators in quality of care concerns, in compliance hotline events or in peer review. the barrier is getting the buy in. getting past the ego that presents itself when you may have asked a question out of turn or made a suggestion to the wrong individual. getting into a space where you can properly challenge the “we’ve always done it this way” mentality. I am ashamed to say that I haven’t always fought past these barriers and frankly just assumed position.
The problem is that healthcare is a for-profit business. i don’t care what the organizations tax filing status is – I have been around long enough to know it’s about the bottom line. the environment will not change until this does. Until the quality departments are allowed to operate for the betterment of the communities in which they serve, I will continue to feel guilty. It is common knowledge that the determinants of health lie in socioeconomic status. It is well known that pharmaceutical and insurance companies run the healthcare system as we know it. Currently we write policies and standard operating procedures that protect or are in the best interest of the insurance companies. We aren’t advocating for our staff that may not have the supplies or the support they need.
For the first time in my healthcare career I faced a stark reality. Acting reactively instead of proactively finally came and bit us in the ass. I refuse to play this game anymore. It’s time every last one of us uses our voice. It’s time that we speak up for what our patients and our coworkers deserve.
& for you, the one who doesn’t feel like a sacrificial lamb… you have a voice too. Use it with your privilege to vote – starting with the small local elections that you may not even realize matter. Continue to care about the future of the healthcare system and the necessary overhaul that it deserves after the smoke settles.
**its important to note that all of this is my personal experience and opinion. this does not represent my employer or any underlying funding source.