Monday, December 21, 2009

Hospital comparisons soon to be a click away

Monday, December 21, 2009 3:12 AM
By Suzanne Hoholik

While you watch parades and football games on New Year's Day, you can fire up your computers and compare Ohio hospitals.

A state law passed nearly four years ago requires hospitals to provide extensive quality and pricing information to the Ohio Department of Health. A consumer-friendly Web site with this information goes live Jan. 1.

Hospitals already report some of this information, but it's difficult for consumers to compare hospitals.

"A lot of that information was out there but was never in a user-friendly format for everyday users of health care," said Jim Raussen, the former state legislator who sponsored the legislation.

"It has to be transparent for the average citizen so they can feel comfort that the information they're getting makes sense to them and is accurate," Raussen said.

The site is called Ohio Hospital Compare and will feature more than 100 quality measures, including mortality and infection rates and how often specific medical procedures are performed at a hospital. There is even information about whether a hospital has a hand-washing program for its health workers.

On the main page, consumers will be able to pick hospitals to compare on quality measures.

Consumers need access to this kind of information, said Cathy Levine, executive director of the Universal Health Care Action Network of Ohio.

"Hospitals need to be reporting publicly their quality measures such as hospital-acquired infections and preventable complications, so they feel public pressure to improve patient quality and safety," she said.

The Web site also will link to lists of hospital charges, but they won't be in an easy-to-use format until the end of 2010, said Sara Morman, a Health Department spokeswoman.

At that time, consumers will be able to compare charges such as for private and semiprivate rooms, the 30 most-common X-rays, and services in emergency, operating and delivery rooms.

Hospitals caution that these charges aren't what the 88 percent of insured Ohioans will pay. Private and government insurance pay lower, negotiated rates.

"Each one of our health plans has a negotiated rate that's substantially less than those charges," said John Stone, chief financial officer at Ohio State University Medical Center. "We don't have two like payments from any one payer."

Even so, knowing what hospitals charge for the same thing will be helpful, said Kelly McGivern, president of the Ohio Association of Health Plans.

"It's a good barometer just for educating consumers on what these services actually cost," she said. "They need to know it's not going to cost them $10 to have a baby, that it actually costs more than that."

On Jan. 1, consumers will be able to compare hospitals by going to and clicking on Ohio Hospital Compare.

Tuesday, November 10, 2009

Sebelius Announces Release of Recovery Act Funding to Improve Care in Nation’s Ambulatory Surgical Centers

To reduce healthcare-associated infections (HAIs) in stand-alone or same-day surgical centers, the HHS Secretary Kathleen Sebelius today announced the availability of up to $9 million in funding from the American Recovery and Reinvestment Act (ARRA) to state survey agencies in 43 states. HAIs are infections some patients acquire when they are in a health care setting such as a hospital or outpatient clinic.

“Because of the Recovery Act, millions of patients who go to stand-alone surgical centers will have greater assurance that they won’t come home with a new infection,” said Health and Human Services’ Secretary Kathleen Sebelius. “Residents in these 43 states will continue to see the benefits from the Recovery Act not only by addressing health care associated infections, but by putting people to work to solve an important issue and improve the quality of life for Americans.”

“Healthcare-Associated Infections kill nearly 100,000 people and add an extra $30 billion in healthcare costs every year. But with a little bit of knowledge, and some extra effort, much of that can be prevented. I’m glad to see these funds going to help put people to work combating this tragedy around the country,” said Congressman Dave Obey (D-WI), the Chairman of the House Appropriations Committee, who was a lead author of the Recovery Act and has been an outspoken advocate for efforts to reduce HAIs.

Accredited facilities are surveyed by CMS-approved private accrediting organizations. As part of the new initiative, surveyors in the 43 states will survey approximately 1,300 ambulatory surgical centers (ASCs) across the nation, one-third of the more than 3,800 non-accredited ASCs across the country during the next 12 months. State surveyors will employ a new CMS survey process for ASCs that uses an infection control tool developed in conjunction with the Centers for Disease Control and Prevention (CDC).

Across the United States, health care services are being shifted to outpatient settings such as ambulatory care facilities, long term care facilities, and free-standing specialty care sites. The number of ASCs participating in Medicare grew from about 3600 in calendar year 2002 to 5200 in early 2009, a 44 percent increase. ASCs account for more than 43 percent of all same-day (ambulatory) surgery in the United States, amounting to about 15 million procedures every year. Typical surgical procedures conducted in ASCs include endoscopies and colonoscopies, orthopedic procedures, plastic/reconstructive surgeries, and eye, foot, and ear/nose/throat surgeries.

HAI outbreaks in outpatient settings continue to occur according to the CDC. In several ASC-related communicable disease outbreaks, failure to employ very basic infection control practices were implicated, leading CMS to identify this as an area for additional oversight.

In the last fiscal year, 12 states volunteered to get a head start on this nationwide effort to reduce healthcare-associated infections in stand-alone or same-day surgical centers by beginning to survey ASCs with funding of nearly $1 million provided through the Recovery Act.

In addition to the funds being made available for the inspection of ASCs, the CDC has also made $40 million available to state public health departments to create or expand state-based HAI prevention and surveillance efforts, and strengthen the public health workforce trained to prevent HAIs.

These funds support activities outlined in HHS’ 2009 Action Plan to Prevent Healthcare-Associated Infections. The plan also establishes national goals, prioritizes recommended clinical practices, and coordinates a national research agenda. Development of this national plan, available at, is coordinated by HHS’ Office of Public Health and Science, and involves participation from the Agency for Healthcare Research and Quality, CDC, CMS, the Food and Drug Administration, the Indian Health Service, the Health Resources and Services Administration, the National Institutes of Health, the Office of the National Coordinator for Health Information Technology, and other HHS offices, and the Department of Veterans Affairs.

Tuesday, November 3, 2009

Where Are the Firing Offenses in Medicine?

Patrick Malone
Posted: October 29, 2009 04:04 PM

The recent news about the two Northwest Airlines pilots whose licenses were revoked, less than a week after they let their plane wander 150 miles off course, raises the question: Where are the firing offenses in medicine?

The pilots injured no passengers, and the event didn't even qualify as a "near miss." But because they egregiously violated safety rules by working on their flight schedules on a laptop in the cockpit, the aviation authorities did not hesitate to pull their licenses.

In the medical industry, by contrast, it is well known that a doctor will lose his or her license for only flagrant patterns of drug or alcohol abuse or other criminal behavior, with a trail of dead and injured patients usually lasting years before the practitioner is finally put out of business.

Medicine's big safety emphasis in recent years has been to create a "no blame" culture that encourages reporting of errors, injuries and "near-misses" by promises of confidentiality and non-punitive action. The idea has been to bring systemic problems out into the open so they can be corrected by implementing "systems" changes, such as checklists to make sure all appropriate steps are taken to prevent infections when inserting catheters into blood vessels.

But what about a doctor who repeatedly puts patients in jeopardy, in small or big ways, by ignoring the rules? Many don't wash their hands routinely when they enter a patient's hospital room, and deadly infections sometimes get spread from patient to patient. Others don't "sign out" their patients at the end of a shift by a person-to-person encounter with the provider taking over.

Some surgeons still won't follow the now routine practice of "signing the site" to prevent wrong-site surgery. If the surgeon is a prominent "feeder" of patients to the hospital, such transgressions can easily be overlooked by administrators who don't want to lose the business. That helps explain why an estimated 4,000 wrong-site surgeries still are performed every year in the United States, more than a decade after the "sign your site" campaign by orthopedic and other surgical specialties.

The good news is that medical safety leaders are starting to call for accountability for rules violations. Dr. Robert Wachter of UC-San Francisco and Dr. Peter Pronovost of Johns Hopkins recently wrote about this in the New England Journal of Medicine. Comparing medicine to aviation (the article was published before the Northwest Airlines incident), they noted: "Every safe industry has transgressions that are firing offenses."

They proposed a short list of offenses in the hospital that should call for suspension of the doctor's practice for one or two weeks: failing to perform hand hygiene, skipping the sign-over to a new provider at the end of a shift, not marking the surgical site, and failing to use a checklist at the start of surgery to make sure everyone in the operating room knows the special needs of the patient. These penalties, they suggested, should only apply after the doctor has failed to respond to an initial warning and counseling.

These modest, tentative steps forward are proposed by the authors to their colleagues as a way of fending off intrusive government regulation. But they also say: "The main reason to find the right balance between 'no blame' and individual accountability is that doing so will save lives."

Amen to that.

Patrick Malone
Attorney and Author of "The Life You Save"

Tuesday, October 6, 2009

Safety Gurus: Penalize Doctors Who Don’t Follow the Rules

October 1, 2009, 3:50 PM ET
By Laura Landro

Should hospitals start penalizing doctors and nurses who fail to follow patient safety rules?

That’s one solution proposed by Peter Pronovost of Johns Hopkins and Robert Wachter of the University of California at San Francisco. Writing in the New England Journal of Medicine, the doctors contend that the failure to hold clinicians accountable for patient safety is the main reason health care is still riddled with errors, adverse events, and just plain non-adherence to some of the most basic rules.

(Compliance with hand hygiene rules ranges from 30% to 70% at most hospitals, and few have sustained rates over 80%, the authors note, while there are about 4,000 wrong-site surgeries in the U.S. annually despite a universally accepted protocol for preventing them.)

In the decade since the Institute of Medicine’s landmark “ To Err is Human” report, which estimated that up to 98,000 people a year die of medical errors, many hospitals have embraced a “no blame” model: Instead of focusing on a single individual to blame for a mistake, they’ve tried to set up systems to prevent mistakes, catch them before they cause harm, or mitigate harm from errors that do reach patients. That’s all well and good if it works, but many hospitals are now finding that a blame-free culture creates its own safety risks, Pronovost and Wachter write.

Punishments such as revoking privileges for a chunk of time tend to be used for administrative infractions that cost the hospital money – things like failing to sign the discharge summaries that insurance companies require to pay the hospital bill. By contrast, hospital administrators may just shrug their shoulders when it comes to doctors who fail or refuse to follow rules like a “time out” before surgery to avoid operating on the wrong body part.

Docs and nurses who fail to follow rules about hand hygiene or patient handoffs should lose their privileges for a week, Pronovost and Wachter suggest. They recommend loss of privileges for two weeks for surgeons who who fail to perform a “time-out” before surgery or don’t mark the surgical site to prevent wrong-site surgery.

Pronovost — best known for his development of medical checklists designed to improve patient safety — tells the Health Blog that he still sees a tremendous amount of “pushback” when he speaks to doctors. Many still resist checklists and don’t feel bound by hand washing rules, even though they’ve been shown to prevent harm to patients.

“Some of these doctors just come to the meetings to throw spears at me,” he says. “We know how important these things are for patient safety, but there needs to be some accountability for infractions,” he adds. The suggested penalties “are an attempt at a practical way to hold people accountable.”

Sunday, July 26, 2009

Doctors Want to Roll Back Policies Curbing Gifts Between Doctors And Drug Company Reps

Perks policy for doctors challenged
Physician organization wants limits rolled back
By Liz Kowalczyk,
Boston Globe July 23, 2009

A growing number of hospitals, universities, and states are barring drug companies from buying physicians dinner, hiring them as speakers, and giving them even token gifts.

Now, a new organization of doctors - several from Boston - wants to roll back policies curbing interactions between doctors and drug company representatives, saying restrictive rules ultimately will hurt the patients they’re designed to protect.

The group, called the Association of Clinical Researchers and Educators, plans to hold its first conference today at Brigham and Women’s Hospital to promote “productive collaboration’’ between industry and physicians, which they say leads to better medicines and treatments. Dr. Jeffrey Flier, dean of Harvard Medical School, is one of 25 speakers and will give the welcoming remarks to about 200 attendees.

Flier, who is unaffiliated with the organization, will not endorse its views, said David Cameron, spokesman for the medical school, which is revising its conflict-of-interest policy. “He will welcome vigorous debate and analysis on the issue of academic collaborations with industry and encourage individuals with varied perspectives to participate in the discussion,’’ Cameron said in a written statement.

Dr. Thomas Stossel, an oncologist at the Brigham; Dr. Jeffrey Garber, chief of endocrinology at Harvard Vanguard Medical Associates; and Dr. Paul Richardson, an oncologist at Dana-Farber Cancer Institute, are among the founders of the group. Stossel said they want “to convey that there is a silent majority out there. And to restore some balance to the debate,’’ he said.

The group’s website says its long-term goals include reversing restrictive new conflict-of-interest policies and establishing chapters at universities and within medical specialty societies.

Massachusetts public health officials plan in two years to review the state’s new conflict-of-interest regulations, which went into effect July 1 and include a ban on gifts to doctors from drug and medical device companies, and Stossel said his group “wants to create an outcry against’’ the law. The law also requires drug and device companies to disclose publicly most payments made to doctors for consulting.

Partners HealthCare, which includes the Brigham and Massachusetts General Hospital, passed its own restrictions in April, which go further than the state law, banning all industry-paid gifts and meals and also forbidding doctors from traveling the country as paid members of company “speakers bureaus.’’

The association’s goals, which run contrary to the widespread movement in medicine to create more distance between doctors and pharmaceutical companies, have been widely discussed - and often derided - on healthcare blogs in the past several weeks.

Patient advocacy groups and lawmakers leading the charge for more restrictive policies say Stossel and his colleagues are misguided. Advocates of the restrictions believe drug companies, by giving doctors gifts and paying them to speak and consult, create bias in favor of their products, causing doctors to write more prescriptions for expensive new drugs even if patients don’t really need the medication or if an older, less expensive drug would work just as well.

Dr. Peter Slavin, president of Mass. General, has said that company-funded meals, gifts, and other practices don’t promote a positive image of doctors and increase healthcare costs.

“The rules benefit consumers by removing the conflicts that we know cloud judgment, and let doctors make decisions free from market pressures,’’ said Brian Rosman, research director for Health Care For All, a Boston-based patient advocacy group.

But Stossel and his colleagues said the new rules stifle invention. They believe the impact of small gifts and meals on doctors is negligible compared with the benefit of collaboration.

“I’ve been in medicine 40 years, and medicine is incomparably better than when I started out,’’ Stossel said. “I don’t think anyone can challenge the fact that it’s because of the tools we’ve gotten from industry.’’

Stossel is a former member of Cambridge-based Biogen Idec’s scientific advisory board. He said he now does occasional consulting to companies on conflict-of-interest policies. The conference is funded by attendees’ fees, though participants who work for drug and device companies are charged more, he said.

Thursday, July 16, 2009

Schwarzenegger Replaces Most of State Nursing Board
by Tracy Weber - July 13, 2009 9:55 pm EDT
Tags: Arnold Schwarzenegger, California, California Board of Registered Nursing, Nurses

California Gov. Arnold Schwarzenegger (John Moore/Getty Images)California Gov. Arnold Schwarzenegger replaced nearly everyone on the Board of Registered Nursing late Monday, citing the unacceptable length of time it takes to discipline nurses accused of egregious misconduct.

Correction (July 14, 2009): This story incorrectly referred to former Board of Registered Nursing vice president Elizabeth O. Dietz as a professor of nursing at San Jose State. Although the board’s web site lists that as her current affiliation, the university said she retired in July 2008.

Update (July 14, 2009): Nursing Board Executive Officer Ruth Ann Terry Resigns [1]
Gov. Arnold Schwarzenegger replaced most members of the California Board of Registered Nursing on Monday, citing the unacceptable time it takes to discipline nurses accused of egregious misconduct.

He fired three of six sitting board members [2] – including President Susanne Phillips [3] – in two-paragraph letters curtly thanking them for their service. Another member resigned Sunday. Late Monday, the governor's administration released a list of replacements.

The shake-up came a day after the Los Angeles Times and ProPublica published an investigation [4] finding that it takes the board, which oversees 350,000 licensees, an average of three years and five months [5] to investigate and close complaints against nurses.

During that time, nurses accused of wrongdoing are free to practice – often with spotless records – and move from hospital to hospital. Potential employers are unaware of the risks, and patients have been harmed as a result.

Reporters found nurses who continued to work unrestricted for years despite documented histories of incompetence, violence, criminal convictions and drug theft or abuse. In dozens of cases, nurses maintained clean records in California even though they had been suspended or fired by employers, disciplined by another California licensing board or restricted from practice by other states.

"It is absolutely unacceptable that it takes years to investigate such outrageous allegations of misconduct against licensed health professionals whom the public rely on for their health and well-being," Schwarzenegger said in a written statement.

Board member Andrea Guillen Dutton, in a resignation letter Sunday [6], said she was leaving in frustration. "Certain ‘bad actors' are jeopardizing the reputation of the entire nursing profession," she wrote. "This deeply saddens me."

"I have fought to defend the integrity of patient care throughout the state by holding the negligent accountable," she wrote. "However, I have grown increasingly frustrated by the board's lack of ability to achieve its stated objectives in a timely and efficient manner."

Besides Phillips, the other fired board members were vice president Elizabeth O. Dietz, a former professor of nursing at San Jose State, and Janice Glaab, a public affairs consultant.

Schwarzenegger's action Monday fills two of three vacancies on the board [2] and replaces four of the board's sitting members – all of whom had been appointed by him.

The two remaining members are Nancy L. Beecham, appointed by the governor in 2006, and Dian Harrison, who was appointed last year by Assembly speaker Karen Bass.

Neither Beecham nor Harrison could be reached late Monday, nor could any of the departing board members.

Schwarzenegger's statement said his "administration is dedicated to protecting public health and safety, and the new board will act quickly and decisively to achieve that goal."

Fred Aguiar, secretary of the State and Consumer Services Agency, said in an interview that the new board would be asked immediately to come up with a plan to eliminate the case backlog. "This plan needs to include how many more investigators are needed, how much that will cost. … I want to know now."

California Board of Registered Nursing executive officer

Ruth Ann Terry (Liz O. Baylen/Los Angeles Times)

The governor's decision does not directly affect the standing of Ruth Ann Terry, who has been the board's executive officer for nearly 16 years and a staff member for 25. Only the board has the power to hire and fire the executive.
Terry, reached late Monday, hung up on a reporter, saying, "We don't have anything to say."

But Aguiar suggested Monday that Terry and other staffers could be vulnerable. The governor "supports the new board in its commitment to protecting patients – and if that means cleaning house, including board staff, so be it," he said. "The days of excuses and status quo are over. It's broken and we're going to fix it."

The Times and ProPublica

In an interview last week, Terry acknowledged that the system needed to be "streamlined" but blamed other parts of the state's bureaucracy for delays.

Early Monday, Terry and her assistant executive officer, Heidi Goodman,

"Ruth and I are aware of the grim picture painted by this article," they wrote, "however, the board members, managers and supervisors know that you work very hard to carry out the mission of the board to protect the healthcare consumers in California and we appreciate all that you do."

Presented with the investigation's findings Thursday, board President Phillips, a family nurse practitioner and associate clinical professor at UC Irvine, said she supported Terry "absolutely – without question."

"The issue of patient safety is of the utmost importance to this board," she said. "It's not that we are ignoring a situation where there are delays. We absolutely are not."

Questions about the board's leadership were first raised last fall

In addition to the governor's action, the state Senate Business and Professions Committee, which has jurisdiction over the board, plans to hold a hearing next month to address the issues raised in The Times' article.

The committee will look at introducing legislation that would appoint an "enforcement monitor" to evaluate the board's discipline process and make recommendations, said Bill Gage, the committee's chief consultant. Such a monitor was appointed at one time to work with the Medical Board of California, which regulates the state's doctors.

Consumer advocate Ken McEldowney said the board members need to do more than just fill seats.

"The leadership is key," said McEldowney, executive director of Consumer Action, a San Francisco-based national consumer advocacy and education membership organization.

"It just appears to me that they don't care."

The six new board members are: Ann Boynton, 47, of Sacramento, a former undersecretary for the Health and Human Services Agency; Judy Corless, 58, of Corona, a clinical nursing director at the Corona Outpatient Surgical
Center since April 2009; Jeannine Graves, 49, of Sacramento, a staff nurse for the Capitol Surgical Associates and the Mercy San Juan Medical Center; Richard Rice, 60, of Imperial Beach, a former chairman of the Unemployment Insurance Appeals Board; Catherine Todero, 57, of La Mesa, director of the school of nursing at San Diego State University and a professor there; and Kathrine Ware, 50, of Davis, a nurse practitioner for the Vascular Center Clinic at the University of California Davis.

These positions do not require Senate confirmation, and the compensation is $100 per working day.

[8] when The Times and ProPublica reported that nurses with serious or multiple criminal convictions kept their licenses for years before the board acted against them. As a result, the board now requires every nurse to submit fingerprints [9], which can be matched against arrest records. Renewing nurses must also disclose any convictions or discipline by other states.sent an e-mail to all board staff members encouraging them not to lose heart [7].found that the board relied heavily on Terry and her staff [4]. At five public meetings attended by reporters since November 2007, Terry never focused on the delays in disciplining errant nurses. Neither did board members, even though they must vet all disciplinary actions.

Saturday, July 4, 2009

Consumer Reports Profiles Survivor Alicia Cole

Reform should make it easy to get information on quality
August 2009

'I lay in my hospital bed watching my stomach turn black and purple and rot. It looked as if I had been snapped in half by a shark.'— Alicia Cole, 46, of Sherman Oaks, Calif.Photo by Melanie Eve Barocas

This article is the archived version of a report that appeared in the August 2009 Consumer Reports magazine.

When Alicia Cole learned she needed surgery for benign fibroids, she did her homework on the surgeon and the hospital. "I looked at HealthGrades, Leapfrog, Hospital Compare, and other Web sites," says Cole, a 46-year-old actress from Sherman Oaks, Calif. "But one thing I didn't check was the hospital's infection rate."

Even if she had tried to check, California hospitals didn't have to make such data public, and hers didn't. Cole had the operation there anyway. During her hospital stay, she came down with a post-surgical flesh-eating infection that turned her entire midsection into something worthy of a horror movie. After two months in the hospital and two years of painful rehabilitation, she still can't work. "The skin and scar tissue is so delicate that the least pressure will tear or scratch it," she says. Federal inspectors subsequently found unsterile conditions in the hospital's operating area.

Enraged by her experience, Cole joined the fight against hospital infections and helped persuade the California legislature to pass a law requiring public reporting; she now sits on the advisory board for the law. Did she ever learn the hospital's infection rate? Sadly, no. The law has not yet been implemented. "What we really need is a national law," Cole says, noting that hospital-acquired infections are a leading cause of death in this country. "It's the elephant in the room," she says.

CU recommends

Health reform should make it simple to get good information on health-care quality. You should be able to find data not only on infection rates, a reform we've backed for years, but also on doctors, drugs, treatments, and errors. Yet most states still allow doctors to shield a history of malpractice settlements. And infection rates, if reported at all, are often kept secret, which doesn't provide enough incentive for improvement.

What does work is disclosure. Pennsylvania, which passed the first statewide reporting law, remains the only state to require disclosure of all major types of hospital infections. And infections there have dropped 8 percent in the last two years.

Read about our latest reform efforts and our analysis of legislation as its being debated in Washington, D.C. in our Guide to Health-Care Reform.

Surgery Tech Suspected of Exposing 5,700 to Hepatitis C

Colorado Springs surgery tech suspected of exposing 5,700 to hepatitis C
July 2, 2009 - 6:28 PM

Federal officials Thursday warned that about 5,700 surgery patients, including 1,000 at a Colorado Springs surgery center, are at risk of having been infected by an operating room technician with hepatitis C.
On Thursday, federal authorities filed criminal charges in U.S. District Court in Denver against Kristen Diane Parker, a former scrub technician at Rose Medical Center in Denver and Audubon Ambulatory Surgery Center in Colorado Springs.
According to the criminal complaint, Parker - a former heroin addict - admitted swapping her own dirty syringes filled with saline solution for syringes filled with Fentanyl, a narcotic 80 to 100 times stronger than morphine.
The drug is supposed to be used to help major post-surgery patients manage pain. Instead, they got no relief while Parker injected herself with the painkiller at home and in the hospital bathrooms before and after a surgery, according to the seven-page complaint.

"I know I (expletive deleted) up," Parker told Denver Police Detective Dale Wallis after he confronted her during a videotaped interview on June 30. "I can't take back what I did, but I will have to live with it for the rest of my life, and so does everybody else."

She told Wallis she expects to spend the rest of her life in prison. She told the detective that she had used heroin from July 2008 to September 2008 while living in New Jersey. She said she had used dirty needles and "was 99.9 percent sure" that is how she was exposed to hepatitis C.

A MySpace page for a woman with the name Kristen Parker describes her as a 26-year-old Colorado Springs resident with interests in heavy metal rock, tattoos and needles.

"I have a crazy fascination with needles.. I just like the way they feel!" the Web page states.

According to an affidavit by Mary F. LaFrance, an investigator for the U.S. Food and Drug Administration, at least nine surgery patients at Rose have tested positive for the incurable disease.
As a result, authorities are advising 4,700 Rose patients and 1,000 Audubon patients that they may have been exposed and need to be tested.

Parker worked at Rose from October 21, 2008 until April 2009. She resigned on April 20 from Rose, but the hospital refused to accept her resignation and instead fired her.

She went to work for Audubon shortly after being fired from Rose. She worked there from May 4 until Monday, said Dr. J. Michael Hall, Audubon's medical director.

Hall said certified letters are being sent to all patients who had outpatient surgery at the center's Circle Drive and Union Boulevard location May 4-July 1 advising them they may have been exposed and with instructions on what to do. Patients at Audubon's two other locations, one near St. Francis Medical Center and a pain management center, are unaffected.

In the criminal complaint she is charged with tampering with a consumer product, creating a counterfeit controlled substance and obtaining a controlled substance "by deceit and subterfuge."

If convicted, she faces up to 10 years in prison and a maximum $250,000 on the most serious charge of tampering. She also faces state charges.
Parker is not a nurse and holds no medical degree although she is trained as a surgical technician. Her job involved preparing operating rooms prior to surgery.

Prior to being hired at Rose, she submitted to a pre-employment blood test which tested positive for hepatitis C. She was allowed to start work but hospital officials counseled her about the disease and exposure possibilities.

Rose placed her on administrative leave following an incident in which a co-worker was pricked by a needle in Parker's pocket on March 23, 2009.

According to the affidavit, Parker quickly disposed of the needle and denied any use of narcotics. She was allowed to return to work after a drug screening test came back negative.

The hospital placed her on administrative leave again after a co-worker reported seeing Parker in an operating room to which she was not assigned. She was tested again for drugs and this time the results were positive for Fentalyn.

The hospital had a press conference Thursday and released a prepared statement that apologized to patients who have been affected.

"It is impossible to adequately express how deeply sorry and angry we are that the unconscionable acts of this terminated employee may have put some of our patients at risk," the statement reads.

The hospital will offer free testing to surgery patients of the hospital or the outpatient surgery center. Also, hospital officials have created a phone line for affected patients and their families who have questions.

After an investigation by the Colorado Department of Health, Parker was ordered by the state to "immediately cease and desist any employment that requires contact with patients and/or pharmaceuticals."

Hall said his center learned of the situation Thursday from the Colorado Department of Public Health and Environment. State and local health authorities, as well as Atlanta physicians with the federal Centers for Disease Control and Prevention, are assisting in tracking the exposures.
Hepatitis C facts

According to the Centers for Disease Control Web site, about 15 to 25 percent of people infected with hepatitis C clear the virus and do not develop chronic infection for reasons that are not well known.

Those who do develop acute hepatitis C develop symptoms such as fever, fatigue, dark urine, abdominal pain, loss of appetite, clay colored stool, nausea, vomiting, joint pain and jaundice.

For every 100 people who contract the disease, 75 to 85 will develop a chronic infection. About 60 to 70 will develop chronic liver disease. About 5 to 20 will develop cirrhosis over a period of 20 to 30 years. Between 1 and 5 will die of liver cancer or cirrhosis.

Chronic hepatitis C infections account for about 8,000 to 10,000 deaths each year in the United States.

No vaccine for hepatitis C is available.

Wednesday, June 24, 2009

Health Insurance Insider: 'They Dump the Sick'

Retired Health Insurance Executive Blows the Whistle on His Former Industry
By ALICE GOMSTYN ABC News Business Unit June 24, 2009

Frustrated Americans have long complained that their insurance companies valued the all-mighty buck over their health care. Today, a retired insurance executive confirmed their suspicions, arguing that the industry that once employed him regularly rips off its policyholders.

Retired health insurance executive Wendell Potter told Congress today that insurance companies routinely rip off customers.

"[T]hey confuse their customers and dump the sick, all so they can satisfy their Wall Street investors," former Cigna senior executive Wendell Potter said during a hearing on health insurance today before the Senate Committee on Commerce, Science, and Transportation.
Potter, who has more than 20 years of experience working in public relations for insurance companies Cigna and Humana, said companies routinely drop seriously ill policyholders so they can meet "Wall Street's relentless profit expectations."
"They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment," Potter said. "…(D)umping a small number of enrollees can have a big effect on the bottom line."
Small businesses, in particular, he said, have had trouble maintaining their employee health insurance coverage, he said.

"All it takes is one illness or accident among employees at a small business to prompt an insurance company to hike the next year's premiums so high that the employer has to cut benefits, shop for another carrier, or stop offering coverage altogether," he said.

Potter also faulted insurance companies for being misleading both in advertising their policies to new customers and in communicating with existing policyholders.

More and more people, he said, are falling victim to "deceptive marketing practices" that encourage them to buy "what essentially is fake insurance," policies with high costs but surprisingly limited benefits.

Insurance companies continue to mislead consumers through "explanation of benefits" documents that note what payments the insurance company made and what's left for consumers to pay out of pocket, Potter said.

The documents, he said, are "notoriously incomprehensible."

"Insurers know that policyholders are so baffled by those notices they usually just ignore them or throw them away. And that's exactly the point," he said. "If they were more understandable, more consumers might realize that they are being ripped off."

For the rest of the story go to:

Thursday, April 9, 2009

Keeps Coming Back to Hygiene and Cleanliness!

Study finds hospital mobile phones transmit message of MRSA
Stressed Out Nurses Weekly, March 16, 2009

A study recently published in the Annals of Clinical Microbiology and Antimicrobials suggests hospital phones could be spreading more than information.

Medical researchers from the Ondokuz Mayis University, located in Samsun, Turkey, tested samples from the hands of 200 ICU and OR healthcare workers from various hospitals, and performed cultures on 200 mobile phones, and found 95% of the phones were contaminated with bacteria including MRSA. Other microorganisms that surfaced have been linked to hospital-acquired infections. The study, which states the bacteria from both examinations was similar, suggests the hospital phones may allow for increased patient-to-patient transmission of bacteria in hospital settings.

In addition, researchers found only 10% of healthcare workers routinely cleaned hospital phones.

Study authors stress the need for healthcare workers to be trained on firm infection control practices, hand hygiene, and environmental disinfection.

They recommend preventative measures, such as regular decontamination of hospital phones with "alcohol containing disinfectant materials" and the use of "antimicrobial additive materials" to cut cross-infection.

Source: Annals of Clinical Microbiology and Antimicrobials

Hazards: Ambulance Stethoscopes May Pose Risk

The New York Times

Stethoscopes carried by ambulance crews are not always cleaned as often as they should be, and as a result they may be exposing some patients to drug-resistant bacteria, a new study reports.
Researchers who looked at stethoscopes used by emergency medical services workers in New Jersey found that a significant number carried methicillin-resistant Staphylococcus aureus, bacteria known as MRSA that are resistant to standard drugs.

Some of the ambulance workers could not recall the last time the instruments had been cleaned, said the researchers, whose report appears in the current issue of Prehospital Emergency Care.

The study’s lead author, Dr. Mark A. Merlin of Robert Wood Johnson Medical School, said it was unclear how big a threat MRSA on a stethoscope posed to a patient. But as incidents of infection by the bacteria become more common, and with the possibility that it will become more resistant to antibiotics, it is important to reduce its spread, he said.

Researchers asked ambulance crews arriving at an emergency department over a 24-hour period to let their stethoscopes be tested. They also asked when the instruments had last been cleaned.

Of 50 stethoscopes tested, 16 had the bacteria, which a simple alcohol swab is usually enough to kill, the researchers said. “The concept of cleaning an entire ambulance after every patient is not practical,” they wrote. “Cleaning a stethoscope, however, is not labor-intensive, does not require much time, and does not require any special equipment beyond currently stocked items.”

Sunday, March 22, 2009

Children's Staph Infections Increasingly Resistant to Drugs

New York Times
Published: January 20, 2009

Children are picking up more stubborn staph infections that don’t respond to common antibiotics, and the proportion of ear, nose and throat infections resistant to standard drug treatment increased dramatically over a six-year period, a new study has found.

Methicillin-resistant Staphylococcus aureus infections, known as MRSA, accounted for 28.1 percent of children’s head and neck staph infections in 2006, up from just 11.8 percent in 2001, according to researchers at Emory University in Atlanta. It once was rare for an ear, nose and throat doctor to see MRSA infections, noted Dr. Steven E. Sobol, the paper’s senior author and director of pediatric otolaryngology at Emory University School of Medicine.. “That was the impetus for the study,” he said.

The report was published in this week’s issue of Archives of Otolaryngology - Head and Neck Surgery.

“Over the past four or five years, we’ve seen an increased prevalence of these infections that used to be caused by other organisms that are now being caused by MRSA,” said Dr. Sobol. The researchers excluded from their analysis skin infections not caused by staph.

Though the study captured information from only a limited number of laboratories, the report’s authors said the overall trend is clear, concluding that there is “an alarming nationwide increase” in the prevalence of MRSA infections in children. The change parallels an increase in so-called community-acquired cases of MRSA among relatively healthy people who aren’t hospitalized or infirm.

The scientists analyzed 21,009 head and neck staph infections occurring among children from January 2001 to December 2006. The data came from a national electronic microbiology database that collects strain-specific drug resistance test results from labs affiliated with 300 hospitals around the country. The average age of the patients was 6.7 years old.

The proportion of drug resistant head and neck staph infections increased dramatically over the six-year period, the researchers found. Overall, 21.6 percent, or 4,534 samples, were methicillin-resistant, the greatest proportion of them involving the ear, nose and sinus and pharynx.

Only 11.8 percent of childhood head infections were resistant in 2001, but the figure jumped to 12.5 percent in 2002, 18.1 percent in 2003, and 27.2 percent in 2004.

The rate fell to 25.5 percent in 2005 and rose again to 28.1 percent in 2006, the researchers reported.

Almost 60 percent of the head and neck infections occurred among children who had not been in medical settings beforehand and were seeing doctors as outpatients, the researchers said, suggesting that children were exposed to resistant bacteria in the community.

Op-Ed Columnist

Monday, January 12, 2009

World MRSA Day

Dedicated to Providing Awareness, Education and Support
For Immediate Release:January 12, 2009

"Activism Marks First World MRSA Day"
Chicago-based MRSA Survivors Network announces the first "World MRSA Day" to be held October 2, 2009 and commemorated each year after on this date. October will also be designated "MRSA Awareness Month" and will call attention to the worldwide epidemic. MRSA was first discovered by Patricia Jevons, a microbiologist in the UK on Oct. 2, 1960 and nearly fifty years later, MRSA has spread worldwide.

Leading consumer patient advocates in their countries are lending their voice to the call of world unity in leadership and commitment in preventing and stopping MRSA, which is pandemic and rising at alarming rates in healthcare facilities and in the community. They call upon healthcare officials and leaders to step up and take a more aggressive and comprehensive approach to eradicate this preventable disease and focus on a broad and pro-active prevention program.

The hope of "World MRSA Day" is to bring people together every year to remind them of those who have lost their lives or have diminished health because of a preventable disease. By working together, whether as an advocate, scientist, healthcare worker, policy maker, student, caregiver or a patient living with MRSA we can collectively heighten the awareness and educate others on prevention.

To help provide education and awareness, a variety of events, exhibits, materials, candlelight vigils and commemoration programs are being planned and will be announced later.

For more information contact: MRSA Survivors Network
Jeanine Thomas – National Spokesperson for MRSA - USA
630 654-4588