tag:blogger.com,1999:blog-77145416182748379702024-03-13T08:10:34.722-07:00Daily Chart NotesALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.comBlogger58125tag:blogger.com,1999:blog-7714541618274837970.post-61568741401420074872010-11-29T20:38:00.000-08:002010-11-29T20:47:48.415-08:00Study Finds No Progress in Safety at Hospitals<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_AzxR2QUWcrc/TPSBqWznqNI/AAAAAAAAAGU/ULCLWoe6AZI/s1600/patient%2Bsafety%2Bgraphic.gif"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 336px; height: 400px;" src="http://3.bp.blogspot.com/_AzxR2QUWcrc/TPSBqWznqNI/AAAAAAAAAGU/ULCLWoe6AZI/s400/patient%2Bsafety%2Bgraphic.gif" alt="" id="BLOGGER_PHOTO_ID_5545199605876500690" border="0" /></a><span style="font-size:78%;">By <a href="http://topics.nytimes.com/top/reference/timestopics/people/g/denise_grady/index.html?inline=nyt-per" title="More Articles by Denise Grady" class="meta-per">DENISE GRADY</a></span> <div id="articleBody"> <p> Efforts to make <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/hospitals/index.html?inline=nyt-classifier" title="Recent and archival health news about hospitals." class="meta-classifier">hospitals</a> safer for patients are falling short, researchers report in the first large study in a decade to analyze harm from medical care and to track it over time. </p> <p> The study, conducted from 2002 to 2007 in 10 North Carolina hospitals, found that harm to patients was common and that the number of incidents did not decrease over time. The most common problems were complications from procedures or drugs and hospital-acquired infections. </p> <p> “It is unlikely that other regions of the country have fared better,” said Dr. <a href="http://sleep.med.harvard.edu/people/faculty/226/Christopher+Paul+Landrigan+MD+MPH" title="Information about Dr. Landrigan.">Christopher P. Landrigan</a>, the lead author of the study and an assistant professor at Harvard Medical School. The study is being published on Thursday in The <a href="http://topics.nytimes.com/top/reference/timestopics/organizations/n/new_england_journal_of_medicine/index.html?inline=nyt-org" title="More articles about New England Journal of Medicine" class="meta-org">New England Journal of Medicine</a>. </p> <p> It is one of the most rigorous efforts to collect data about patient safety since a <a href="http://www.nap.edu/openbook.php?record_id=9728" title="The report.">landmark report in 1999</a> found that medical mistakes caused as many as 98,000 deaths and more than one million injuries a year in the United States. That report, by the <a href="http://www.iom.edu/">Institute of Medicine</a>, an independent group that advises the government on health matters, led to a national movement to reduce errors and make hospital stays less hazardous to patients’ health. </p> <p> Among the preventable problems that Dr. Landrigan’s team identified were severe bleeding during an operation, serious breathing trouble caused by a procedure that was performed incorrectly, a fall that dislocated a patient’s hip and damaged a nerve, and vaginal cuts caused by a vacuum device used to help deliver a baby. </p> <p> Dr. Landrigan’s team focused on North Carolina because its hospitals, compared with those in most states, have been more involved in programs to improve patient safety. </p> <p> But instead of improvements, the researchers found a high rate of problems. About 18 percent of patients were harmed by medical care, some more than once, and 63.1 percent of the injuries were judged to be preventable. Most of the problems were temporary and treatable, but some were serious, and a few — 2.4 percent — caused or contributed to a patient’s death, the study found. </p> <p> The findings were a disappointment but not a surprise, Dr. Landrigan said. Many of the problems were caused by the hospitals’ failure to use measures that had been proved to avert mistakes and to prevent infections from devices like urinary catheters, ventilators and lines inserted into veins and arteries. </p> <p> “Until there is a more coordinated effort to implement those strategies proven beneficial, I think that progress in patient safety will be very slow,” he said. </p> <p> An expert on hospital safety who was not associated with the study said the findings were a warning for the patient-safety movement. “We need to do more, and to do it more quickly,” said the expert, <a href="http://hospitalmedicine.ucsf.edu/facstaff/robertwachter.html" title="Dr. Wachter’s profile at the university site.">Dr. Robert M. Wachter</a>, the chief of hospital medicine at the <a href="http://topics.nytimes.com/topics/reference/timestopics/organizations/u/university_of_california/index.html?inline=nyt-org" title="More articles about the University of California." class="meta-org">University of California, San Francisco</a>. </p> <p> A <a href="http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf" title="The report (PDF).">recent government report</a> found similar results, saying that in October 2008, 13.5 percent of <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier" title="Recent and archival health news about Medicare." class="meta-classifier">Medicare</a> beneficiaries — 134,000 patients — experienced “adverse events” during hospital stays. The report said the extra treatment required as a result of the injuries could cost Medicare several billion dollars a year. And in 1.5 percent of the patients — 15,000 in the month studied — medical mistakes contributed to their deaths. That report, issued this month by the inspector general of the <a href="http://topics.nytimes.com/top/reference/timestopics/organizations/h/health_and_human_services_department/index.html?inline=nyt-org" title="More articles about Health and Human Services Department, U.S." class="meta-org">Department of Health and Human Services</a>, was based on a sample of Medicare records from patients discharged from hospitals. </p> <p> Dr. Landrigan’s study reviewed the records of 2,341 patients admitted to 10 hospitals — in both urban and rural areas and involving large and small medical centers. (The hospitals were not named.) The researchers used a “trigger tool,” a list of 54 red flags that indicated something could have gone wrong. They included drugs used only to reverse an overdose, the presence of bedsores or the patient’s readmission to the hospital within 30 days. </p> <p> The researchers found 588 instances in which a patient was harmed by medical care, or 25.1 injuries per 100 admissions. </p> <p> Not all the problems were serious. Most were temporary and treatable, like a bout with severe <a href="http://health.nytimes.com/health/guides/disease/hypoglycemia/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Hypoglycemia." class="meta-classifier">low blood sugar</a> from receiving too much insulin or a urinary infection caused by a catheter. But 42.7 percent of them required extra time in the hospital for treatment of problems like an infected surgical incision. </p> <p> In 2.9 percent of the cases, patients suffered a permanent injury — brain damage from a stroke that could have been prevented after an operation, for example. A little more than 8 percent of the problems were life-threatening, like severe bleeding during surgery. And 2.4 percent of them caused or contributed to a patient’s death — like bleeding and organ failure after surgery. </p> <p> Medication errors caused problems in 162 cases. Computerized systems for ordering drugs can cut such mistakes by up to 80 percent, Dr. Landrigan said. But only 17 percent of hospitals have such systems. </p> <p> For the most part, the reporting of medical errors or harm to patients is voluntary, and that “vastly underestimates the frequency of errors and injuries that occur,” Dr. Landrigan said. </p> <p> “We need a monitoring system that is mandatory,” he said. “There has to be some mechanism for federal-level reporting, where hospitals across the country are held to it.” </p> <p> Dr. Mark R. Chassin, president of the Joint Commission, which accredits hospitals, cautioned that the study was limited by its list of “triggers.” If a hospital had performed a completely unnecessary operation, but had done it well, the study would not have uncovered it, he said. Similarly, he said, the study would not have found areas where many hospitals have made progress, such as in making sure that patients who had heart attacks or <a href="http://health.nytimes.com/health/guides/disease/heart-failure/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Heart failure." class="meta-classifier">heart failure</a> were sent home with the right medicines. </p> <p> The bottom line, he said, “is that preventable complications are way too frequent in American health care, and “it’s not a problem we’re going to get rid of in six months or a year.” </p> <p> Dr. Wachter said the study made clear the difficulty in improving patients’ safety. </p> <p> “Process changes, like a new computer system or the use of a checklist, may help a bit,” he said, “but if they are not embedded in a system in which the providers are engaged in safety efforts, educated about how to identify safety hazards and fix them, and have a culture of strong communication and teamwork, progress may be painfully slow.” </p> <p> Leah Binder, the chief executive officer of the Leapfrog Group, a patient safety organization whose members include large employers trying to improve health care, said it was essential that hospitals be more open about reporting problems. </p> <p> “What we know works in a general sense is a competitive open market where consumers can compare providers and services,” she said. “Right now you ought to be able to know the infection rate of every hospital in your community.” </p> <p> For hospitals with poor scores, there should be consequences, Ms. Binder said: “And the consequences need to be the feet of the American public.” </p> <div class="articleCorrection"> </div> </div>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com1tag:blogger.com,1999:blog-7714541618274837970.post-61912955212197876042010-11-24T23:24:00.000-08:002010-11-24T23:31:39.705-08:00State Officials Fine 12 Hospitals for Major Patient Safety Issues<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_AzxR2QUWcrc/TO4QqI8qVKI/AAAAAAAAAGM/T-vc4lcc0IE/s1600/DoctorsinOperatingRoom.ashx.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 253px; height: 181px;" src="http://3.bp.blogspot.com/_AzxR2QUWcrc/TO4QqI8qVKI/AAAAAAAAAGM/T-vc4lcc0IE/s200/DoctorsinOperatingRoom.ashx.jpg" alt="" id="BLOGGER_PHOTO_ID_5543386507482125474" border="0" /></a>On Friday, the California Department of Public Health <a href="http://www.cdph.ca.gov/Pages/NR10-87-.aspx" target="_blank">announced fines</a> levied on 12 hospitals for serious medical errors that sometimes led to patient injuries or death, the <a href="http://articles.latimes.com/2010/nov/13/local/la-me-1113-hospital-fines-20101113" target="_blank"><i>Los Angeles Times</i></a> reports (Hennessy-Fiske, <i>Los Angeles Times</i>, 11/13). <div><div style="overflow: hidden; color: rgb(0, 0, 0); background-color: transparent; text-align: left; text-decoration: none; border: medium none;"> <p>The department issued 14 penalties totaling $575,000 (Clark, <a href="http://www.healthleadersmedia.com/content/LED-259024/12-Hospitals-Fined-for-Immediate-Jeopardy-Violations-in-CA" target="_blank"><i>HealthLeaders Media</i></a>, 11/15).</p> <p class="subheading">Background</p> <p>Under a 2006 state law, hospitals must notify state regulators of all significant patient injuries.</p> <p>For incidents occurring prior to 2009, the state issued $25,000 fines for each violation. Starting in January 2009, the sanctions increased to $50,000 for a hospital's first violation, $75,000 for its second and $100,000 for its third and subsequent violations (<i><a href="http://www.californiahealthline.org/articles/2010/5/21/state-regulators-issue-fines-to-9-hospitals-for-patient-safety-lapses.aspx" target="_blank">California Healthline</a></i>, 5/21).</p> <p>Since the law took effect, state regulators have issued 170 fines totaling $4.8 million against 112 hospitals. Hospitals are appealing 39 of those fines.</p> <p class="subheading">Latest Penalties</p> <p>The 12 hospitals targeted in the latest round of penalties are: </p> <ul><li>California Pacific Medical Center in San Francisco, which received one $50,000 fine and one $75,000 fine;</li><li>Citrus Valley Medical Center in Covina, which received one $25,000 fine;</li><li>Hanford Community Medical Center, which received one $25,000 fine;</li><li>Kindred Hospital in Westminster, which received one $25,000 fine;</li><li>Palomar Medical Center in Escondido, which received one $50,000 fine;</li><li>Petaluma Valley Hospital, which received one $50,000 fine;</li><li>Placentia Linda Hospital, which received one $25,000 fine;</li><li>Scripps Memorial Hospital in La Jolla, which received one $50,000 fine;</li><li>Southwest Healthcare System in Riverside County, which received one $25,000 fine;</li><li>UC-San Francisco Medical Center, which received two $25,000 fines;</li><li>USC University Hospital in Los Angeles, which received one $50,000 fine; and </li><li>Western Medical Center in Santa Ana, which received one $75,000 fine (<i>HealthLeaders Media</i>, 11/15).</li></ul> <p>DPH requires all penalized facilities to submit plans to correct the patient safety issues. Hospitals also can appeal the fines (<i>Los Angeles Times</i>, 11/13).</p> <p>Funds collected from the penalties are set aside for projects to improve patient safety (<i>HealthLeaders Media</i>, 11/15).</p><span style="font-size:78%;"><span>Read more: <a style="color: rgb(0, 51, 153);" href="http://www.californiahealthline.org/articles/2010/11/15/state-officials-fine-12-hospitals-for-major-patient-safety-issues.aspx?topic=hospitals#ixzz16HDqK4ja">http://www.californiahealthline.org/articles/2010/11/15/state-officials-fine-12-hospitals-for-major-patient-safety-issues.aspx?topic=hospitals#ixzz16HDqK4ja</a></span></span></div></div>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-75559153264112704662010-11-24T23:05:00.000-08:002010-11-24T23:23:33.901-08:00State Health Regulators Urge Some Hospitals To Recheck Error Reporting<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_AzxR2QUWcrc/TO4OfFKz92I/AAAAAAAAAGE/ZVguEq-XDGw/s1600/second%2Blook.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 156px; height: 200px;" src="http://4.bp.blogspot.com/_AzxR2QUWcrc/TO4OfFKz92I/AAAAAAAAAGE/ZVguEq-XDGw/s200/second%2Blook.jpg" alt="" id="BLOGGER_PHOTO_ID_5543384118465918818" border="0" /></a><br />California health officials are urging 87 hospitals that have not reported a serious medical error in more than three years to recheck their records, the <a href="http://www.vcstar.com/news/2010/nov/17/state-inspectors-ask-some-hospitals-to-be-sure/" target="_blank"><i>Ventura County Star</i></a> reports. <div><div style="overflow: hidden; color: rgb(0, 0, 0); background-color: transparent; text-align: left; text-decoration: none; border: medium none;"><div style="text-align: left;"><br />A state law that took effect in 2007 requires hospitals to report any of 28 designated adverse medical events.</div> <p>In October, state Department of Public Health officials sent notifications to the nonreporting hospitals in an attempt to ensure that administrators understand what qualifies as adverse event and their responsibility to report such errors.</p><p>The state told nonreporting hospitals that they have until the end of November to submit amended claims and report errors. Hospitals that report errors could receive a $100 per day fine dating back to when the adverse event occurred.</p> <p>The nonreporting hospitals also could sign an attestation indicating that none of the designated medical errors have occurred. </p> <p class="subheading">Health Care Stakeholders Respond</p> <p>Jim Lott, executive vice president of the Hospital Association of Southern California, expressed concern about the state's request for signed attestation. He said the state should "educate the hospital as opposed to setting them up for follow-up legal action." Lott added that some hospitals might not understand the reporting requirement.</p> <p>Meanwhile, Anthony Wright of Health Access California praised the state's efforts to take a closer look at hospitals that have not reported any medical errors. Wright suggested that hospitals that have not experienced any adverse events should share their safety strategies with other facilities (Kisken, <i>Ventura County Star</i>, 11/17).</p><span style="font-size:78%;">Read more: <a style="color: rgb(0, 51, 153);" href="http://www.californiahealthline.org/articles/2010/11/18/state-health-regulators-urge-some-hospitals-to-recheck-error-reporting.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+CaliforniaHealthline+%28CHL%29#ixzz16H8NkxXQ">http://www.californiahealthline.org/articles/2010/11/18/state-health-regulators-urge-some-hospitals-to-recheck-error-reporting.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+CaliforniaHealthline+%28CHL%29#ixzz16H8NkxXQ</a></span></div></div>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-29060957554038393542010-11-05T19:18:00.000-07:002010-11-05T19:30:37.150-07:00Lawsuit alleges substandard care led to deaths at Valley Medical Center<span style="font-size:78%;">By Lisa Fernandez lfernandez@mercurynews.com</span><span><span id="mn_Article"><span><span id="mn_Article"><span><span id="mn_Article"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_AzxR2QUWcrc/TNS8wIa-PFI/AAAAAAAAAF0/YUAQwAXHDSs/s1600/silent+doc.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 193px; height: 158px;" src="http://1.bp.blogspot.com/_AzxR2QUWcrc/TNS8wIa-PFI/AAAAAAAAAF0/YUAQwAXHDSs/s320/silent+doc.jpg" alt="" id="BLOGGER_PHOTO_ID_5536257377025539154" border="0" /></a></span></span></span></span></span></span><br /><br />Two doctors and a medical assistant have filed a workplace discrimination lawsuit against Santa Clara Valley Medical Center, claiming that more than one patient has died there as a result of "substandard care" and that they were ignored or embarrassed, and in one case, terminated, for speaking out.<span id="mn_Article"><div id="articleBody" class="articleBody"><p>Santa Clara County Executive Jeff Smith said several outside and internal inspectors found "absolutely no evidence'' that the patients in question died because of negligence. </p><p>But Smith acknowledged that the hospital's cardiology department is "dysfunctional" because of the many "personality conflicts" and "plethora of he-said, she-said arguments."</p><p>Filed Friday in U.S. District Court in San Jose, the federal lawsuit offers a rare glimpse into the mostly private goings-on in the county-run hospital hallways. Seventy-four pages of allegations paint a one-sided picture of death, backbiting and sexism.</p><p>The suit was brought by Thressa Walker, a medical administrative assistant in the cardiology department; Dr. Geeta Singh, a cardiologist; and Dr. Kai Ihnken, chief of cardiothoracic surgery.</p><p>"This was a last resort,'' said Charles Bonner, a Sausalito attorney who filed the suit with his partner and son, A. Cabral Bonner. "But the plaintiffs felt this was a moral imperative that they come forward. We have to tell the community what is going on here, that people are dying, and the administration will not change."</p><p>Named as defendant<span id="mn_Global"><span id="mn_Article">s are Santa Clara County, Valley Medical Center; Dr. Hollister Brewster, chief of cardiology; Dr. Alfonso Banuelos, chief medical officer; Dr. Dolly Goel, medical director; and Dr. Peter Gregor, a cardiologist. Among other things, the suit alleges retaliation, discrimination, a hostile work environment, invasion of privacy, slander and intentional infliction of emotional distress.<p>One of the most serious allegations stems from the death of an unnamed patient in February 2009. Singh said she advised the patient not to get a stress test on his heart because of his fragile health and history of family heart attacks. Singh said she recommended a "cardiac catheterization" instead.</p><p>But other cardiologists ignored the patient's wishes and Singh's advice, the lawsuit alleges, and gave the patient a stress test anyway. The patient suffered cardiac arrest and died. </p><p>Both Walker and Singh allege that they were retaliated against by being ignored, verbally abused and embarrassed in e-mails, among other things, as a result of filing complaints with the Joint Commission of Accreditation Health Organizational regarding what they felt was "substandard" patient care.</p><p>This allegation does not surprise Smith, who was well aware of this complaint, and many others that the three plaintiffs have filed with county, state and federal officials. He said the negligence allegations have been thoroughly investigated internally and by outside experts, and they found "absolutely no evidence of poor or detrimental care."</p><p>The third plaintiff, Ihnken, states that in April 2008 he had wanted to perform surgery on a heart patient sooner rather than later, but "administrators denied him that possibility," and the patient died, the suit alleges. Ihnken said after he spoke out about this, he was slandered in public and that his contract wasn't renewed because of it. His last day of work will be in June, his lawyer said.</p><p>Smith insisted that none of the "three individuals" have been retaliated against, although he acknowledged that from their point of view, they probably would have liked to see more done on their behalf. Smith said the decision not to retain Ihnken was a cost-cutting move since the number of cardiac surgeries has been declining.</p><p>The multicomplaint suit also alleges misanthropy and inappropriate sex jokes at the hospital. In one example, the suit accuses Brewster of making a rude comment to a patient regarding his genital infection and sex with a pig, and using an expletive at a staff meeting after seeing a movie on personality types.</p><p>Smith said it's "natural" for the head of a department to receive the lion's share of criticism, and he added none of these allegations are new to him. The trouble has been long documented.</p><p>"This lawsuit is the last forum available to them," Smith said. "I'm not surprised, I'm disappointed."</p><p class="tagline">Contact Lisa Fernandez at 408-920-5002.</p></span></span><span id="mn_Global"><span id="mn_Article"><p class="tagline"><br /></p></span></span></p></div></span>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com6tag:blogger.com,1999:blog-7714541618274837970.post-66281927451842428982010-11-04T20:11:00.000-07:002010-11-04T20:19:04.065-07:00Bandage changes color if wound becomes infected<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_AzxR2QUWcrc/TNN3LxZOjZI/AAAAAAAAAFs/ZuhpwJz5-Xk/s1600/color-changing-bandages.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 400px; height: 225px;" src="http://3.bp.blogspot.com/_AzxR2QUWcrc/TNN3LxZOjZI/AAAAAAAAAFs/ZuhpwJz5-Xk/s400/color-changing-bandages.jpg" alt="" id="BLOGGER_PHOTO_ID_5535899411089886610" border="0" /></a>This is one of those things that is so obvious that you want to smack your head against the wall for not thinking of it first. Researchers in Munich, Germany have invented an indicator dye that changes color when bruises become infected. <a name="more"></a> <p>The researchers at the Fraunhofer Research Institution for Modular Solid State Technologies EMFT say that the the dye works by measuring pH values. Regular human skin and healed wounds have a pH value around 5 — if the pH value goes up to 6.5 or 8.5, then the dye will change color from clear to purple. When it changes to purple is when you should start panicking because you'll likely have an infection. </p> <p>EMFT is currently working hard to find an industrial partner to mass produce its dye for commercial sale. Hopefully <a href="http://dvice.com/archives/2010/07/scientists-on-v.php">bandage</a> makers are seeing the full potential this dye has to offer.</p> <p>We can't tell you how many times this infection indicating dye would have come in handy when we were little tots. Think about how many fewer wrinkles we would have on our foreheads if we weren't stressing the fear of an infection. </p>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-23004140532631747062010-10-24T23:26:00.000-07:002010-10-24T23:33:24.058-07:00Solutions to hospital infections are sought<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_AzxR2QUWcrc/TMUjpYqqlLI/AAAAAAAAAFk/2ka7pjtd160/s1600/100icon+%282%29.gif"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 100px; height: 100px;" src="http://3.bp.blogspot.com/_AzxR2QUWcrc/TMUjpYqqlLI/AAAAAAAAAFk/2ka7pjtd160/s200/100icon+%282%29.gif" alt="" id="BLOGGER_PHOTO_ID_5531866911197533362" border="0" /></a><br />Howard Fischer Capitol Media Services Arizona Daily Star | Posted: Tuesday, October 19, 2010 12:00 am | Comments<br /><br />PHOENIX - A special panel studying how to cut down on hospital infections that kill 2,000 Arizonans a year is looking at solutions - <span style="font-weight: bold;">everything short of actually telling would-be patients which hospitals have the worst record.</span><br /><br />"It's more important to focus on prevention efforts in hospitals and other health-care organizations than it is to report rates," said Kris Korte, a member of the committee. She also is a nurse in charge of infection prevention at Banner Thunderbird Medical Center.<br /><br />Korte acknowledged there's a more basic reason why hospitals oppose any sort of public reporting. She said patients would not understand the data.<br /><br />"Infection rates are very difficult to explain to people that are not involved in creating those rates," she said.<br /><br /><span style="font-weight: bold;">State Health Director Will Humble, who said more Arizonans die from infections they get in hospitals than from motor-vehicle accidents, said he isn't going to push for a change in state law to make this kind of information available.</span> That means not only is the public denied access to the information, but it's not provided to his own agency, either.<br /><br />Humble said given the size and complexity of his agency, he has to "rely on stakeholder groups" to analyze problems and make recommendations to him.<br /><br />"I'm not in a position to second-guess the committee," he said.<br /><br />Humble said he understands the desire to have options on where to have a procedure performed to have access to that kind of information.<br /><br />"On an intuitive level, it does make some sense to report," he said. But Humble said he told committee members to find what works elsewhere to bring down infection rates.<br /><br />He said some of what the panel learned is that most of the effective infection-control practices are "really low-tech and simple." They're also inexpensive.<br /><br />"It's things like doing a better job of hand washing, both surgeons but also the nursing staff," Humble said.<br /><br />"It's paying attention to details when you're doing central lines" designed to provide medications directly into a patient's blood vessel, he continued. And it includes trying to prevent infection on cutting into the body, like swabbing anti-bacterial cream onto surgical patients.<br /><br />And public disclosure?<br /><br />"The data suggest that, in fact, it's not the most effective tool at driving down infection rates within hospital and health-care facilities," Humble said. "What I want to do is focus on those things that actually work."<br /><br />But the Committee to Reduce Infection Deaths, headed by former New York Lt. Gov. Betsy McCaughey, reports that Arizona appears to be in the minority in keeping this information from the public.<br /><br />It reports on its website that 27 states have laws requiring public reporting of what are formally known as "health-care-acquired infection rates." That allows, for example, New York residents to view a 135-page report that shows each hospital's rate of infection for various medical procedures.<br /><br />Two other states have confidential reporting to state health officials.<br /><br />Shoana Anderson, deputy chief of the health department's Bureau of Epidemiology and Disease Control, said raw data could be misleading.<br /><br />"Some hospitals that are large research-level hospitals tend to get patients that are more ill," she said, at least in part because they are better capable of taking care of those people. Anderson said there needs to be a baseline that takes factors like that into account "to make sure you're comparing apples to apples."<br /><br />Even without disclosure, Humble said there is financial pressure on hospitals to control infection rates because the federal government, which is increasing the paying for health care for the poor and the elderly, has "a big interest in driving down what the costs are."ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-26386514008949825882010-08-02T22:16:00.000-07:002010-08-02T22:24:49.513-07:00The M.D.: Silence on bad doctors<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_AzxR2QUWcrc/TFenx7GQvDI/AAAAAAAAAFU/uQo0R5bC_PA/s1600/la+times+2+docs.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 166px; height: 200px;" src="http://1.bp.blogspot.com/_AzxR2QUWcrc/TFenx7GQvDI/AAAAAAAAAFU/uQo0R5bC_PA/s200/la+times+2+docs.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5501049945975733298" /></a><br />Not all physicians are well-qualified to practice medicine. And doctors who keep mum about their colleagues' incompetence have their own issues.<br /><br />By Valerie Ulene, Special to the Los Angeles Times<br /><br />August 2, 2010<br /><br />Few doctors make it through their training without being involved in at least one case that goes awry. I was no exception.<br /><br />As an intern, I was assisting in a routine hernia operation when the attending surgeon cut the vas deferens, the tube that transports sperm from the testicle. I expected to be grilled by my colleagues afterward on the details, pressed to explain how this largely avoidable mistake possibly could have been made. That didn't happen.<br /><br />Everyone already suspected what had gone wrong and who was responsible — the attending surgeon was notorious for his careless surgical technique — and they were simply willing to let it pass.<br /><br />The surgeon's technical error was the first of two mistakes made in this case. The surgeon's colleagues committed the second error post-operatively: They chose to overlook a pattern of seemingly suboptimal care.<br /><br />As patients, we'd like to believe that every physician is well-qualified to practice medicine. It simply isn't so. Some doctors are impaired by substance abuse; others by medical conditions such as mental illness. And some simply lack the technical skills or knowledge to safely care for patients; they are, frankly, incompetent.<br /><br />No one knows precisely how many such doctors are actively caring for patients. But, according to a study published in July in the Journal of the American Medical Assn., the numbers are likely substantial. Researchers at Massachusetts General Hospital surveyed thousands of physicians in a variety of medical specialties; 17% said they'd had direct, personal knowledge of an impaired or incompetent colleague in their hospital, group or practice in the last three years.<br /><br />Weeding out physicians who threaten the quality of care is challenging. Hospitals must routinely undergo detailed reviews, but doctors are largely unmonitored. In large part, they are expected to police one another. "Physicians are really the first line of defense," says Catherine DesRoches, lead author of the JAMA study.<br /><br />In many ways, this approach makes sense. After all, who better to judge the work of one professional than someone with the same training and skills? But without other methods of monitoring in place, many incompetent and impaired physicians are allowed to continue treating patients.<br /><br />According to the American Medical Assn.'s Code of Ethics, individual physicians have an ethical responsibility to report colleagues who they suspect are unable to practice safely; in most states, including California, reporting is actually a legal requirement. Nevertheless, many doctors fail to follow through on concerns about fellow physicians. In the JAMA study, 1 in 3 doctors who had reason to report chose not to do so.<br /><br />"Whether that's a good number or a bad number depends on where you sit," DesRoches says.<br /><br />Two-thirds of doctors are acting responsibly, but patients naturally want that number to reach 100%.<br /><br />Patients are destined to be disappointed. Some doctors simply don't believe that reporting is always the right thing to do. In fact, only 64% of physicians surveyed in the JAMA study completely agreed that they have a professional commitment to report a colleague who may be endangering patients or not adequately performing his or her job. Further, many doctors don't feel prepared to assume the role of overseer. For some, it's an issue of logistics; they don't know whom to contact or how the process works. Others simply don't feel qualified to determine whether or not someone should be reported.<br /><br />"Sometimes determining who's competent and who's incompetent is difficult," says Dr. Matthew Wynia, director of the AMA's Institute for Ethics.<br /><br />Not only can incompetence levels vary, but someone can be competent at one thing and incompetent at another. Then there's the issue of clinical opinion: Doctors frequently approach the same problem in different ways. Just because two doctors don't agree on the best way to care for a patient doesn't mean that either of them is wrong.<br /><br />Sometimes doctors opt not to report because they worry about the potential repercussions — for both themselves and the physicians they're turning in. They fear that reporting one colleague will damage their own personal and professional relationships. If they're viewed as a "snitch," for example, other physicians may stop referring patients to them or avoid collaborating with them lest they be deemed incompetent too. In the JAMA study, 12% of physicians who failed to report a problematic colleague made that choice because they feared retribution.<br /><br />Doctors also worry that their colleagues will be punished excessively. Even the suggestion of a problem can irreparably damage a physician's reputation within the medical community. And, if a physician's license is revoked, his or her career is over.<br /><br />"We need to recognize that doctors are human beings," Wynia says. Like anyone else, they have difficulty being the whistle-blower and have trouble turning in their friends.<br /><br />"It's not the only method we should use to monitor professional behavior," says Wynia. "There are other mechanisms for quality assurance that are equally, if not more, important." For example, physicians should be required to pass rigorous recertification exams. "You should have to not only maintain your competence to practice over time, you should have to prove it."<br /><br />There are plenty of details about my internship I can't remember; the hernia surgery, however, remains vividly clear. None of my colleagues wanted to hear what had happened in the operating room that day; it would have put them in the awkward situation of having to do something about it. Because the error had been corrected and the patient was doing fine, everyone could rationalize that it was a case of no harm, no foul.<br /><br />I was distressed by the response but, being new on the job, figured it wasn't my place to accuse anyone of practicing bad medicine. I also thought that ultimately someone with more authority would address the problem. As far as I'm aware, nobody ever did.<br /><br />Ulene is a board-certified specialist in preventive medicine practicing in Los Angeles. The M.D. appears once a month.<br /><br />health@latimes.com<br /><br />Copyright © 2010, The Los Angeles TimesALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com1tag:blogger.com,1999:blog-7714541618274837970.post-3477784371034095942010-07-19T20:19:00.000-07:002010-07-19T20:49:48.166-07:00Hospital Infection Deaths Caused by Ignorance and Neglect<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_AzxR2QUWcrc/TEUch0AgIPI/AAAAAAAAAFM/1yYavaQlJkQ/s1600/lazy+exec.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 200px; height: 187px;" src="http://3.bp.blogspot.com/_AzxR2QUWcrc/TEUch0AgIPI/AAAAAAAAAFM/1yYavaQlJkQ/s200/lazy+exec.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5495830287497568498" /></a><br />Hospital infection deaths caused by ignorance and neglect, survey finds<br /><br />By N.C. Aizenman<br />Washington Post Staff Writer<br />Tuesday, July 13, 2010; A03<br /><br />Deadly yet easily preventable bloodstream infections continue to plague American hospitals because facility administrators fail to commit resources and attention to the problem, according to a survey of medical professionals released Monday.<br /><br />An estimated 80,000 patients per year develop catheter-related bloodstream infections, or CRBSIs -- which can occur when tubes that are inserted into a vein to monitor blood flow or deliver medication and nutrients are improperly prepared or left in longer than necessary. About 30,000 patients die as a result, according to the Centers for Disease Control and Prevention, accounting for nearly a third of annual deaths from hospital-acquired infections in the United States.<br /><br />Yet evidence suggests hospital workers could all but eliminate CRBSIs by following a five-step checklist that is stunningly basic: (1) Wash hands with soap; (2) clean patient's skin with an effective antiseptic; (3) put sterile drapes over the entire patient; (4) wear a sterile mask, hat, gown and gloves; (5) put a sterile dressing over the catheter site.<br /><br />The approach also calls for clinicians to continually reconsider whether the benefits of keeping the catheter in for another day outweigh the risks and to use electronic monitoring systems that allow them to spot infections quickly and assemble a rapid response team to treat them.<br /><br />A federally funded program implementing these measures in intensive-care units in Michigan hospitals reduced the incidence of CRBSIs by two-thirds, saving more than 1,500 lives and $200 million in the first 18 months. Similar initiatives across the country helped bring the overall national rate of these and related bloodstream infections down by 18 percent in the first six months of 2010, according to the CDC.<br /><br />"Our research shows that the cost of implementing [such programs] is about $3,000 per infection, while an infection costs between $30,000 to $36,000," said Peter Pronovost, a professor at Johns Hopkins University School of Medicine who led the program. "That means an average hospital saves $1 million."<br /><br />So why aren't hospitals leaping to adopt these best practices?<br /><br />The survey released Monday, which was conducted by the Association for Professionals in Infection Control and Epidemiology and funded by Bard Access Systems, a maker of catheters, pointed to ignorance and neglect at the top.<br /><br />More than half of the 2,075 respondents, most of whom were infection control nurses employed by hospitals, reported that they use a cumbersome paper-based system for tracking patients' conditions that makes it harder to spot infections in real time. Seven in 10 said they are not given enough time to train other hospital workers on proper procedures. Nearly a third said enforcing best practice guidelines was their greatest challenge, and one in five said administrators were not willing to spend the necessary money to prevent CRBSIs.<br /><br />Pronovost said part of the problem was that many hospital chief executives aren't even aware of their institution's bloodstream infection rates, let alone how easily they could bring them down.<br /><br />When hospital leaders decide to create a culture in which preventing infections is a priority, he added, nurses feel empowered to remind physicians to follow the checklist when inserting catheters, physicians are provided antiseptic soaps as part of their catheter kits and infection control personnel have the best tools to monitor patients.<br /><br />"If anyone in that chain of accountability doesn't work, you won't get your [infection] rates down," he said. "But it's the hospital's senior leadership that is ultimately responsible."ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com1tag:blogger.com,1999:blog-7714541618274837970.post-51427881847841821402010-07-19T19:43:00.000-07:002010-07-19T20:10:37.011-07:00Doctors Okay with Industry Gifts<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_AzxR2QUWcrc/TEUTWDcwDiI/AAAAAAAAAFE/S0y9nOFWvbE/s1600/gift-ban.gif"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 200px; height: 132px;" src="http://4.bp.blogspot.com/_AzxR2QUWcrc/TEUTWDcwDiI/AAAAAAAAAFE/S0y9nOFWvbE/s200/gift-ban.gif" border="0" alt=""id="BLOGGER_PHOTO_ID_5495820189879504418" /></a><br />MDs OK @industry gifts<br />Posted by medconsumers on July 19, 2010<br /><br />One thing that adds to the inefficiency of our medical care system is the distorting influence of the pharmaceutical industry’s marketing techniques. A new survey of 600 doctors, surgeons, and medical students found that most have positive attitudes towards the marketing activities of the drug companies. Unfortunately, most seem to miss the fact that marketing is all about getting them to prescribe the most expensive drugs. <br /><br />The most disturbing finding in this survey, published in Archives of Surgery, is the 58% of respondents who said they believe that drug samples improve patient care. Free drug samples to doctors—one of the pharmaceutical industry’s most effective marketing strategies—are all about increasing the sales of brand-name drugs. They tend to be the newest, most expensive drugs, offered to patients in this way, “Try this free drug sample and see how you do.” The patients who do just fine continue with the expensive drug, which might very well have a less expensive alternative that is just as good…or safer. So far, no one has come up with any good evidence that free samples improve patient care. <br /><br />The pharmaceutical industry would have us believe that the free drugs go to low-income patients, but that didn’t hold up once researchers took a hard look. They found that the people most likely to receive free drug samples from their physicians are the financially well off and the insured. (Click here) Another study showed that the people who get free samples wind up with significantly more out-of-pocket expenditures than those who don’t.<br /><br />Three-fourths of the doctors in the new survey believe that accepting free gifts and free lunches did not influence their own prescribing practices, but 52% said other doctors are likely to be swayed by such marketing tactics.<br /><br />I think we can safely assume that the pharmaceutical marketing pros know exactly what works in terms of gifts to doctors, be it a free mug with drug company logo or a lavish dinner at the local French restaurant. One anti-drug industry documentary featured a former drug saleswoman turned whistle-blower. She said that her company could clock an uptick in drug prescriptions after something as seemingly minor as bringing a $10 take-out Chinese lunch for each person on the doctors’ staff. <br /><br />You have no way of knowing how much marketing influences your own doctor’s prescribing behavior. A doctor too ready to prescribe the newest drug is a bad sign. So is the doctor whose waiting room often includes a well-dressed drug sales representative (usually female) and/or an office that is heavy on the industry-generated posters, pens, mugs, and brochures. One friend noticed the place she was expected to place her feet on the scale in her doctor’s office had a paste-on ad for Meridia, the weight-loss drug. <br /><br />Revealing as this survey is, it centers on marketing tactics that are small potatoes compared to what’s happening at academic medical centers and is largely hidden from public view. It’s the fact that half of all continuing medical education is funded by industry. It’s the large consulting fees paid to key opinion leaders to “educate” their peers about the latest drugs. (For the definitive article describing how this works, click here.) Things have gotten so bad that medical students at Harvard are reportedly asking hard questions about which of their professors are paid consultants for the pharmaceutical industry (click here).<br /><br />Reforms are on the way but still relatively new. Under a new federal law, drug and device companies will soon have to disclose, on a publicly accessible website, the names of doctors who accept speaking fees, as well as the value of all gifts. We already know that this will have an immediate effect. Vermont is one of three states that already put this law into practice in 2002. Early this year, the attorney general of Vermont release data showing that total payments to doctors dropped 13% in 2009 to $2.6 million. Vermont now plans to improve its law with an outright ban on most gifts, including food, which amounts to $800,000 of the 2009 total.<br /><br />Several years from now we can look forward to another survey to see how doctors react to the new federal law. <br /><br /><br />Maryann Napoli, Center for Medical Consumers©ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-43778361628095282972010-05-14T13:56:00.000-07:002010-05-14T14:08:59.625-07:001,000 Nurses Call on Congress to Act Now on Patient Safety<a href="http://1.bp.blogspot.com/_AzxR2QUWcrc/S-27e0pKp9I/AAAAAAAAAE8/uGBGSHYveFM/s1600/St+joe+nurses.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 154px; height: 200px;" src="http://1.bp.blogspot.com/_AzxR2QUWcrc/S-27e0pKp9I/AAAAAAAAAE8/uGBGSHYveFM/s200/St+joe+nurses.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5471235260526798802" /></a><br />Gathering Highlights Growth of National Nurses Movement<br /><br />More than 1,000 registered nurses from across the country rallied in Washington DC Wednesday, raising an unprecedented, unified voice for patient safety reforms and new, national standards for patient care conditions and standards for nurses.<br /><br />The event was sponsored by the nation’s largest nurses’ union and professional association, the 155,000-member National Nurses United, which came to Washington to press the case for quality of care legislation that was not part of the national healthcare bill enacted earlier this year, and to build on the unity of RNs who are NNU members from coast to coast.<br /><br />In addition to a march, rally, and conference, the RNs visited nearly 100 members of Congress, prodding legislators to work on the unfinished business of healthcare reform, quality of care and patient safety. The actions coincided with National Nurses Week.<br /><br />Noting recent national attention on the West Virginia mining disaster and the Gulf Coast oil spill, NNU Co-President Jean Ross, RN said that “similar accidents happen every day away from the media spotlight in U.S. hospitals and other healthcare settings. It’s time to act to protect our patients and our communities.”<br /><br />"We're the voice of not only nurses but patients across the country,” said NNU Co-President Karen Higgins, RN. “When we leave this room I want everyone to remember that. When it comes time to make decisions about healthcare and people say 'leave it to the experts,' tell them 'I am the expert.' "<br /><br />Among the legislative solutions are S 1031/HR 2133 that would, among other components, establish minimum ratios of nurses to patients for all U.S. hospitals, modeled after a successful California law, and S 1788/HR 2381 which would also promote nurse retention and reduce patient accidents and injuries by establishing safe patient lifting and handling policies.<br /><br />Sen. Al Franken of Minnesota, author of S 1788, hosted a hearing on the bill Tuesday at which several nurses on hand for the week cited experiences that demonstrated the need for the bill.<br /><br />Speaking Wednesday to an NNU rally across from the Capitol, Franken told the RNs, "You are the ones we look to for advice, comfort, expertise and care. You are tireless advocates for the country's well-being. You're the ones we trust to care for our loved ones, that's what your expertise is, and it's simply unacceptable that you're putting your own health on the line to care for patients."<br /><br />"Now it's time to make sure that all nurses in all states have access to a safe workplace. One injured nurse is one too many. Employers have a fundamental obligation to put in place a safe working environment for all workers and nurses are no exception," Franken said.<br /><br />Rep. Lynn Woolsey of California, speaking to the nurses, also emphasized why the bill is needed, "We don't need to create another patient in the process of caring for one."<br /><br />U.S. Labor Secretary Hilda Solis, who also addressed the conference, told the nurses that more than 36,000 health care workers were injured by lifting and transferring patients, according to 2008 Bureau of Labor Statistics data. In addition, she said, 12 percent of nurses who plan to leave the profession cited back injuries as a contributing factor.<br /><br />“What a waste when the career of an experienced nurse is ended years or decades too early because of an easily preventable back injury,” Solis said. “In these days of ever-rising health care costs, what a waste of money to pay workers compensation and disability for easily preventable back injuries.”<br /><br />S 1031 author Sen. Barbara Boxer of California and HR 2133 author Rep. Jan Schakowsky of Illinois also spoke the NNU event about the ratio legislation which, according to a groundbreaking study from the University of Pennsylvania released last month, could have cut post-surgical patient deaths by 14 percent in New Jersey and 11 percent in Pennsylvania, two comparable states the researchers compared to California.<br /><br />"We know that nurse-to-patient ratios work, and it is time to enact them around the nation. California was the testing ground and it's working," Boxer said. "Too often you are overworked because of staffing levels that are inadequate and that is unacceptable."<br /><br />The Penn study, from noted researcher Linda Aiken, RN, PhD, documents “what California nurses have seen every day at the bedside since passage of the law -- safer care conditions, an enhanced quality of life for patients, and, as an added bonus, reduced burnout for nurses which mitigates the nursing shortage,” said California RN and NNU co-president Deborah Burger.<br /><br />NNU is also seeking passage of HR 949/S 362 to restore equal collective bargaining rights for Veterans Affairs nurses.<br /><br />Strengthening the rights of direct care RNs and their ability to more effectively advocate for patients and their colleagues, was another major theme of the NNU gathering.<br /><br />"We've got to say something in a united way that tells employers it's a new day in America and RNs are going to stand up and not take it anymore," NNU Executive Director Rose Ann DeMoro said.<br /><br />The RNs unanimously endorsed a resolution to establish national collective bargaining standards that notes the growing attack by many hospital employers against nurses and patient safety conditions.<br /><br />The resolution notes that NNU will oppose “concessionary agreements that are injurious to our patients, our members, and our profession that undermine all represented RN contract standards” that include reductions in health coverage, pensions and other retirement security, two-tier programs for new hires, and reductions that impair patient safety.<br /><br />Additionally, the resolution pledges NNU to fight for enhanced RN staffing and other improvements in patient care standards, improved retirement security for RNs, limits on the introduction of new technology that displaces RNs or RN professional judgment, and additional workplace safety measures.ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-36220954092136306362010-04-30T21:53:00.000-07:002010-04-30T22:02:02.790-07:00Suit-Proof Physicians in Ohio?An Ohio Supreme Court ruling has limited a patient's opportunity to sue for medical malpractice based on where the treatment occurred and who was present for the treatment. <br /><br />In Theobald v. University of Cincinnati, the Court ruled that when a physician is negligent in treating a patient, the physician will be immune from liability as long as a medical student or resident was present during the treatment. Basically, under these circumstances, the physician is legally considered to be a state employee acting within the scope of his or her employment, and therefore is immune from civil liability.<br /><br />Keith Theobald, the plaintiff in the above-referenced case, was injured in a serious auto accident. Afterward, Theobald was treated at University Hospital, a private hospital, but one which is affiliated with the University of Cincinnati. After treatment, Mr. Theobald awoke to find himself blind and with worsened paralysis. He sued the treating physicians but, ultimately, was precluded from having his day in court.<br /><br />The Supreme Court first determined that Theobald's treating physicians were immune from liability as employees of the state because they were “teaching” or supervising students from a state medical school. The physicians had privileges at University Hospital, and they performed the treatment resulting in this case at the hospital. <br /><br />Even though the physicians were employees of the state, they would only enjoy immunity from civil liability if the Court determined that they were acting within the scope of their state employment during the time of the alleged negligence. <br /><br />Theobald argued that because the doctors’ private practice billed for the procedure, this was evidence that the doctor was not “teaching.” However, the Supreme Court determined that the focus must be on the “employment relationship” as opposed to the business or financial arrangements. If the physician was “educating a student or resident when the negligence occurred,” then the physician will be immune. In other words, the doctor is immunized whenever negligence occurs in the presence of a student.<br /><br />The Court's ruling in this regard creates a controversial precedent for Ohio citizens and physicians. One of the roles of an attending physician at University Hospital is to teach the medical students and residents. The Court determined that the treating physicians were acting within the scope of their state employment because they were teaching a resident while delivering medical care to Theobald. The Court found this to be true no matter what “percentage” of the procedure was actually teaching. However, as Justice Pfeifer noted in his dissenting opinion, “the mere presence of a student does not establish that instruction is taking place.” The ruling extends immunity to a physician merely because a student was present, even if the only thing the student was doing was observing. Pfeifer also noted that when the state is a defendant, the Court of Claims has jurisdiction. However, jury trials are not permitted in the Court of Claims. This would effectively deny medical malpractice plaintiffs their constitutional right to a jury trial.<br /><br />This ruling will change the remedies available to Ohio patients who find themselves the victim of medical malpractice when a student is involved in any aspect of the procedure. By allowing physicians (and their malpractice insurance companies) to avoid liability by having a resident present for treatment, patients who are treated at hospitals will be left with no one to sue if they are injured and legitimately deserve to be compensated.<br /><br />ABC6 News Report http://www.abc6onyourside.com/shared/newsroom/top_stories/videos/wsyx_vid_3942.shtmlALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-59618168913316181462010-04-30T15:49:00.000-07:002010-04-30T15:53:58.996-07:00Cleveland Primary Care Doctors Fired For Lack of "Productivity"Physicians for a National Health Program<br />April 29, 2010<br /><br /><br />Dear PNHP board members and activists,<br /><br />We're writing to call your attention to an extremely significant event in the Cleveland area, which is sadly an increasingly frequent experience of physicians working for corporate entities.<br /><br />Dr. George Randt and his colleague are board-certified internists who have had a contractual relationship with St. John Medical Center covering some 2,500 patients for several years. These two doctors have excellent records with the hospital, high patient satisfaction and retention rates, and have never had an unfavorable review. Both were awarded bonuses in 2009, and Dr. Randt's contract was renewed in January of this year.<br /><br />This past month they were notified by the president of their hospital, Mr. Cliff Coker, that their contracts were being terminated due to lack of productivity and their having incurred excessive overhead expense. In other words, they weren't sufficiently profit-driven. At a previous staff meeting, the staff physicians were told by the CFO to admit just "one more Medicare patient a month" to improve hospital revenues.<br /><br />If you can, please join Dr. Randt, his patients, and others at a rally at St. John Medical Center, 29000 Center Ridge Road, Westlake, Ohio, this Sunday, May 2, at 1:00 p.m. to call for the reinstatement of these two physicians and for the elimination of policies which are justified solely on the basis of maximizing the profits of a health care system. Speakers at the rally include PNHP's congressional fellow, Dr. Margaret Flowers, and Dr. Carol Paris. (See the press release below for more information.)<br /><br />Call Mr. Cliff Coker today and demand that these physicians be reinstated to their position. His office number is (440) 827-5008. He can also be reached by e-mailing cliff.coker@csauh.com <br /><br />We welcome you to share your views that patients should come before profits with the newspapers in the area by writing a letter to the editor to the The Plain Dealer or Sun News.<br /><br />Dismissing these physicians without cause, merely to maximize hospital revenues, is the embodiment of the derangement of our system of health care finance. This was done without any semblance of due process. The livelihood and status of skilled professionals are being sacrificed to assure profitability; this is rapidly becoming the norm within our profit-driven system. As a result, it poses the gravest threat to professionalism and patient primacy. These issues would be greatly alleviated under a single-payer health financing system that places value on health outcomes, continuity of care, and quality.<br /><br />Please join us in calling for the reinstatement of Dr. Randt, a longtime PNHP member, and his colleague and an end to health care practices that place the goals of profitability over the care of patients.<br /><br /><br />Health care for all,<br /><br />Quentin Young, M.D.<br />National Coordinator, PNHP <br /><br />Johnathon Ross, M.D.<br />Past-president, PNHP<br />State Coordinator, PNHP Ohio<br /><br />http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x8243878ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-76272505568903550822010-04-11T15:55:00.000-07:002010-04-11T15:59:36.532-07:00C Difficile Surpasses MRSA as the Leading Cause of Nosocomial Infections in Community HospitalsEmma Hitt, PhD<br /><br />March 23, 2010 (Atlanta, Georgia) — Hospital-onset healthcare-facility-associated Clostridium difficile infections (CDI) have increased in incidence and have surpassed methicillin-resistant Staphylococcus aureus (MRSA) infections, according to a new study of a large cohort of patients from community hospitals.<br /><br />Becky A. Miller, MD, an infectious disease fellow from Duke University in Durham, North Carolina, presented the findings during an oral session here at the Fifth Decennial International Conference on Healthcare-Associated Infections 2010.<br /><br />"This is the first time this has been described using patient-level data (i.e., with the number of cases as the numerator and the number of patient days as the denominator)," Dr. Miller told Medscape Infectious Diseases.<br /><br />"We think this trend, particularly in community hospitals, would not have been captured without our large network of 39 hospitals where we perform infection control and surveillance," she said. "We were also unaware that cases of nosocomial C difficile infection had increased and surpassed MRSA."<br /><br />The researchers performed a prospective cohort study in 28 community hospitals participating in the Duke Infection Control Outreach Network between January 2008 and December 2009.<br /><br />The cohort consisted of 3,007,457 patient-days. Numerically, nosocomial CDI was the most common healthcare-associated infection (847 cases), followed closely by nosocomial bloodstream infection (838 cases).<br /><br />Nosocomial infections due to MRSA and intensive care unit device-related infections were approximately equal, at 680 and 681 cases, respectively.<br /><br />Patients with nosocomial CDI (n = 840) and nosocomial MRSA (n = 655) were equally likely to be male, and to have diabetes or end-stage renal disease requiring hemodialysis. However, patients who developed nosocomial CDI were, on average, older than patients who developed nosocomial MRSA infection (65 vs 59 years; P < .0001). In addition, time to infection was, on average, 8 days for CDI and 7 days for MRSA infection (P < .0001), and overall mortality was higher among patients with MRSA infection than CDI (P < .0001).<br /><br />The rate of nosocomial CDI was 0.28 cases per 1000 patient-days, whereas the rate of nosocomial MRSA infection was 0.23 cases per 1000 patient-days. Thus, nosocomial CDI occurred 25% more frequently than nosocomial MRSA infection.<br /><br />Since 2007, rates of healthcare-associated MRSA infection have steadily decreased, whereas rates of CDI have increased, Dr. Miller said during her presentation.<br /><br />According to Dr. Miller, C difficile spores are shed in stool, and these spores can persist in the hospital environment for months. "These infections are not being prevented by methods that are clearly working to prevent nosocomial infections due to MRSA," she said. She added that "we think that this study represents the tip of the iceberg, as we did not include nosocomial C difficile cases diagnosed after patients leave the hospital."<br /><br />In another presentation on C difficile, researchers described a targeted strategy to eliminate C difficile using ultragermicidal bleach wipes. Robert Orenstein, DO, from the Mayo Clinic in Rochester, Minnesota, reported the findings here in a poster session.<br /><br />"The beauty of this project was that implementation was relatively simple — it required putting together a committed team and emphasizing our goal of improving patient outcomes," Dr. Orenstein told Medscape Infectious Diseases.<br /><br />The researchers targeted 2 units with a focused intervention of daily cleaning of all patient rooms with Clorox brand ultragermicidal bleach wipes containing 6.15% sodium hypochlorite, and cleaning after the patient had been discharged.<br /><br />Cleaning was assessed by environmental services supervisors, and Clean-Trace technology was used. Patients and environmental services employees who cleaned the rooms responded to a survey regarding satisfaction and tolerance of the cleaning procedure.<br /><br />Before the intervention was initiated, the incidence of CDI was 18.4 per 10,000 patient-days; after the intervention was initiated, the incidence was 3.76 per 10,000 patient-days, "far exceeding" their goal of a reduction in incidence of 30%, Dr. Orenstein said.<br /><br />According to the authors, patients tolerated the cleaning well, and although environmental services "employees initially had concerns regarding odor and irritation, these were resolved." The cost of the intervention was estimated at $18,671 per year.<br /><br />"I am struck by the fact that our highest-risk unit has gone 6 months without a hospital-acquired case attributable to their unit, despite the fact that the overall incidence (i.e., cases admitted with this infection) continues to rise," Dr. Orenstein said. "This suggests what we did really had a great impact," he added. "This is especially gratifying knowing the impact that C difficile disease can have on our patients lives."<br /><br />"C difficile has been in the news for the last decade," said Carlene A. Muto, MD, medical director for infection control at the University of Pittsburgh School of Medicine in Pennsylvania. "What has taken focus this year is that the environment matters," she said.<br /><br />According to Dr. Muto, an analysis by their group presented in the late-breaking session described the undetected reservoir in patients who asymptomatically carry C difficile (~6% of the patients tested).<br /><br />"Many studies have described noncompliance with cleaning patient rooms and how a focused effort can change this behavior," Dr. Muto told Medscape Infectious Disease. "Our group implemented a bleach/detergent cleaning program years ago, but since June 2009, we have used this product on every surface, every time, not just in the rooms of patients known to be positive."<br /><br />She noted that "patients not known to be colonized/infected one day may be so the next. We did see a decrease in C difficile healthcare-associated infections using this approach."<br /><br />Neither study was commercially funded. Dr. Miller, Dr. Orenstein, and Dr. Muto have disclosed no relevant financial relationships. <br /><br />Fifth Decennial International Conference on Healthcare-Associated Infections (ICHAI) 2010: Abstract 386, presented March 20, 2010; Abstract 142, presented March 19, 2010.ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-11430675545364195322010-04-09T21:41:00.000-07:002010-04-11T16:04:46.421-07:00New State Regulation Could Affect California's Low Physician Disciplinary Rate<a href="http://2.bp.blogspot.com/_AzxR2QUWcrc/S8AC6oD5G9I/AAAAAAAAAE0/ssYZB4kUBCA/s1600/silent+doc.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 130px; height: 106px;" src="http://2.bp.blogspot.com/_AzxR2QUWcrc/S8AC6oD5G9I/AAAAAAAAAE0/ssYZB4kUBCA/s200/silent+doc.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5458365954582453202" /></a><br />California is one of the least likely states to take serious disciplinary action against physicians, according to a new study. But a new state regulation might soon change that.<br /><br />Starting in June, California's 125,000 physicians will be required to post signs in their offices or otherwise inform patients about how to contact the Medical Board of California to file quality of care complaints.<br /><br />The new regulation comes in response to concerns that California patients are not lodging complaints about quality of care very often, a position given credence by a report released this week showing California ranks 41st in the country in disciplinary action against physicians.<br /><br />Using data from the Federation of State Medical Boards, consumer group Public Citizen found an average of 3.05 serious disciplinary actions per 1,000 physicians nationally. In comparison, California's medical board took 2.36 serious disciplinary actions per 1,000 doctors last year. Researchers defined serious discipline as license revocations, surrenders, suspensions, probation or restrictions.<br /><br />Under the state's new regulations, physicians must provide a notice with the name, phone number and Web site of the medical board. Proponents hope more consumer information will help uncover misconduct and increase quality of care in the state.<br /><br />The California Medical Association criticized the new rule, claiming it could undermine the doctor-patient relationship.<br /><br />Meanwhile, here's a rundown of health care bills making their way through the Legislature.<br /><br />Health Plans<br /><br />AB 2586 by Assembly member Wesley Chesbro (D-Santa Rosa) would require health insurers to demonstrate that a planned modification to its health care provider network meets certain standards. The measure also would require insurers to provide consumers with an accurate list of contracting providers upon request. In addition, the bill would require insurers post an interactive map on their Web sites to help consumers locate providers in their area (Bill text, 4/5). The bill is before the Assembly Committee on Health (Bill status, 4/5).<br /><br />Doctors and Nurses<br /><br />Under AB 2699 by Assembly member Karen Bass (D-Los Angeles), health care providers licensed in another state would be exempt from California's medical licensure requirements if they provide care on a short-term, voluntary basis in association with certain registered sponsoring entities. The bill also would state the intent of the Legislature that the voluntary services be primarily provided to uninsured and underinsured populations (Bill text, 4/5). The bill is before the Assembly Committee on Rules (Bill status, 4/5).<br /><br />Prescription Drugs<br /><br />SB 1106 by Sen. Leland Yee (D-San Francisco) would require prescribers who dispense prescription drug samples to either provide patients with a copy of the FDA-approved package insert for the medication or ensure that the manufacturer's warnings are on the packaging of the samples (Bill text 4/5). The bill is before the Senate Committee on Appropriations (Bill status, 4/5).<br /><br />Health Care Reform<br /><br />SB 1378 by Sen. Tony Strickland (R-Moorpark) would prohibit the state from enacting any Medi-Cal expansions mandated under the national health care reform law unless the federal government fully funds the expansion. Medi-Cal is California's Medicaid program (Bill text, 4/5). The bill is before the Senate Committee on Rules (Bill text, 4/5).ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-36167290423055460852010-02-15T21:03:00.000-08:002010-02-15T21:07:07.101-08:00CEOs are less concerned about quality and patient safety<strong>Healthcare CEOs Focusing on the Now</strong> <br />Philip Betbeze, for HealthLeaders Media, February 12, 2010<br /><br />Here's a statement that should get your attention: CEOs are less concerned about quality and patient safety this year than last year. Actually, that broad conclusion is tough to draw from the data contained in the HealthLeaders Media Industry Survey 2010, which went live on our site yesterday. But what's clear is that long-term goals are dropping in importance in favor of initiatives that can bring near-immediate returns.<br /><br />Without a doubt, CEOs are spending more of their intellectual capital this year on patient experience/satisfaction as well as cost reduction, according to the survey.<br /><br />CEOs, obviously, drive their organizations, so what they say about their priorities carries a lot of weight. We actually asked CEOs to rank their top three priorities for the next three years, and what came back showed us that CEOs, perhaps in light of the turbulent economic times, are trimming back the importance they give to quality and patient safety (only 39.5% selected it this year, compared with 69% in 2009) while patient experience/satisfaction (33.98% vs. 25%) as well as cost reduction (35.36% vs. 19%) recorded big increases.<br /><br />Interestingly, physician recruitment and retention dropped from 43% in 2009 to 35.36% for 2010. So what conclusions can we draw from this data? Perhaps CEOs feel like after years of concentration, their quality levels don't need as much attention. Perhaps more of them have achieved their short- and medium-term goals with physician recruitment.<br /><br />But in the bigger picture, quality still leads the herd, and physician recruitment isn't far behind. They just have much less of a commanding lead than they did before. I think some areas simply have improved so much that they aren't highest priority anymore, at least at the top levels of the organization. That certainly seems true for revenue cycle, for example, which only 7.73% of CEOs ranked as among their top three priorities for 2010, compared with 23% in 2009.<br /><br />But I think there's something else at work here. Short-term thinking has invaded the decisions emanating from the C-suite.<br /><br />On first glance, that seems myopic. But it's not necessarily a bad thing: Sometimes a crisis requires you to dramatically shift your priorities, and if 2009 wasn't a crisis year with the recession and healthcare reform looming on the horizon, I don't know what would qualify. For example, physician recruitment is a long-term investment in a single human being. Improving quality also takes time, and while it generates an ROI, its ROI doesn't flow directly to the bottom line.<br /><br />Banner Health, for example, spent big bucks on driving quality at their organization. They don't regret it. In fact, their quality scores in the obstetrics department recently meant they could reduce their reserves for malpractice to near zero for 2010. But it took at least three years of low or no claims to make the actuarial team comfortable with reducing those reserves and letting them flow to the bottom line.<br /><br />CEOs in 2010 don't necessarily have that luxury of waiting for results, no matter how impressive they might eventually be. And that's the key for CEOs in 2010. They want to expend their energy on initiatives that bring immediate or near-immediate return because frankly their jobs, the jobs of others in the organization, and in some cases, their hospital's existence, are on the line.<br /><br />Obviously, this is just very narrow snapshot of the wealth of information available in our survey. I encourage you to spend a half-hour on it in the next week or so. We've broken the results down by pillar, meaning there's one for CEOs, one for quality, one for CFOs, etc.<br /><br />I've focused here on one question from the CEO pillar and have been able to draw several conclusions from it. But there's a story behind every question and knowledge to be gleaned from every pillar. Delve into the survey's findings now. You won't be sorry.<br /><br />--------------------------------------------------------------------------------<br />Philip Betbeze is a senior leadership editor with HealthLeaders Media. He can be reached at pbetbeze@healthleadersmedia.com.ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-78926505460174654722010-02-09T19:42:00.000-08:002010-02-09T19:48:02.052-08:00Texas Nurse On Trial After Reporting DoctorFebruary 8, 2010 A nurse in Texas is standing trial for reporting a doctor she thought was practicing bad medicine. Prosecutors have charged 52-year-old Anne Mitchell with making inflammatory statements about a doctor at a rural hospital in Kermit, Texas. She faces up to 10 years in prison. Mitchell says she was just trying to protect her patients. Kevin Sack of The New York Times says much of the case stems from local politics.<br /><br /><embed src="http://www.npr.org/v2/?i=123502251&m=123502238&t=audio" height="386" wmode="opaque" allowfullscreen="true" width="400" base="http://www.npr.org" type="application/x-shockwave-flash"></embed><br /><br />http://www.npr.org/templates/story/story.php?storyId=123502251ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-11093279209858762672009-12-21T19:25:00.000-08:002009-12-21T19:28:12.676-08:00Hospital comparisons soon to be a click awayMonday, December 21, 2009 3:12 AM<br />By Suzanne Hoholik<br /><br />THE COLUMBUS DISPATCH<br />While you watch parades and football games on New Year's Day, you can fire up your computers and compare Ohio hospitals.<br /><br />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.<br /><br />Hospitals already report some of this information, but it's difficult for consumers to compare hospitals.<br /><br />"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.<br /><br />"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.<br /><br />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.<br /><br />On the main page, consumers will be able to pick hospitals to compare on quality measures.<br /><br />Consumers need access to this kind of information, said Cathy Levine, executive director of the Universal Health Care Action Network of Ohio.<br /><br />"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.<br /><br />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.<br /><br />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.<br /><br />Hospitals caution that these charges aren't what the 88 percent of insured Ohioans will pay. Private and government insurance pay lower, negotiated rates.<br /><br />"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."<br /><br />Even so, knowing what hospitals charge for the same thing will be helpful, said Kelly McGivern, president of the Ohio Association of Health Plans.<br /><br />"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."<br /><br /><strong>On Jan. 1, consumers will be able to compare hospitals by going to http://www.odh.ohio.gov/ and clicking on Ohio Hospital Compare.</strong>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-19553739661670840312009-11-10T16:11:00.000-08:002009-11-10T16:16:21.056-08:00Sebelius Announces Release of Recovery Act Funding to Improve Care in Nation’s Ambulatory Surgical CentersTo 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.<br /><br />“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.”<br /><br />“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.<br /><br />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). <br /><br />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. <br /><br />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.<br /><br />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.<br /><br />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. <br /><br />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 http://www.hhs.gov/ophs/initiatives/hai, 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.ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-47535625630865410422009-11-03T09:56:00.000-08:002009-11-03T10:01:26.275-08:00Where Are the Firing Offenses in Medicine?Patrick Malone<br />Posted: October 29, 2009 04:04 PM <br /> <br />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? <br /><br />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. <br /><br />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.<br /><br />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.<br /><br />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. <br /><br />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.<br /><br />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."<br /><br />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. <br /><br />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." <br /><br />Amen to that.<br /><br /> <br />Patrick Malone <br />Attorney and Author of "The Life You Save"ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-19037427160123928032009-10-06T15:10:00.000-07:002009-10-06T15:24:46.644-07:00Safety Gurus: Penalize Doctors Who Don’t Follow the Rules<a href="http://1.bp.blogspot.com/_AzxR2QUWcrc/SsvBkUl-4hI/AAAAAAAAAEo/DtKTVcic7xw/s1600-h/handwashing_D_20090910121843.jpg"><img style="MARGIN: 0px 0px 10px 10px; WIDTH: 200px; FLOAT: right; HEIGHT: 133px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5389614208826401298" border="0" alt="" src="http://1.bp.blogspot.com/_AzxR2QUWcrc/SsvBkUl-4hI/AAAAAAAAAEo/DtKTVcic7xw/s200/handwashing_D_20090910121843.jpg" /></a><span style="font-size:78%;">October 1, 2009, 3:50 PM ET<br />By Laura Landro</span><br /><br />Should hospitals start penalizing doctors and nurses who fail to follow patient safety rules?<br /><br />That’s one solution proposed by <span style="color:#000099;">Peter Pronovost</span> of Johns Hopkins and <span style="color:#000099;">Robert Wachter</span> 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.<br /><br />(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.)<br /><br />In the decade since the <em><strong>Institute of Medicine’s</strong></em> landmark <span style="color:#000099;"><strong>“ To Err is Human”</strong></span> 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 <strong>a blame-free culture creates its own safety risks</strong>, Pronovost and Wachter write.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />“Some of these doctors just come to the meetings to throw spears at me,” he says. <strong>“We know how important these things are for patient safety, but there needs to be some accountability for infractions,”</strong> he adds. <strong>The suggested penalties “are an attempt at a practical way to hold people accountable.” </strong>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-15220292214235227222009-07-26T22:13:00.000-07:002009-07-26T22:20:58.024-07:00Doctors Want to Roll Back Policies Curbing Gifts Between Doctors And Drug Company Reps<strong>Perks policy for doctors challenged</strong><br /><em>Physician organization wants limits rolled back</em><br /><span style="font-size:85%;">By Liz Kowalczyk,<br />Boston Globe July 23, 2009<br /></span><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.’’<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />“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.<br /><br />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.<br /><br />“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.’’<br /><br />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.ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-12909902904134327012009-07-16T00:41:00.000-07:002009-07-16T01:00:31.854-07:00<strong><span style="font-size:130%;">Schwarzenegger Replaces Most of State Nursing Board</span></strong><br />by Tracy Weber - July 13, 2009 9:55 pm EDT<br />Tags: Arnold Schwarzenegger, California, California Board of Registered Nursing, Nurses<br /><br /><a href="http://4.bp.blogspot.com/_AzxR2QUWcrc/Sl7dDy9UfFI/AAAAAAAAAEI/e3cGKUVCJBU/s1600-h/board-members-bw-w-arnold.jpg"><img style="MARGIN: 0px 10px 10px 0px; WIDTH: 320px; FLOAT: left; HEIGHT: 222px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5358963663905782866" border="0" alt="" src="http://4.bp.blogspot.com/_AzxR2QUWcrc/Sl7dDy9UfFI/AAAAAAAAAEI/e3cGKUVCJBU/s320/board-members-bw-w-arnold.jpg" /></a><br />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.<br /><br /><em>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.</em><br /><em><br />Update (July 14, 2009): Nursing Board Executive Officer Ruth Ann Terry Resigns [1]<br />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.</em><br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />"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.<br /><br />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."<br /><br />"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."<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />Neither Beecham nor Harrison could be reached late Monday, nor could any of the departing board members.<br /><br />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."<br /><br />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."<br /><br />California Board of Registered Nursing executive officer<br /><br /><a href="http://4.bp.blogspot.com/_AzxR2QUWcrc/Sl7dg6hQW7I/AAAAAAAAAEQ/lAl0bXMU0J0/s1600-h/terry-ruth-ann-lat-175px.jpg"><img style="MARGIN: 0px 10px 10px 0px; WIDTH: 170px; FLOAT: left; HEIGHT: 200px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5358964164151761842" border="0" alt="" src="http://4.bp.blogspot.com/_AzxR2QUWcrc/Sl7dg6hQW7I/AAAAAAAAAEQ/lAl0bXMU0J0/s200/terry-ruth-ann-lat-175px.jpg" /></a>Ruth Ann Terry (Liz O. Baylen/Los Angeles Times)<br /><br /><br />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.<br />Terry, reached late Monday, hung up on a reporter, saying, "We don't have anything to say."<br /><br />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."<br /><br />The Times and ProPublica<br /><br />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.<br /><br />Early Monday, Terry and her assistant executive officer, Heidi Goodman,<br /><br />"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."<br /><br />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."<br /><br />"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."<br /><br />Questions about the board's leadership were first raised last fall<br /><br />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.<br /><br />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.<br /><br />Consumer advocate Ken McEldowney said the board members need to do more than just fill seats.<br /><br />"The leadership is key," said McEldowney, executive director of Consumer Action, a San Francisco-based national consumer advocacy and education membership organization.<br /><br />"It just appears to me that they don't care."<br /><br />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<br />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.<br /><br />These positions do not require Senate confirmation, and the compensation is $100 per working day.<br /><br /><em><br />[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.</em>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-32774942467643992352009-07-04T22:56:00.000-07:002009-07-04T23:08:27.982-07:00Consumer Reports Profiles Survivor Alicia Cole<a href="http://3.bp.blogspot.com/_AzxR2QUWcrc/SlBBKseurDI/AAAAAAAAAEA/IISAbmNm6gE/s1600-h/CR+Photo.jpg"><img id="BLOGGER_PHOTO_ID_5354851608938064946" style="FLOAT: right; MARGIN: 0px 0px 10px 10px; WIDTH: 240px; CURSOR: hand; HEIGHT: 200px" alt="" src="http://3.bp.blogspot.com/_AzxR2QUWcrc/SlBBKseurDI/AAAAAAAAAEA/IISAbmNm6gE/s320/CR+Photo.jpg" border="0" /></a><strong><span style="font-size:130%;">Reform should make it easy to get information on quality</span></strong><br />August 2009<br /><br />'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<br /><br />This article is the archived version of a report that appeared in the <a title="August 2009 Consumer Reports magazine" href="http://www.consumerreports.org/cro/magazine-archive/august-2009/august-2009-toc.htm" inlinetype="rxhyperlink" rxinlineslot="103" sys_dependentid="256288" sys_dependentvariantid="795" sys_folderid="256286" sys_relationshipid="2211714" sys_siteid="308">August 2009 Consumer Reports magazine</a>.<br /><br />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."<br /><br />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.<br /><br />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.<br /><br />CU recommends<br /><br />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.<br /><br />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.<br /><br />Read about our latest reform efforts and our analysis of legislation as its being debated in Washington, D.C. in our <a title="Guide to Health-Care Reform" href="http://www.consumerreports.org/health/insurance/health-care-reform-guide/health-care-reform-guide.htm" inlinetype="rxhyperlink" rxinlineslot="103" sys_dependentid="256257" sys_dependentvariantid="799" sys_folderid="256255" sys_relationshipid="2211713" sys_siteid="313">Guide to Health-Care Reform</a>.ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-90249835435701509612009-07-04T20:47:00.001-07:002009-07-04T21:07:08.586-07:00Surgery Tech Suspected of Exposing 5,700 to Hepatitis CColorado Springs surgery tech suspected of exposing 5,700 to hepatitis C<br /><span style="font-size:78%;">July 2, 2009 - 6:28 PM<br />JOHN C. ENSSLIN AND BRIAN NEWSOME<br />THE GAZETTE</span><br /><div><div><div><br /><div>Federal officials Thursday warned that about 5,700 surgery patients, including 1,000 at a<a href="http://1.bp.blogspot.com/_AzxR2QUWcrc/SlAl4xhrxnI/AAAAAAAAAD4/MlW22SZlKGM/s1600-h/kristenparker.jpg"><img id="BLOGGER_PHOTO_ID_5354821614241039986" style="FLOAT: right; MARGIN: 0px 0px 10px 10px; WIDTH: 200px; CURSOR: hand; HEIGHT: 150px" alt="" src="http://1.bp.blogspot.com/_AzxR2QUWcrc/SlAl4xhrxnI/AAAAAAAAAD4/MlW22SZlKGM/s200/kristenparker.jpg" border="0" /></a> Colorado Springs surgery center, are at risk of having been infected by an operating room technician with hepatitis C.<br /></div><div>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.<br /></div><div>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.<br /></div><div>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.<br /></div><br /><div>"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."<br /></div><br /><div>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.<br /></div><br /><div>A <a href="http://www.myspace.com/kris10_1227">MySpace page</a> 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.<br /></div><br /><div>"I have a crazy fascination with needles.. I just like the way they feel!" the Web page states.<br /></div><br /><div>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.<br /></div><div>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.<br /></div><br /><div>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.<br /></div><br /><div>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.<br /></div><br /><div>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.<br /></div><br /><div>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."<br /></div><br /><div>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.<br /></div><div>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.<br /></div><br /><div>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.<br /></div><br /><div>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.<br /></div><br /><div>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.<br /></div><br /><div>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.<br /></div><br /><div>The hospital had a press conference Thursday and released a prepared statement that apologized to patients who have been affected.<br /></div><br /><div>"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.<br /></div><br /><div>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.<br /></div><br /><div>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."<br /></div><br /><div>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.<br />Hepatitis C facts<br /></div><br /><div>According to the <a href="http://www.cdc.gov/hepatitis/ChooseC.htm">Centers for Disease Control Web site</a>, 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.<br /></div><br /><div>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.<br /></div><br /><div>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.<br /></div><br /><div>Chronic hepatitis C infections account for about 8,000 to 10,000 deaths each year in the United States.</div><div><br />No vaccine for hepatitis C is available.</div></div></div></div>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0tag:blogger.com,1999:blog-7714541618274837970.post-50617285485815488312009-06-24T22:13:00.000-07:002009-06-24T22:27:37.385-07:00Health Insurance Insider: 'They Dump the Sick'<img id="BLOGGER_PHOTO_ID_5351131938762766610" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 207px; CURSOR: hand; HEIGHT: 160px" alt="" src="http://2.bp.blogspot.com/_AzxR2QUWcrc/SkMKJZQzuRI/AAAAAAAAADY/42xQxVwNGTw/s320/healthcare_cost_potter_090624_mn.jpg" border="0" />Retired Health Insurance Executive Blows the Whistle on His Former Industry<br /><span style="font-size:78%;">By ALICE GOMSTYN ABC News Business Unit June 24, 2009</span><br /><div></div><br /><div>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.<br /><br />Retired health insurance executive Wendell Potter told Congress today that insurance companies routinely rip off customers.</div><br /><div>"[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.<br /></div><div>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."<br /></div><div> </div><div>"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."<br /></div><div>Small businesses, in particular, he said, have had trouble maintaining their employee health insurance coverage, he said.<br /></div><br /><div>"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.<br /></div><br /><div>Potter also faulted insurance companies for being misleading both in advertising their policies to new customers and in communicating with existing policyholders.<br /></div><br /><div>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.<br /></div><br /><div>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.<br /></div><br /><div>The documents, he said, are "notoriously incomprehensible."<br /></div><br /><div>"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." </div><br /><div>For the rest of the story go to:</div><div></div><div><a href="http://abcnews.go.com/Business/Health/story?id=7911195&page=1">http://abcnews.go.com/Business/Health/story?id=7911195&page=1</a></div>ALLIANCE FOR SAFETY AWARENESS FOR PATIENTShttp://www.blogger.com/profile/12137071565175732536noreply@blogger.com0