What If Medical Care Came With A 90 Day Warranty
A Great Way To Avoid Costly Mistakes 
Geisinger Health System is trying to learn in an experiment that some experts say is a radically new way to encourage hospitals and doctors to provide high-quality care that can avoid costly mistakes. After taking a cue from the makers of television sets, washing machines and consumer products, Geisinger essentially guarantees its workmanship, charging a flat fee that includes 90 days of follow-up treatment. Even if a patient suffers complications or has to come back to the hospital, Geisinger promises not to send the insurer another bill.
Geisinger stands out as a group that has transformed the way it delivers care, said Dr. Donald M. Berwick, the chief executive of Institute for Healthcare Improvement, a national nonprofit organization whose goal is better patient care. In almost no other field would consumers tolerate the frequency of error that is common in medicine, Dr. Berwick said, and Geisinger has managed to reduce the rate significantly. “Getting everything right is really, really hard,” he said. Researchers estimate that roughly half of American patients never get the most basic recommended treatments — like an aspirin after a heart attack, for example, or antibiotics before hip surgery.Reviewing the existing professional guidelines and medical literature, Geisinger’s cardiac surgeons came up with their list of 40 action items viewed as best practices — including giving a patient antibiotics within a specified time before surgery, and then giving beta blocker drugs afterward to reduce the chances of an irregular heartbeat. Doctors can choose not to follow a particular measure, based on the needs of an individual patient. But they rarely do so. And they also know that any of the steps can be altered if new medical evidence emerges.
