All Entries Tagged With: "studies"
ED interpreters improve satisfaction
Patients in the ED are often distressed and on edge. It’s well noted that communicating with the patient, whether that means telling them the expected wait time or giving explicit discharge directions, is one of the best ways to increase patient satisfaction. But when the patient does not speak fluent English, good communication can be harder to come by.
A new study shows just how important that communication is by surveying patients who received professional on-site interpreters in the emergency department. Out of these 242 patients, 96% were “very satisfied” with their ability to communicate during the ER visit, compared to 24% in the control group. The study, Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients with Limited English Proficiency: Results of a Randomized Controlled Trial, also showed that clinicians who worked with the patients with professional on-site interpreters were on average more satisfied.
Consumers Union says healthcare lacks progress in reducing medical errors
It’s been 10 years since the Institute of Medicine (IOM) published its groundbreaking report To Err Is Human, which detailed the need for reform in healthcare. The report, published in 1999, estimated that 98,000 American die every year from preventable medical errors.
Ten years later and the Consumers Union has issued a new report, To Err is Human-To Delay is Deadly, its own version of the current state of progress in reducing preventable medical errors. Director of Consumer Union’s Safe Patient Project Lisa McGiffert said there’s little evidence to suggest much progress has been made, yet billions of dollars have been spent. She says the U.S. healthcare system failed to adopt the reforms recommended by the IOM in 1999. [more]
C. difficile elimination tougher than previously thought
Tough news for infection control officers. A study presented at the Society for Healthcare Epidemiology of America Annual Scientific Meeting found that Clostridium difficile (C. difficile) is harder eliminate from hands and surfaces than previously believed, according to report by Medscape.
The study found that sticky C. difficile spores stick on hands, and that most hand-hygiene products (rubs and soaps included) do not get more than 90% of the spores off hands. Senior author Dale Gerding, MD, said the results prove the importance of using gloves when in contact with patients to protect against C. difficile when caring for a C. difficile-infected patient, and to pay attention to environmental cleaning.
New research finds electronic prescribing saves time, money
Talk about efficiency: new research shows that electronic prescribing systems, on average, reduced the time required for a provider to place an order from 41.2 minutes to 27 seconds. In a study published in the May issue of the Journal of the American College of Surgeons, researchers found that electronic prescribing might improve quality of care through drastically improved prescribing efficiency.
The research is timely, as the Institute of Medicine has called for the use of electronic prescribing systems in all healthcare organizations by 2010. Though rates of medication errors in the study were not greatly affected, the greater efficiency, as well as the fact that personnel no longer needed to clarify and transcribe written orders into an accessible format, may free up time to focus on better quality of care, according to the study’s press release. It also saves money-the implementation of the systems eliminated 11 positions out of 56 at the Mayo Clinic Hospital where the study took place.
Do you have electronic prescribing? Why or why not? If you do, what do you think of it?
About one-third of surgeons suffer from burnout, study suggests
A new study in the Archives of Surgery has found that 30 – 38% of surgeons across the country suffer from burnouts, according to a piece in Wall Street Journal’s Health Blog.
The study suggests that younger surgeons and female surgeons are at especially high risk for stress and burnout, and found that a number of factors lead to its cause, including:
- Length of training
- Long hours and large workloads
- Imbalance between career and family
- Feeling of isolation
- Grief or guilt over patient death
- Insufficient research time and funding
- High self-imposed expectations
- An inefficient and/or hostile work environment
The study describes an attitude among surgeons that long hours and heavy workloads are expected and emotional responses are not, which researches say feeds stress and burnouts. The study concludes that being overworked is counterproductive and leads to self-destructive behavior that may affect quality of care.
Update to IHI Surgical Sprint post on 3/31
I wanted to clarify some of the information I had in my original posting about the IHI’s Surgical Sprint, posted on March 31. I originally stated that the modified checklist that combined the World Health Organization (WHO) checklist with some of the requirements in the Universal Protocol was developed by the IHI- I was wrong about that. The IHI posted that modified “USA” checklist to its Web site, but it was created by a team of people at the WHO during the IHI’s National Forum in December 2008.
Additionally, although there has been concern about Joint Commission-accredited hospitals using either the Universal Protocol requirements or the WHO checklist, they are meant to work in harmony. The intention of the WHO checklist was not to make hospitals choose between one or the other, but rather to offer hospitals guidance in making their surgeries safer and integrate with existing processes. Because the Universal Protocol covers many elements of the process prior to surgery that the WHO checklist does not, the two will not match up. The modified checklist can help American hospitals integrate the WHO checklist with certain steps of the Universal Protocol.
I apologize for these errors, and hope this posting clears up any questions.
Please see the IHI’s Surgical Checklist Sprint Web page for many resources on the topic.
IHI’s Surgical Checklist “Sprint” ends April 1
Announced at the Institute for Healthcare Improvement’s (IHI) National Forum in December 2008, the Surgical Checklist Sprint asked all hospitals in the country to institute the World Health Organization’s (WHO) surgical checklist in one operating room. The goal was to have this done by April 1, 2009, and to then measure the effects. The IHI has a resource page on it’s Web site where those interested in the initiative can find a map of those hospitals participating.
The “Sprint” was bolstered by an article published in the New England Journal of Medicine in January that the WHO checklist had been tested at hospitals in eight major cities around the world and lowered the rate of death and complications due to surgery by one third.
There has been some controversy about how the WHO’s surgical checklist does not line up exactly with what The Joint Commission requires in its Universal Protocol. Some members of the field felt they had to choose to use one or the other and possibly worry about the consequences during a Joint Commission survey. Some comments on the IHI’s Surgical Sprint blog highlight this topic.
The intention of the WHO checklist was not to make hospitals choose between one or the other, but rather to offer hospitals guidance in making their surgeries safer. Because the Universal Protocol covers many elements of the process prior to surgery that the WHO checklist does not, the two will not match up. However, a team from the WHO met at the IHI’s National Forum and created a “USA” version of the checklist that has been modified to help American hospitals integrate the WHO checklist with certain steps of the Universal Protocol. You can find this checklist here.
Has your hospital participated in IHI’s Sprint?
Doctor and nurse cell phones contaminated with MRSA, other bacteria
Here’s something to think about before answering that call: After testing the cell phones of 200 doctors and nurses working in ORs and ICUs, researchers in Turkey found that 95% of cell phones tested had bacteria on them, according to redOrbit news service.
Researchers from the Ondokuz Mayis University in Turkey published the study in a recent issue of BioMed Central’s Annals of Clinical Microbiology and Antimicrobials. The study found that one out of every eight cell phones showed traces of methicillin-resistant Staphylococcus aureus (MRSA). It also found that only 10% of staff members regularly cleaned their phones. Researchers worry that phones could help spread infections to already sick patients.
Joint Commission releases top sentinel events
In its March issue of Perspectives, The Joint Commission published an update of its top 10 most reported sentinel events. At the top is wrong-site surgery, with 741 cases reported. Out of these reported events, 69% of patients died. The top five events are:
- Wrong-site surgery
- Suicide
- Op/post-op complication
- Medication Error
- Delay in treatment
In the same issue, The Joint Commission listed its top compliance issues for hospitals. At the top is EC.5.20 (ensuring environment complies with the Life Safety Code©). Second is National Patient Safety Goal 2C, (referred to now as NPSG.02.03.01) on the reporting of critical test results. The rest of the top noncompliance standards focus mainly on information management, medication management and environment of care.
New Jersey hospitals feeling economic pinch
New Jersey hospitals, like many across the nation I would assume, are feeling the effect of a dwindling economy. Layoffs, delays in capital improvement projects, and more charity-care patients are a few of NJ hospitals’ woes, according to a report in the Philadelphia Business Journal. The New Jersey Hospital Association conducted a survey over the last two months involving 74 of New Jersey’s acute-care hospitals. Key findings include:
- 45 hospitals reported layoffs in 2008
- 21% anticipate layoffs this year
- 13% have instituted a hiring freeze
- 17% eliminated services such as clinics and inpatient psychiatric care
- 76% saw in increase in emergency department visits
Not surprisingly, the New Jersey Hospital Association says the cuts are affecting patient care. I’m guessing this is just an example of what’s happening across the nation. I’m curious to know how the economy is affecting your hospitals. How are cuts affecting patient care? How are they affecting you? Has your hospital managed to stay afloat, and how? What are you concerns for the upcoming months?
