You might be wondering why this is appearing on a blog devoted to exploring controversial issues in preventing infections in hospitals. As a hospital epidemiologist in a safety net hospital, I have always struggled with this big issue of distributive justice: as we continously pour more energy and resources into perfecting inpatient medical care, more of our people are losing access to care. Unfortunately, our public health metrics reflect this abysmal reality. As a society we have decided that it's more important to provide perfect inpatient medical care to a stroke patient than to ensure access to basic primary care and treatment of her hypertension that would have averted the stroke, a paradox that I will never understand.
Wouldn't it be refreshing if a JCAHO surveyor asked what your hospital is doing to care for the uninsured? In my wildest dreams, there's a National Patient Safety Goal that addresses how well a hospital provides evidence-based primary care to medically indigent patients. Maybe someday. For now, JCAHO has its hands full trying to eliminate unapproved abbreviations.