Haimanti Banerjee lives in Boston, USA, and works for a major hospital. She has a Masters Degree in Physics from BHU and Masters Degree in Computer Science from Boston University. She is a co-founder and board member of the Boston Center of Excellence for Health and Human Development.
I am living in the US for nearly 30 years, and I have experienced how the system works here from within, especially while giving birth to two of our children. I have studied computer science. I work and have worked for some of the most renowned hospitals in the USA. My main job has been related to safety and quality. Tracking, analyzing, and reporting the patients’ care quality and safety based on some essential criteria is what my domain is.
My experience comes from decades of working at the ground zero of the American healthcare system. In a modern healthcare system, for the betterment of the patients, staff, and communities, we must promise to focus on the equitable delivery of high-quality care to all patients and change their systems and practices to eliminate bias in hiring, retention, and promotion of staff.
In order to truly ensure that hospitals live up to these goals, robust health equity metrics must be incorporated into mainstream hospital ranking systems, which should be based on structure, process, and outcomes.
The structure encompasses health system organization, financing, staffing, and technology that give hospitals the tools they need to care for the communities they serve. This includes funding for community and population health efforts, education and training which are key in achieving progress in health equity.
The process reflects the practices of diagnosis, treatment, prevention, and patient education. Outcomes refer to survival, functional outcomes, and rates of adverse events.
I presnt here how the system works in the USA. Public policies can further facilitate or impede hospitals’ efforts to improve quality by a coordinated effort between various important institutes. The American Hospital Association (AHA) )and its member hospitals work closely with the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, Food and Drug Administration, Agency for Healthcare Research and Quality, the National Quality Forum, and the Joint Commission and other national accreditation bodies.
As hospitals and health systems continue to look for ways to advance the quality of care while lowering costs, the AHA has taken a leadership role in supplying information to hospitals to help them further improve the work they do.
Let’s take up the issue of Quality and safety, which included few important parameters.
1. Infection control: In hospitals in West Bengal HAI should not be a hidden, cross-cutting problem. Thus continuous surveillance is imperative for determining the extent of the problem and its effective prevention and control.
2. Emergency Readiness: Private hospitals meet on surge-readiness. The state should step up to meet on surge readiness in public hospitals. A great example is the Covid 19 Pandemic.
3. Reducing Health care Disparities:
Research has shown that individuals of belonging to poor, minority and scheduled caste/tribe communities have less access to best possible care, receive different care, and often have worse health than the affluent, educated and belonging to upper class. In the case of India and, more specifically, the disparity is between the rich and the poor, urban and rural, is huge.
The two key health indicators are very important – the health infrastructure index (HII) and health inequality index with respect to health infrastructure at the block level of the district. A health infrastructure index can be developed using health inputs fromthe number of hospitals, nursing homes and dispensaries, the number of available beds, and the number of doctors in government hospitals.
4. Quality measurement and Star ratings: The goal should be to make the data on Hospital Compare easier for consumers to understand.
5. Standards, Surveys, and Accreditations should be advocated for more clarity in interpreting standards.
6. Appropriate use of Medical resources: The healthcare authorities must examine the drivers of health care costs and contributing factors. They should identify alist of hospital-based procedures or interventions for which the hospital and the medical staff should craft policies and establish procedures intended to ensure the appropriate use of services. These include:
• Patient Blood Management
• Antimicrobial Stewardship
• Ambulatory Care Sensitive Conditions
• Elective Percutaneous Coronary Intervention
• Aligning Treatment with Patient Priorities in the Context of Progressive Disease for the use of the ICU
West Bengal’s Healthcare system needs a major overhaul to achieve few essential goals:
Accessibility, Affordability and Quality healthcare for all. Poor must have access to the best quality facilities, not just the rich. Where affordability is an issue, Government projects such as Ayushman Bharat may hasten these systemic changes. West Bengal must be a global partner for the United Nation’s Sustainable Development Goal 3 (SDG 3) – Good Health And Well-Being to ensure health and well-being for all at every stage of life.