All Entries in the "Public reporting" Category
Press Ganey report: Patient satisfaction increasing across the country
Patient satisfaction is on the rise, according to Press Ganey’s annual Hospital Pulse Report. The report surveyed nearly 3 million patients about their experiences at more than 2,000 hospitals nationwide during 2008. Overall, patient satisfaction has steadily increased since 2003, with 85% of those surveyed reporting satisfaction with care in October 2008. Additionally, Press Ganey found that more patients than ever before (a 1.96 % increase) were likely to recommend the facility where they had received care to a friend. The area that most affects how patients rate their care corresponds to communication—how staff members communicate with patients, especially when patients express concerns or complaints during their stays.
The report identifies as a catalyst for quality improvement that hospitals began publicly reporting their Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data in March 2008, and in turn increased patient satisfaction scores. The scores are available on www.hospitalcompare.hhs.gov. Some members of the public are turning to the site to find information for comparing inpatient care in their area. However, according to the report, the larger effect has been that providers are aware of their own and their competitors’ scores, and are putting more effort into delivering patient-centered care as a result.
Have you seen a change in how services are offered, or how your day-to-day shifts occur due to some of the focus areas on the HCAHPS survey?
Another case of hospitals behaving badly
St. Francis Hospital and Medical Center in Hartford CT is the latest facility to make headlines for violating state regulations concerning patient care. The hospital was placed on probation by the Connecticut Department of Health, according to the Hartford Courant. One of the more recent instances involved a heart surgery patient who sustained a brain injury during a May18 surgery. The patient later died on June 18, and on July 2, the hospital stopped offering non emergent cardiac surgeries.
The major problem in this case stemmed from a pump failure with the pump used for cardiopulmonary bypass, according to the Courant. The hospital did not address the pump failure adequately. Specifically, the hospital didn’t report the pump failure to the Food and Drug Administration or the manufacturer or communicate the failure to hospital leaders and other members of the medical staff. Additionally some of those providers involved in the surgery did not participate in a cause analysis, and what I think constitutes the worst offense, the hospital put the pump that failed back into use just three or four days after the incident.
The hospital has issued a statement saying that it has made administrative changes, updated OR procedures, and revised equipment and maintenance protocols. You can find the full article here.
I wrote this post last week about a Rhode Island hospital that was fined by the state’s Department of Health. I know that these two cases are gaining media attention, so that’s not to say that other facilities in their area are not committing similar errors. But in reading the descriptions of how the situations were handled, it seems to me that neither facility really placed much emphasis on learning from their mistakes, which I think is what is most startling.
RI hospital commits fifth wrong-site surgery since January 2007
Staff members at Rhode Island Hospital in Providence, have committed the facility’s fifth wrong-site surgery since January 2007, resulting in a $150,000 fine levied by the state’s Department of Health (DOH), reports The Providence Journal. This is only the second time that the hospital has been fined, the first being after the hospital’s third incorrect neurosurgery occurred in 2007. The latest wrong-site surgery involved a procedure done on a patient’s incorrect finger. In addition, the DOH is requiring that the hospital
- install video and audio monitors in each operating room
- allow a licensed clinical professional who isn’t part of the surgical team to observe every surgery for a year
- adopt the statewide procedure for using safety checklists and marking the surgical site
- summarize each wrong-site surgery since 2005 to send to accrediting and government agencies
- conduct mandatory training sessions for all staff members who work in the operating room to review procedures
Readers, I’m wondering what you, as people who work in hospitals each day, make of this? This hospital, which should have been by all accounts been following the Universal Protocol as well as the state’s guidelines for preventing wrong-site surgery, did not. However, many readers of this blog may know and understand the culture necessary to ensure that the correct steps are taken to prevent a wrong-site surgery. Do you think the requirements made by the Health Department will prove to help this facility sort out its patient safety issues? Do you have any general thought about this instance?
In a related note, the president and CEO of Rhode Island Hospital, Timothy Babineau, MD, has offered to answer questions on the hospital’s Web site through November 9 (not specifically related to this event, but you could get any questions on this topic to him if you so desire).
Please see the Providence Journal article, it does a good job of explaining the story.
Medical device review process to be investigated by IOM
The Food and Drug Administration (FDA) has asked the Institute of Medicine (IOM) to review the current process for approving medical devices, reports the Wall Street Journal. The request comes after the FDA recently came under fire for rapidly approving certain devices. The current process allows device makers to market products without having those products undergo in depth trial testing. Devices can be cleared for marketing as long as they are similar to other devices already in existence. However, the current process is viewed by many as too quick, allowing devices that should not be cleared for use available for use.
The IOM expects its review, which will cost $1.3 million, will run through 2011. The medical device industry defended its practices. It has expected changes, however, since the Obama administration announced changes in leadership at the FDA earlier this year.
AHRQ spearheads effort to bring patient voice into error reporting
The Agency for Healthcare Research and Quality (AHRQ) is leading an effort to give patients a voice in error reporting. I wrote this article for HealthLeaders Media last week, and a longer version will be appearing in the September Briefings on Patient Safety. It discusses how the AHRQ is working with a couple of groups to design a consumer reporting system. 2009 brought us Patient Safety Organizations, formalized reporting opportunities for healthcare professionals, but often missing from the discussion about how medical errors occur is that of the patient. However, patients offer a viewpoint that is unique–one that observes the entire continuum of care. Healthcare providers are at the disadvantage of only knowing what happens when a patient is under his or her care, and not once that patient has moved on.
I spoke with Sue Sheridan, of Consumers Advancing Patient Safety, about her involvement with the project. Sheridan, a woman who has had two major medical errors occur to family members, has been a great voice in helping to design what a consumer reporting system might look like. She, along with 17 other experts that are part of a technical expert panel, are helping to advise and mold a possible consumer reporting system. The project also involves extensively interviewing patients and family members who have been victims of medical errors.
You can read the article by clicking here. What are your thoughts about standardizing a method for collecting consumers’ error reports?
Joint Commission releases latest sentinel event data
Coming off of yesterday’s post about The Joint Commission’s newest Speak Up campaign, which is geared toward preventing medical errors with pediatric patients, today’s post is about the latest sentinel event data released by The Joint Commission. As of June 30, 2009, wrong-site surgery is still the most commonly reported sentinel event, making up 13.4% of all reported events. In the first two quarters of 2009, 53 wrong-site surgeries were reported to The Joint Commission. In 2008, 116 wrong-site surgeries were reported during the entire year, to give you some background.
Close behind wrong-site surgery is suicide for reported sentinel events, making up 12% of all reported events. The top five most frequently reported sentinel events through the first two quarters of 2009 are:
- wrong-site surgery
- suicide
- operative/ post operative complication
- medication error
- delay in treatment
To read the full list, click here. To find The Joint Commission’s Web page about sentinel events, click here.
New bills, initiatives push for greater patient involvement in care
Today’s patients want to have a greater involvement in their care. To that end, both the federal government and several states are pushing forth new legislation to ensure that patients are in fact taking on a more expanded role in the decision-making processes for their care. The Wall Street Journal Health Blog yesterday posted a great summary of some of the initiatives currently in the works. These include:
- The Empowering Patient Choices Act: This federal proposal would form a pilot project to study the effects of shared decision-making.
- Washington State 2007 Law: Requires the study of how cost effective using decision aids are.
- Pending Maine bill: Would require the use of decision aids for patient care as a means of reducing unnecessary care and improving the quality of medical care.
Has your facility taken any action to involve patients more in the decisions concerning their own care?
CNBC hosting healthcare roundtable tonight
I thought readers of the Patient Safety Monitor blog may be interested in a healthcare debate taking place tonight on CNBC at 9 p.m. The debate, moderated by CNBC’s Maria Bartiromo, is between both industry and government leaders. These include Jennifer Granholm, governor of Michigan; Angela Braly, CEO of Wellpoint; Steven Nissen, MD, chairman of the department of cardiovascular medicine at the Cleveland Clinic; J. James Rohack, MD, president of AMA; Michael Milken, chairman of The Milken Institute; John, Lechieiter, PhD, CEO and President of Eli Lilly; and Bill Frist, MD, Professor of Business and Medicine at Vanderbilt University, Former Majority Leader, U.S. Senator.
To find out more, you can click here. The clip below previews the debate.
Public reporting of HAIs included in healtchare legislation
Debate continues surrounding the healthcare legislation that is currently being poured over by members of Congress, report the Washington Post and Wall Street Journal Health Blog. However, one part of the healthcare reform that has not been a sticking point, but is important in the world of patient safety, is the requirement of a national reporting system for healthcare-associated infections. The legislation, HR 3200, would require all hospitals and ambulatory surgery centers to report data concerning healthcare-associated infections to a database that already exists with the Centers for Disease Control and Prevention (CDC).
A group of healthcare organizations sent a letter to Congress today, urging the adoption of HR3200. These groups include The Association for Professionals in Infection Control and Epidemiology (APIC), the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the Council of State and Territorial Epidemiologists (CSTE), and the Trust for America’s Health (TFAH).
The organizations hope that a national database of HAIs, run through the CDC’s National Healthcare Safety Network, would help improve transparency, as well as reduce rates of HAIs, which claim 99,000 lives annually and run up a bill of $20 billion extra healthcare dollars. The groups noted above also want HR3200 amended to include language about antimicrobial resistant organisms.
AHRQ finds nearly 20% of ED patients are uninsured
The AHRQ announced yesterday that a new data analysis of the The Nationwide Emergency Department Sample shows nearly 1 in 5 emergency department patients are uninsured. The data are taken from 2006. Kathleen Sebelius, secretary of the department of Health and Human Services, said that this statistic highlights the burden that uninsured patients are placing on the nation’s emergency system. Faced with no other option for care, uninsured patients use the emergency department for sicknesses that a primary care physician could handle. Additionally, uninsured patients may wait longer to seek care at the emergency department because they have no option for primary care, which exacerbates their health problems.
“Our health care system has forced too many uninsured, rural and low-income Americans to depend on the emergency room for the care they need,” said Secretary Sebelius in a press release. “We cannot wait for reform that gives all Americans the high-quality, affordable care they need and helps prevent illnesses from turning into emergencies.”
Whenever I find data about emergency department usage, I’m never really surprised. But, as Secretary Sebelius says in her above statement, when will the nation take action to fix this problem that has crippled our emergency departments and treated the uninsured as second class citizens? Perhaps legislation we see coming from the federal government in the coming weeks will provide some sort of solution.
