Today [Aug 28] I’m participating in the workshop “Engaging Minority Communities in Safer Healthcare” organized by MITSS (Medically Induced Trauma Support Services), a Boston non-profit I’ve written about before.
The current speaker is Lisa O’Connor, VP of Nursing at Boston Medical Center. She just showed this four-minute safety awareness video, produced by Quantros. Much of its content will be familiar to our readers here (the frequency of medical errors and hospital acquired infections), but I’m posting it because of its good, concrete, specific actions every patient should know.
The part with specific actions for patients starts around 2:30. (My highlights are below.) Read more »
*This blog post was originally published at e-Patients.net*
There are many stories journalists could report on about conflicts of interest and questions about evidence in the treatment of low back pain, perhaps especially with spinal fusion. We talked about many of these with journalists from the American Society of News Editors in a workshop at the Foundation for Informed Medical Decision Making in Boston in May.
John Fauber of the Milwaukee Journal-Sentinel hammers one of these issues, looking at how Medtronic’s Infuse product “went from revolutionary advance to public health alert.”
Why are so many stories so unquestioning about these runaway surgical Twitter practices? Just look at this frame grab from a Google search showing all of the stories (so far) on one hospital team’s surgical Twitter exploits. One story stated:
“Senior hand fellows…when not actively involved in the surgery, sat at a laptop just outside the operating suite and tweeted real-time updates during the procedure, according to a hospital press release. According to the Twitter feed, expert teams of hand surgeons rotated in and out of the operating room throughout the surgery.”
Oh, phew, their hands were tweeting when their hands weren’t operating! I might rather that my surgeons — even when not actively involved in the operation and when rotating out of the OR — would just rest their digits and not flex them digitally. But what an old-fashioned guy I am.
Recently, JAMA published a study concluding that doctors are hesitant to report incompetent physicians or those who were impaired. According to the article:
“…more than a third of docs don’t think they’re responsible for reporting those who aren’t fit to practice, according to the results just published in JAMA. And only 69 percent of the docs who knew about an impaired or incompetent colleague reported them.
To those who advocate that the medical profession self-police, the numbers aren’t encouraging. Read more »
*This blog post was originally published at KevinMD.com*
Many conservatives are up-in-arms about President Obama’s decision to appoint Don Berwick, a pediatrician and renowned expert in quality improvement and patient safety, to lead the Center for Medicare and Medicaid Services (CMS). They object to Dr. Berwick’s views on a range of issues, and to Obama’s decision to use his office’s authority to appoint Dr. Berwick while the Senate was out on a short Independence Day holiday recess. As a “recess appointment,” Dr. Berwick was able to take office without Senate hearings and confirmation, but he can only serve through the end of the 111th Congress — that is, until the end of 2011 — unless ratified by the Senate.
Berwick, though, also has many supporters. Maggie Mahar articulates the “pro” viewpoint on Dr. Berwick’s appointment in a recent Health Beatpost. She observes that two former CMS administrators who served in Republican administrations have commented positively about Dr. Berwick’s qualifications. Read more »
From KevinMD’s medical blog, guest post by Toni Brayer, M.D., shares a story where a team approach in medicine is critical for quality patient care.
Dr. Brayer writes:
“Medicine is a team sport and it is only when the team is humming and everyone is working together that patients can have good outcomes. Hospital errors, medication errors, poor communication between doctors and nurses are prevented by adherence to protocols that everyone follows. It takes laser focus, measuring outcomes and a great deal of hard work to ensure everyone is pulling together in a hospital. The fact that these bedside nurses take the time to work on error reduction and patient safety is really amazing. Have you seen how hard nurses work? My hat is off to these dedicated caregivers.”
Dr. Brayer is exactly right when she writes “medicine is a team sport.” Read more »
*This blog post was originally published at Health in 30*
I don’t know what’s going on with American College of Emergency Physicians (ACEP) lately, but it’s disheartening. Their abdication of responsibility and engagement during the healthcare reform debate was depressing. Then there was a rigged poll designed to elicit a predetermined result. Now I see a bizarre op-ed piece in USA Today entitled “Opposing view on drug addiction: Don’t make us ‘pain police’” and authored by ACEP President Angela Gardener. An excerpt:
The patient-physician relationship is sacrosanct, demanding candor and trust. In the emergency department, trust is built in nanoseconds because patients and doctors do not have prior relationships. Knowing that any pain prescription will be entered into a large, public database might prevent patients from being truthful, or in the worst case, from seeking needed care. … As an emergency physician, I can assure you that the drug abusers who use the emergency room simply to get a prescription drug fix represent a micropopulation of the 120 million patients who seek emergency care every year in the USA. … Put bluntly, if legislators have money to spend, they should spend it where it will do the most good for our patients, and that is not on drug databases.
I really don’t know what to say, other than to wonder whether Dr. Gardner and I practice in the same United States in which abuse of prescription drugs is growing exponentially and in which “drug-seeking” patients are a part of each and every shift worked in the ER, where deaths due to overdoses of prescription medications are on the rise, and where diversion of narcotics is a serious and growing problem. Read more »
*This blog post was originally published at Movin' Meat*
We medical folks have always known that July is the worst time for a patient to be admitted to the hospital. It has nothing to do with nice summer weather or staff vacations. Although it cannot be proven, we think the answer to the mystery of July hospital errors is human — yes, it’s the new interns.
A new study published in the June issue of the Journal of General Internal Medicine looked at all U.S. death certificates from 1979 to 2006. They found that in teaching hospitals, on average deadly medication mistakes surged by 10 percent each July. The good news is they did not find a surge in other medical errors, including surgery or in non-teaching hospitals. Read more »
*This blog post was originally published at ACP Internist*
Babies born between the 34th and 36th week have more complications and cost the U.S. $26 billion annually. These children have more risk of death, cerebral palsy, cognitive impairment, or respiratory problems.
In the United States, nearly 13% of infants are born before they reach 37 weeks gestation. According to the Society for Maternal-Fetal Medicine (SMFM), that rate is much higher than other developed nations, and physicians may be partially to blame for the early deliveries.
Some of the reasons may be older moms or the increased use of artificial reproductive technology and multiple births, but some physicians are choosing to deliver between 34 and 37 weeks even when there is no clear medical indication. Read more »
Ten years after the release of the IOM report To Err is Human, which documented the toll taken by medical errors in this country, the question remains: What can be done to reverse the trend of ever-increasing morbidity and mortality due to medical errors? Last December, a look back over the decade since the release of To Err is Human — and a steady medical error death rate of about 100,000 per year included a series of suggestions for tweaks to the health care delivery system that may help ameliorate the situation. Earlier this week, a gadget that enforces good handwashing technique by sniffing caregiver and clinician hands for soap before a hospital patient may be touched has been touted as potentially saving significant costs related to HAIs.
Today, the Lucian Leape Institute released a report titled Unmet Needs: Teaching Physicians to Provide Safe Patient Care which focuses on moving back the point in time where an intervention is needed to reverse the trend documented in To Err is Human and since. Leape and his colleagues at the National Patient Safety Foundation are now focused on reinventing the medical school curriculum, so that patient safety will be taught more effectively in medical schools. Read more »
Update From Haiti: Despair Sets In And Women Consider Suicide
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From Dr. Toni Brayer at 
Babies born between the 34th and 36th week have more complications and cost the U.S. $26 billion annually. These children have more risk of death, cerebral palsy, cognitive impairment, or respiratory problems.
