Callous or careless?: Hospital said fetus was dead, but it wasn’t

Here’s another cringe-worthy story from the hospital world which should make healthcare leaders say “Ouch!”  According to a report from the BBC, a hospital told parents of  a developing baby that their child was dead — but later found out that it wasn’t.

The basics of the story are as follows. Last July, Dublin-based Michael Redmond and his wife Melissa went to get a prenatal check-up at  Our Lady of Lourdes Hospital in Drogheda.  After conducting a scanning test (not named in the article) the staff told her the baby was dead and advised her to make arrangements to remove the deceased fetus.

Not satisfied with this result, which didn’t square with her instincts, Melissa got a second opinion from a local doctor, and learned that her son was in fact alive. Her baby boy, Michael Jr, is now 13 weeks old, the Beeb story reports.

Our Lady of Lourdes has considerable experience dealing with pregnancy and delivery — in fact, according to published reports, 4,000 women gave birth there last year, and it runs a regional NICU. But all of that is useless if your technology doesn’t work. As it turned out, the scanning equipment used by Our Lady of Lourdes  was six years old, an age which might have contributed to or even caused the misdiagnosis, news reports suggest.

Now, I don’t mean to be callous, but we all know that mistakes happen. We’d all like to see them eliminated — and many clinicians give their lives to reducing medical errors — but we’ll never get the number down to zero.  That being said, it’s worth pausing to see what we can take away from this case. Some points that leapt out at me:

*  Are we taking the patient’s input seriously?  I have no way of knowing, but my gut tells me that this woman must have communicated her distrust of the results to caregivers at the hospital.  If  they minimized her concerns or even ignored her, and could have committed irreversible harm.  To my knowledge, few hospitals are doing much to catch “not listening” errors — but clearly, they should.

* When a patient complains, double-check everything:  Even if this hospital did listen to Melissa Redmond, and advised her to get a second opinion, I doubt they would have double-checked how their equipment was functioning. They would probably have gone about their business, using the scanner as always, since their analysis would not have too deeply into Ms. Redmond’s worries.

Now, the kicker. Despite looking a near-catastrophe in the fact, it took the Irish hospital six months to change the scanner after finding out about the Redmond’s traumatic experience.  Not very reassuring, is it?

Theory #4: nextHospitals are politically engaged

Last week, Sen. Tom Daschle appeared at a conference for sehior healthcare finance types. While much of his talk was devoted to inside baseball on reform, he took a moment to urge healthcare executives to get involved directly in the legislative process. “If you don’t know the name of your healthcare legislative assistant, then you aren’t [involved enough,]” Daschle told the crowd.

Unfortunately, it’s likely that his reminder fell on deaf ears. In our experience, few hospital executives get involved directly in politics, though they may support lobbying efforts by trade groups. It’s not just that they’re too busy;  many seem to see legislative activism as some sort of specialized skill, like accounting or database programming.

But it’s high time that they change their style

If hospital execs leave lobbying and hand-holding to specialists, legislators may never hear how things are playing out on the day-to-day level, or learn first-hand what kind of  messy dilemmas your facility faces. What’s more, there’s nothing like a real-life example to make the case for, say, funding for uncompensated care. (“Here at County General, 23 percent of our patients are uninsured. That saps our finances and endangers our ability to survive. We turned away 147 people from our ED last year and the number may be higher this year.”)

nextHospitals can’t sit idly by and let the so-called professionals handle legislative issues.  In fact, getting to know the healthcare LA is just the beginning.

Identify what issues matter most for your facility, find out how you can hammer them home to your political reps, and find a way to communicate your position to everyone that counts. Yes, it will take extra time and staffing, but you already have PR folks, community outreach staffers, business analysts and more.  Put politics on their radar: You’ll be glad you did.

– Katherine