Linda Dynan, Northern Kentucky University – Hospital Safety and Quality

On Northern Kentucky University Week:  Hospital safety and quality are a pressing concern.

Linda Dynan, professor of economics, takes an economic outlook on this issue.

Dr. Linda Dynan is a Professor of Economics at Northern Kentucky University. She earned her B.A. in economics from the University of Pennsylvania, and her MA, MPhil and doctorate in economics from Columbia University in the City of New York. She completed a post-doctoral Crosby Research Fellowship with the Hospital Research and Educational Trust of the American Hospital Association.  Dr. Dynan’s research interests and grant writing activity focus on health economics. She maintains an appointment as Adjunct Research Associate Professor at the Anderson Center for Health System Excellence of Cincinnati Children’s Hospital Medical Center. Dr. Dynan’s work has been published in leading health services research and medical journals such as Health Affairs,

Pediatrics, Medical Care Research and Review, and Health Services Research. She examines the organization, delivery, and quality improvement of health services as well as exploring the intersection of behavioral economics and health as it relates to childhood obesity. Her teaching interests include health, labor and development economics, econometrics, and research methods.

Hospital Safety and Quality

Most of us think of hospitals as places to go in order to get well when we are too ill to recover from illness or injury at home.

Researchers from many disciplines and health care providers are striving to make sure that is true.  I am an economist who studies how to improve health care, which means either 1) we can we improve access to and the quality of health care at same cost or 2) maintain access and quality but produce these at lower cost.

A 2000 report documented the alarming incidence and cost of preventable adverse events (i.e. patient-safety events) in America’s hospitals, reporting that as many as 98,000 people die in hospitals every year as a result of preventable medical errors 

Since then, government agencies and hospitals have worked to measure medical error and provide incentives for hospitals to minimize these events.  This is where my research comes in.

 What type of polices are effective in reducing medical error?  What types of investments by hospitals lead to improvements in patient safety? (IT, nurse training, empowering frontline caretakers to signal problems) Once we know what works how do we get other hospitals to adopt these systems and processes?  How do we make these changes sustainable?

What have we learned? 

 We can do better, we have seen improvement in many measures of hospital quality. Preliminary results indicate increased expenditure on the education and training of nursing staff and on data processing produce improvements in patient safety

Context matters—that is each hospital is different and quality improvement efforts need to be tailored to each environment. 

Incentives matter=government policies related to value-base care and nonpayment encourage hospitals to change behaviors to improve outcomes

Health care workers are motivated to do the right thing

Doing the right thing is often costly

And—we have much more to learn.