INFECTION CONUNDRUM. The Leapfrog Group’s recent earth-shattering revelation from its hospital quality and safety survey that 87 percent of hospitals fail to prevent avoidable infections acquired within their facilities is a lot like the recent study that men pursue attractive women largely for sex. Honestly, this is not breaking news. Because the federal government and a growing number of insurance companies and private agencies that evaluate and report on hospital quality and safety issues for a public demanding accountability and transparency, The Leapfrog Group seems to want a piece of the action – or at least the publicity. The Washington-based The Business Roundtable launched the group in mid November 2000 with such promise and a powerful premise: The consortium of large private and public companies sought to wield its collective buying power to crack down on preventable medical errors in hospitals nationwide and push for more stringent patient safety measures. Now, seven years later, apparently little progress has been made. Whether that’s because the group’s efforts carried limited clout and credibility among those who actually could do something about it, its recommendations lacked accountability and teeth, the healthcare industry grew weary with the message, the group’s efforts were nothing more than theater disguised as policy or some combination only invites speculation. What needs to be stressed is simple behavior modification (with a nod to Albert Bandura, Ivan Pavlov and B.F. Skinner). We don’t need to be told that there’s a problem because it’s widely acknowledged the problem predated the creation of The Leapfrog Group. We need to learn specifically how to fix the problem and understand the consequences of doing nothing or merely going halfway. Such consequences must extend beyond adverse events and negative patient outcomes and involve financial discipline and pain – namely accountability that should hurt. Whether that’s reduced reimbursement, fiscal penalties, lawsuits or C-suite salary cuts and firings for non-compliance will have to be determined by the industry – hopefully well in advance of government intervention.

ROUND ROBIN. Imagine the ripple effects if the United States adopted and implemented universal healthcare coverage. Conceivably, the roll of the uninsured millions would dwindle to virtually nothing. On the surface that may represent a good thing, unless you factor in a lack of behavior modification (e.g., failure to stop poor health and hygiene habits and risky practices), which would needlessly and unfairly overburden the system. But let’s leave government influence over morality and personal privacy off the table for now. With everyone "guaranteed" basic healthcare services, what happens to the tax exemption status of not-for-profit hospitals? Will consumers have to accept income, property and sales tax increases or mere "sin" tax increases? Will the definition of "sin" be expanded beyond alcohol, cigarettes and gambling, for example, to include fatty foods, gasoline, junk food and entertainment? How about the safe harbor exemption from the Medicare anti-kickback statute for group purchasing organizations? Would insurance company, private payer and supplier profits take a hit? Would this mean that the government would usurp the control over the healthcare industry that Insurance Inc. wrested from hospitals and physicians back in the late 1970s and has enjoyed for the last three decades?

LAB RATS. The Wall Street Journal reported that some devastating medical mistakes can start in pathology laboratories, as well as on the operating room table. How? Examples include mislabeled blood samples, missed diagnoses and misdiagnoses based on poor quality biopsy specimens. But we hear more about surgeon screw-ups than anything else – and not even enough of that to generate a public outcry. As a result, we lose sight of the real quest – eliminating mistakes and protecting patients, regardless of the cause and source.

MOBILE EXCITEMENT. A study shows that cellular telephones apparently stimulate the brain (even though the long-believed cancer link has yet to be discovered). We’ve all read the stories that explored how doctors’ exposure to video games can improve their surgical skills, thereby contributing to decreased medical and surgical errors. This represents a new wrinkle in the war on mistakes. Forget about cutting 20 hours from those 100-hour maximum workweeks and equip surgeons with RAZRs or SLVRs.

Celebrate success, readers.