The University of California-San Francisco (UCSF) has made a significant announcement that could be a watershed moment for how medications are given to hospital patients in the United States.
In a typical hospital setting, patients are receiving many different types of prescription medications — ranging from mundane vitamins to more intense drugs such as chemotherapy. In the thousands of times medications are given to patients, and with the high number of humans handling the process of organizing and giving the medications, human error is bound to occur. And medication errors can be life threatening — especially if related to a chemotherapy agent.
UCSF wants to make the rate of error for medication administration to be zero. In order to do this, they are using robot technology to prepare and track medications, with the main goal, obviously, being to improve patient safety. In the phase-in of the project, not a single error occurred in the 350,000 doses of medication prepared — remarkable.
Once computers at the new pharmacy electronically receive medication orders from UCSF physicians and pharmacists, the robotics pick, package, and dispense individual doses of pills. Machines assemble doses onto a thin plastic ring that contains all the medications for a patient for a 12-hour period, which is bar-coded.
There are some key advantages this system brings to the workflow of a hospital setting:
— The robots can do chemotherapy dosing, one of the toughest and most sensitive things to do. They can also do complex IV medication dosing.
— There is no touching of the medications by hand. The medications come from the manufacturer, are processed by the robots, and then sent to the nurses and the patient’s bedside in sterile packaging.
— The robots allow for pharmacists and nurses to be more efficient by taking away repetitive tasks. While they do not replace either, they enable a healthcare system already stretched for resources to increase productivity.
— The system costs $15 million, but with the payoff in regards to improved patient outcomes, as well as time saved, the investment should make this endeavor by UCSF more than worthwhile.
When it comes to understanding medical information, even the most sophisticated patient may not be “smarter than a fifth grader.”
In one of the largest studies of the links between health literacy and poor health outcomes, involving 14,000 patients with type 2 diabetes, researchers at the University of California San Francisco and Kaiser Permanente found that more than half the patients reported problems learning about their condition and 40 percent needed help reading medical materials. The patients with limited health literacy were 30 to 40 percent more likely to experience hypoglycemia — dangerously low blood sugar that can be caused if medications are not taken as instructed — than those with an adequate understanding of medical information.
Now, federal and state officials are pushing public health professionals, doctors, and insurers to simplify the language they use to communicate with the public in patient handouts, medical forms, and health websites. More than two-thirds of the state Medicaid agencies call for health material to be written at a reading level between the fourth and sixth grades.
A new federal program called the Health Literacy Action Plan is promoting simplified language nationwide. And some health insurers, doctors’ practices, and hospitals have begun using specialized software that scans documents looking for hard-to-understand words and phrases and suggests plain-English replacements. Read more »
I [recently] received a press release from a friend in the Bay Area. Investigators at UCSF have published a study in the New England Journal of Medicine showing that less chemotherapy can be effective at treating some childhood cancers.
The paper was the result of an eight-year clinical study in children with neuroblastoma. In this particular population, researchers were able to reduce chemotherapy exposure by 40 percent while maintaining a 90 percent survival rate. You can read about it here.
The press release sparked a brief email exchange between me and my friend: Who might be interested in writing about this study and is there any way to get it to spread? What would make it sticky in the eyes of the public?
Here are a few ideas:
Figure out who cares. Sure it’s niche news, but there are people who would think this is pretty darn important. Think organizations centered on parents of children with cancer, adult survivors of childhood cancer, pediatric hematology-oncology physicians, pediatricians and allied professionals in pediatric medicine like nurse practitioners and hematology-oncology nurses. Networks form around these groups. Find them and seed them.
Make a video. Offer powerful, visual content beyond a press release. A four-minute clip with the principal investigator, Dr. Matthay, would be simple and offer dimension to what is now something restricted to print. The Mayo Clinic has done this really well. Read more »
*This blog post was originally published at 33 Charts*
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 »
In a development that may have you undergo your next medical procedure the old-fashioned way, two researchers from the University of California-San Francisco and the University of Oslo are reporting that inhaled anesthetics significantly contribute to the destruction of the ozone layer and add to the overall global warming gas content in the atmosphere.
Moreover, the study’s authors conclude with some valuable advice for your own practice: “From our calculations, avoiding N2O and unnecessarily high fresh gas flow rates can reduce the environmental impact of inhaled anesthetics.”
We’d like to venture even further. Not only would we recommend closed-circuit, low-flow anesthesia even with sevoflurane (damn those kidneys!), we’d also suggest that patients arrive by bicycle or, if absolutely necessary, a biodiesel-powered ambulance.
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The University of California-San Francisco (UCSF) has made a significant announcement that could be a watershed moment for how medications are given to hospital patients in the United States.
In a development that may have you undergo your next medical procedure the old-fashioned way, two researchers from the University of California-San Francisco and the University of Oslo are reporting that inhaled anesthetics significantly contribute to the destruction of the ozone layer and add to the overall global warming gas content in the atmosphere.
