CNBC Interviews CEO about Patient Safety

Patient Safety Interview presented on www.cnbc.com

Over the last twenty years, Americans have witnessed unprecedented advances in the care of patients. Improved diagnostic procedures, quantum leaps in medical technology, enhanced treatments and a public with the concept of preventative medical care all mean that healthcare – especially in the hospital – has changed to meet the health care needs of today’s patients.

And while the advances in hospitalized care are largely positive, the increased touch points between patients and healthcare providers have increased the risk of errors and of preventable hospital infections. New research published in Health Affairs revealed that about one-in-three patients encounter an adverse event during a hospital stay.This demonstrates that much more needs to be done to improve patient safety.


Which is why we support the Obama Administration’s new focus on patient safety and reducing preventable errors. The new Partnership for Patients will work with doctors, hospitals, insurers and employers to support patient safety improvements and reductions in preventable hospital readmissions.

While hospitals have made important strides to reduce healthcare associated infections, there is still much work to be done to eliminate them completely.

Every American should receive safe, high quality healthcare. That’s the goal driving the work between the Blue Cross and Blue Shield companies, the Society of Hospital Medicine, the American Hospital Association and their partners in healthcare across the country to promote programs that improve the way care is delivered in the hospital.

Many hospitals, hospitalists and insurers have already begun the journey toward improved patient safety and reduced hospital readmissions. And their experience will pave the way for millions of Americans to receive safer care. A new report from the Agency for Healthcare Research and Quality shows a 35 percent reduction in central line-associated bloodstream infections in hospitals participating in AHA’s Comprehensive Unit-Based Safety Program.

Creating financial incentives to reward quality instead of quantity of healthcare delivered is a major way to drive better and safer patient quality care. The Blue Cross and Blue Shield system has taken the lead in experimenting with many different payment systems meant to reward higher quality and has partnered with hospitals and other providers to directly support important safety improvement activities.

Working closely with hospitals and partners on the widespread adoption of life-saving health information technology like electronic medical records, and adopting “e-prescriptions” to flag and prevent potentially life-threatening drug interactions on a real-time basis, is also bearing real results.

Making sure that patients continue to get the care they need after they leave the hospital is critical to reducing readmissions. This means ensuring that patients understand the instructions on taking and monitoring their medications.

To read the full interview please visit:

http://www.cnbc.com/id/42768103

Scott P. Serota, is President and Chief Executive Officer, Blue Cross and Blue Shield Association, Jeff Wiese, MD, SFHM, President of Society of Hospital Medicine and Rich Umbdenstock, President American Hospital Association.

WSJ Report on Medication Errors and New Efforts to Improve Labeling

Reported in the Wall Street Journal
By Laura Landro

A new push is under way to make prescription drug information clearer and stem the rise in emergency room visits and hospitalizations resulting from patients incorrectly taking their medicine. The Food and Drug Administration is planning to test single-page consumer information sheets that would replace the multi-page package inserts and medication guides widely used in retail pharmacies. And the U.S. Pharmacopeial Convention, which sets quality standards enforced by the FDA for the quality, strength and purity of medicines, is developing a new national standard for prescription labels, which can vary widely from pharmacy to pharmacy and befuddle consumers. The standards, if adopted, would require clear instructions on dose and timing and state in simple terms the purpose of the drug—such as "for high blood pressure"—unless the patient prefers that it not appear.

Improving Patient Safety By Reducing Medication Errors

• Nearly 1.9 million people were treated in hospitals for illnesses and injuries from taking medicines, a 52% increase from 2004 to 2008.
• Another 838,000 people were treated and released from emergency rooms due to harm from medications in 2008.
• Almost 36% of treat-and-release emergency room visits were patients ages 18 to 44, and 18% were elderly.

Doctors and pharmacists are also being encouraged to counsel patients more effectively about their medications. About 100 industry and nonprofit groups are participating in a national awareness campaign about the importance of taking medication as directed, to be launched in May by the National Consumers League. The campaign includes a website for health professionals and a separate website where consumers can download tools such as work sheets to manage their medications. The group says more than a third of medication-related hospital admissions are linked to poor medication adherence.

Medication mishaps often happen in the hospital, due to clinician error and unexpected allergies or reactions. According to the Agency for Healthcare Research and Quality, the number of people treated in U.S. hospitals for illnesses and injuries from taking medications jumped 52% to 1.9 million between 2004 and 2008, the latest year available, including patients admitted from the emergency room. More than half of the increase was due to corticosteroids, blood thinners, and sedatives and hypnotics.

Another 838,000 patients were also treated and released from the ER with problems related to those and other medications, including painkillers, antibiotics, cardiovascular drugs, insulin and other hormones used to treat common diseases such as asthma, arthritis and ulcerative colitis. FDA officials say inadvertent errors made by patients who misunderstand information are causing significant harm. One reason cited is low literacy skills. A study in 2006 showed that of 70% of patients with low literacy who could correctly state the instructions "take two tablets by mouth twice daily," only 34% could then demonstrate the number to be taken daily.

Michael Wolf, an associate professor at Northwestern University's Feinberg School of Medicine who serves on an FDA risk-communication advisory panel, says in recent studies, more than half of adults misunderstood one or more common prescription warnings and precautions. In one study Dr. Wolf and colleagues found that patients better understood simple, explicit language on warning labels—like "use only on your skin" instead of "for external use only"—and those with lower literacy skills also benefited from picture icons, such as a sun with a black bar across with words, "limit your time in the sun."

To read the full article please visit  http://online.wsj.com/article/SB10001424052748703521304576279123606877448.html?mod=ITP_personaljournal_0

Hospital Aquired Infections at Houston Hospitals Reported In New Study

As reported by Yang Wang/ Houston Chronicle

The most common patient safety issue among older patients in the Houston area is systemic vascular infections, a problem often caused by unsanitary or improper procedures during their hospital stay, a new study of Medicare claims shows. Among forty six hospitals within a fifty mile radius of the city of Houston, 50% reported vascular infections in Medicare patients through catheters. A total of 472 "hospital-acquired conditions" were reported from the 234,200 Medicare discharges from October 2008 through June 2010. That's two incidents per 1,000 Medicare discharges in Houston.

Allowing the public to see information about mishaps and errors that occur during a patient's hospital stay has been a contentious issue for hospital personnel, who believe the public could misread it. To date, there's no universal ranking system for the public to determine the safety of the nation's hospitals.The reports released this month by the Centers for Medicare and Medicaid Services is the first to look strictly at how many times bedsores, surgical errors and falls and trauma, for example, occur among Medicare patients. 

To read the full article please visit:  http://www.chron.com/disp/story.mpl/metropolitan/7535533.html

For more reporting on hospital acquired infections please visit Patient Safety & Quality Healthcare

CDC Increases Focus on Patient Safety

Patient Safety Increases Organization focus on Patient Safety

As reported in Medical news Today

HHS Services Secretary Kathleen Sebelius announced the Partnership for Patients: Better Care, Lower Costs, aimed at improving patient safety in America's health care facilities through the prevention of health care-acquired conditions. CDC is one of several federal agencies participating in the initiative. Medical advances have brought lifesaving care to patients in need, but many of these advances come with a risk of health care-acquired conditions, including infections, falls, pressure ulcers (or bed sores), and blood clots (known as deep vein thrombosis).

"Americans expect and deserve safe health care," said CDC director Thomas R. Frieden, M.D., M.P.H. who has made patient safety a top priority at CDC. "CDC has an established track record of improving the quality of health care delivery. This new initiative will help protect patients and ensure that they live healthier, longer, and more productive lives while reducing healthcare costs."


In hospitals and other health care facilities, falls are among the most frequently reported incidents for inpatients. Pressure ulcers, which can occur in health care settings or at home, affect more than 2.5 million people annually. In total, health care-acquired conditions can have devastating emotional, financial, and medical consequences.

Public health officials and clinicians know how to prevent many health care-acquired conditions. However, the problem has been in getting proven protective measures adopted and used consistently in all health care facilities. CDC works with federal, state and local public health and healthcare partners to prevent these conditions.

-- CDC conducts rapid field investigations to address emerging health care safety issues.

-- CDC conducts cutting-edge infection prevention research, turning that knowledge into evidence-based guidelines that health care providers can use.

-- Several published studies have shown that health care-associated infections (HAIs) can be decreased as much as 70 percent when existing CDC prevention recommendations are put into place.

-- CDC has funded 51 locally based HAI coordinators and has supported 30 state-based HAI prevention networks to drive progress toward goals in the HHS Action Plan to Eliminate Healthcare-associated Infections.

-- CDC is working with patient and professional organizations to raise awareness and promote the implementation of current clinical guidelines for the prevention of deep vein thrombosis. CDC has been actively working to prevent deep vein thrombosis by collecting statewide registry data and tracking the quality of hospitalized stroke patients for the past decade through the Paul Coverdell National Acute Stroke Registry.

-- CDC has developed a fall risk assessment tool for practitioners that can be used in clinical settings, because the most effective single approach for fall prevention is an individualized risk factor assessment by a physician or health care provider coupled with referral and treatment.

Tracking progress toward prevention is key to achieving success in improving patient safety. CDC provides the nation's health care facilities with a free system to track infections, monitor prevention progress, and collaborate with peers. The system, called the National Healthcare Safety Network (NHSN), is used in over 4500 U.S. hospitals and is part of the Centers for Medicare and Medicaid Services pay-for-reporting program. CDC is enhancing NHSN to track the occurrence of deep vein thrombosis and the implementation and impact of prevention measures in participating hospitals. CDC also is beginning work with the acute care community to provide guidance for tracking and preventing pressure ulcers in high-risk injured patients.

Together, public and private partners can expand upon the successes seen in individual healthcare facilities and employ these best practices nationwide to protect all Americans and ensure safe healthcare.

Source: U.S. Department of Health and Human Services

Florida Hospitals Reducing Infections Through Hand Hygenie Rules

Hand Hygiene Important Factor in Patient Safety in Florida Hospitals

As reported in News- Press.com by Frank Gluck

Signs posted in hospital break rooms at  Lee Memorial Health System hospitals keep tabs on how often staffers are caught skipping hand washing — usually not often. Once taboo in hospital and health care settings, nurses and support staff are encouraged to call out doctors doing anything that might spread germs. Even casual patient contact with doctors’ neckties and iconic white coats are suspect.

These and a long list of hygiene rules, started in earnest seven years ago and taking place at hospitals nationally, may be behind sharp drops in one of the most common hospital infections, a pair of new studies show. Central-line associated bloodstream infections, which kill up to a quarter of patients who contract them, have plummeted 40 percent at Lee Memorial’s hospitals over the past few years, system records show. Central lines are catheters usually guided near the heart by way of large veins, typically in the neck, chest or arm. They are used to monitor blood circulation, or to provide medication and fluids into the body. 

“It really does take a cultural shift. You really have to work as a team,” said Dr. Marilyn Kole, the system’s medical director for clinical services. “And when you have units that are at zero (infections) — some units have been at zero for several years — it’s devastating for everyone when it doesn’t.” 

Some individual hospital units have not had central-line infections for years. Less than a decade ago, roughly half of patients in a given intensive care unit would get infections.

The Agency for Healthcare Research and Quality reported this month that Florida hospitals have cut central line-related infections by 37 percent since 2009.

To read full article please visit

http://www.news-press.com/article/20110421/HEALTH/110420043/Increased-vigilance-helps-Southwest-Florida-hospitals-lower-infections?odyssey=tab|topnews|text|Home

CDC issues guidance on preventing bloodstream infections

 Hospital Acquired Infections Still A Major Patient Safety Problem

 As reported in American Medical News
By Kevin B. O'Reilly



Recently health officials  updated their recommendations on preventing catheter-related bloodstream infections in light of successful efforts that have helped reduce  the national rate of central-line infections in intensive care units by fifty eight percent between 2001 and 2009. The new guidelines were released in April by the Centers for Disease Control and Prevention's Healthcare Infection Control Practices Advisory Committee 

Among the recommended infection-prevention measures, the new guidance calls for:

• Educating health professionals about when to use catheters, how to insert them and what infection-control measures to take when doing so.
• Designating trained, competent professionals to insert and maintain peripheral and central vascular catheters.
• Avoiding the femoral vein for central venous access in adult patients.
• Using a fistula instead of a central venous catheter in dialysis patients with chronic renal failure.
• Promptly removing any intravascular catheter that is no longer essential.
• Cleaning patients' skin with a chlorhexidine preparation with alcohol before inserting a central venous catheter.

 To read the full article please visit: http://www.ama-assn.org/amednews/2011/04/18/prsb0419.htm?utm_source=twitterfeed&utm_medium=twitter


For more information on Patient Safety please visit www.psqh.com

Patient Mobilization Best Practices Improve Patient Safety

Best practices improve health outcomes and ensure patient safety for patients and staff alike.


By Barbara Peterson, RN, BSN, MPH, and Betty Bogue, RN, BSN

Research supports the critical need for mobilizing  hospitalized patients. The adage “If you don’t use it, you will lose it” sums up the weakness and loss of functional status seen with prolonged hospital bed rest. In a hospital , patients often depend on their caregivers for mobilization. The physical demands of mobilization on healthcare caregivers often places risk on both the patient and the caregiver. This article will explore how an effective safe handling practice will improve patient safety, health outcomes, increase healthcare organizations’ profitability, and ensure caregivers’ safety.

In-Patient Early Mobilization Programs 
 
Human mobility serves a greater physiological purpose than just transferring one’s self from one point to the next. Mobility helps us perform activities of daily living, express emotions, and gratify basic needs, as well as sustain our health and enhance our body’s ability to heal and repair. With bed rest or a dramatic reduction of mobility, the body systems most affected are metabolic (fluid and electrolyte imbalance), respiratory (hypostatic pneumonia), cardiovascular (orthostatic hypotension, thrombus), musculoskeletal (atrophy and contractures), urinary elimination (infection and dehydration), integumentary (pressure ulcers) and psychosocial (depression).

To read rest of article please visit Patient Safety & Quality Healthcare