Healthcare gets a social media makeover

Are you a Twitterer? Can’t get through the day without constantly posting and reading “Tweets” on your mobile device? Yeah, me neither.

But an increasing number of folks are hooked on the social media network, which allows users to send out quick, 140-character updates on what they’re doing and what they’re interested in. Twitter and other forms of social media like blogs, instant messaging, and video chat are also ways for doctors and patients to stay in touch on a more regular basis.

Twitter’s also making inroads into healthcare, with the advent of small group practices like Brooklyn’s Hello Health, which allows patients to “visit” doctors online as well as in person. The practice started a year ago and already has 300 enrollees and just opened a second office last month.

There are valid concerns being raised about patient privacy being violated by physician blog posts and Tweets, but in general, the incorporation of social media into healthcare is seen as a good thing. What do you think?

Positive Deviance proven to lower MRSA rates

The Robert Wood Johnson Foundation and Plexus Institute today announced the results of a Positive Deviance program, trialed to see the effects it had on MRSA rates. The story caught my eye because I’ve written a couple of stories about Positive Deviance for Briefings on Patient Safety in 2007 and 2008, and the idea always struck me as something so simple, yet so empowering. Positive Deviance solicits ideas for solving a problem from those who deal with that problem often and may think of a solution that might be considered “out of the norm,” but one that works. It’s an approach that attempts to gather behavioral change from those frontline workers who solve problems with the same resources as their peers.

Using Positive Deviance to lower MRSA rates has succeeded, as it was announced at the annual scientific meeting of the Society for Healthcare Epidemiology of America this past weekend. The study began in 2006 and introduced the idea of Positive Deviance into three hospitals from different parts of the country. Each hospital was to use Positive Deviance to help carry out the following three actions:

• screening all patients admitted to a pilot unit for MRSA
• isolating all patients who tested positive
• rigorously adhering to hand hygiene and contact precautions

A team from the Centers for Disease Control and Prevention analyzed the data from these facilities to show a reduction in MRSA rates between 26 and 62%.

This video clip from CBS News shows how one transporter helped his hospital adhere to hygiene and contact precautions (sorry about the commercial before the news).

Could this technique be something your hospital implements? Have you thought of using Positive Deviance for tackling other issues at your facility, not just MRSA?

You can find out more about Positive Deviance by visiting the Positive Deviance Initiative Web site.

Press Ganey report assesses culture of safety

The Patient Safety and Quality Healthcare Web site posted news yesterday on Press Ganey Associates, Inc.’s recently released report on the culture of safety that had some interesting finds in it. Though it was released a week ago in conjunction with Patient Safety Awareness Week, I thought Patient Safety Monitor readers would find this Safety Culture Pulse Report worthy of note.

Data was collected from 42,378 healthcare employees, and gives insight into what your staff might be thinking. Here are some of the results:

• New employees (those who worked less than one year at a hospital) reported the highest level of safety focus in their hospital; veteran employees (six to 10 years of employment at a hospital) had the lowest sense of safety.
• Similarly, employees who worked fewer hours a week (less than 20) reported the highest sense of a focus on safety; employees with 60 hours per week or more under their belt had lower perceptions of safety focus at their hospital.
• As the size of the facility increases, healthcare providers’ perception of safety decreases.
• Biggest threats to patient safety culture, according to employees, are assessing blame for medical errors instead of addressing system failures and mistakes made during patient handoffs.

PSM readers, as always, please share any comments on these findings. Anything surprise you here?

Joint Commission releases more FAQs

The Joint Commission has released another set of FAQs, this time addressing some emergency management, environment of care, and Universal Protocol concerns. Though you can see the full list of FAQs by clicking here, I’m going to highlight the FAQs for the Universal Protocol, as it most relates to patient safety, has been a major trouble spot for hospitals, and is a topic we’ve talked about in other Patient Safety Monitor Blog posts.

• Bilateral procedures: The Joint Commission has addressed the issue of performing site marking for a bilateral procedure by saying it’s not required, but it is recommended. The intent of the Universal Protocol has been to specifically note the correct side of the patient for those surgeries requiring laterality, but this new FAQ was released in acknowledgement that it is possible to perform the wrong bilateral procedure.
• Documenting the timeout: The Joint Commission has addressed the outcry it received from the field about how onerous a requirement it was to require each element of the timeout be documented individually. This FAQ specifies that it is acceptable to create a check box or brief note that documents that all parts of the timeout were completed. This simple documentation must be in the same part of a patient’s record for each patient, and the components of the full time out have to be listed elsewhere (like in a policy or procedure), but one check box will comply with the Universal Protocol.

Has your facility struggled with the 2009 Universal Protocol? Do these recent FAQs clear up any issues you may have been having with documentation?

NQF urges adoption of Safe Practices

The National Quality Forum this week rolled out its 2009 Safe Practices for Better Healthcare, a series of 34 evidence-based practices including catheter-associated urinary tract infection, multidrug-resistant organisms, and organ donation.

To get the word out, the NQF is launching a year-long webinar series will begin in April to provide Safe Practices implementation strategies and commentary from experts in the field. The practices are based on six years of work defining and refining strategies to improve patient safety. Several previously endorsed practices were updated based on new evidence, including practices in areas such as the pharmacist’s role in medication management and pressure ulcers, and an entire chapter on healthcare-associated infections.

You can download the report here.

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.

Patient Safety Awareness Week starts March 8th

As many of you may know, Patient Safety Awareness Week is coming up, beginning on Sunday March 8 and running through Saturday March 14. This annual observance, sponsored by the National Patient Safety Foundation (NPSF), serves as a great opportunity for hospitals to not only offer unique and creative patient safety-related programming, but it provides a chance for hospital staff members to connect with the outside community to emphasize patient safety.

This year’s theme, “A Prescription for Patient Safety: One Partnership, One Team” highlights this need to better involve patients in their own care. If you visit the NPSF’s Patient Safety Awareness Week web site, you’ll find a host of suggested activities for patients, staff members, and other community members to take part in as a means of building awareness about patient safety topics. The NPSF also just announced the release of a Universal Compact, which is aims to foster clearer lines of communications among patients and their clinicians.

“The Universal Patient Compact is an evolution of the concept of the Patient’s Bill of Rights,” said Diane Pinakiewicz, MBA, president of the NPSF in an interview. “It will focus on the patient and provider working together as a team. We want to get the patient’s voice inside the provider team, and build a partnering between the parties.”

The Association for Professionals in Infection Control and Epidemiology (APIC) has also released some helpful reminders specifically for those people visiting hospitalized patients in honor of the week. Some of these include:

• Sanitize hands before and after your visit
• Stay home if you’re sick
• Before you bring the kids, flowers, or food, check to make sure they are allowed
• Don’t contribute to the clutter by bringing unnecessary personal items

Click here to find the full list.

I know lots of facilities use Patient Safety Awareness Week as a chance to host hospitalwide events that focus on keeping patients safe and engage both staff members and community members in creative ways. What is your hospital doing? What have you been a part of in the past as far as event programming?

Sebelius chosen to replace Daschle as HHS secretary

For those anxiously awaiting President Obama’s second nomination for Secretary of Health and Human Services (HHS), the wait is over. The governor of Kansas, Kathleen Sebelius, democrat, is the president’s next choice for the position. Sebelius, who we mentioned earlier in this Patient Safety Monitor Blog posting as a possible candidate as secretary of HHS, has a track record of working closely with health insurers in her home state. In fact, prior to working as the governor, Sebelius served as Kansas’ state insurance commissioner. Her nomination has received praise from both republicans and democrats alike. Unlike Obama’s first nomination for HHS secretary, Tom Daschle, Sebelius will not serve as both HHS secretary and “healthcare czar,” a position that will specifically focus on reforming healthcare.

Should Sebelius be confirmed, she will have a lot on her plate as soon as she starts. A commissioner of the Food and Drug Administration has yet to be named, mostly because of the delay in confirming an HHS secretary. Known for her pro-abortion and stance and bipartisan policies, Sebelius successfully blocked the sale of Blue Cross Blue Shield of Kansas to Anthem Inc. because she said it would have raised insurance premiums for residents of the state.

You can read more about Sebelius in these articles from the Wichita Tribune and New York Times.

Do you have any initial thoughts about President Obama’s choice?

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:

1. Wrong-site surgery
2. Suicide
3. Op/post-op complication
4. Medication Error
5. 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.

AHRQ announces states involved in CLABSI prevention project

The Agency for Healthcare Research and Quality (AHRQ) has decided which states will participate in its $3 million grant for preventing central line-associated bloodstream infections (CLABSI) in intensive care units (ICU). This press release from the AHRQ caught my eye because I wrote a story for Briefings on Patient Safetywhen this program was announced. The program will model similar prevention efforts after the Johns Hopkins University and the Michigan Hospital Association’s project that reduced these types of infections in 100 Michigan ICUs. The states announced to be involved in the study are California, Colorado, Florida, Massachusetts, Nebraska, North Carolina, Ohio, Pennsylvania, Texas, and Washington.

The goal for these states is to reduce CLABSI by 80%. Currently, the rates of infection nationally are five per every 1,000 patient days. The Michigan program set the bar high, and is the reason for replication on a broader scale. Within three months there, infection rates in more than half or participating ICUs dropped to 0%.

It seems that there was so much interest in participating in the study that the AHRQ had to turn interested states away. However, it says that the Johns Hopkins Quality and Safety Research Group has received some additional private funding to involve some of those states.

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