All Entries Tagged With: "adverse events"
AHRQ reports show quality improvement for hospitals, but existing disparities in minority care
The Agency for Healthcare Research and Quality yesterday released two reports that summarize many of the issues with which healthcare professionals and specifically those in quality improvement struggle.
The National Healthcare Quality Report for 2008 highlights strategic areas to measure whether the quality of care in the U.S. is getting better–or not. Although quality within hospitals improves annually by 3%–the most out of all care settings, some of the findings related to patient safety within hospitals are nothing short of a rude awakening:
- One in seven adult patients is the victim of at least one medical error
- Hospital compliance with the six core indicators in the report have declined about 1%
- 40% of all hospital-acquired infections are the result of catheter-associated urinary tract infections
You can find the full report here for futher details. The report details some suggestions for the future, such as standardizing patient safety measures and better collecting patient safety data.
The National Healthcare Disparities Report, also released yesterday, shows that disparities do indeed still exist as far as access to healthcare and quality of healthcare goes. For African Americans, Asians, Hispanics, Alaska natives/ American Indians, and poor people, 60% of quality measures either stayed the same or got worse. Some progress is being made, however, in reducing the occurrence of certain illnesses that disproportionately affect one minority.
Joint Commission releases document on hand hygiene adherence
I’m sure many of you have had trouble not only getting staff members to comply with your facility’s hand hygiene rules, but also measuring their compliance, which can be just as tricky. Do you measure by observing secretly, by surveying staff members, or by product use? Guidance has finally come in the form of a 232-page document released by The Joint Commission yesterday. The monograph offers a more standardized framework to measuring hand hygiene compliance and offers guidance on when, why and how to measure how well staff members are adhering to proper hand hygiene protocol.
The document includes examples of measurement methods, and came to fruition after a two-year collaboration with a number of organizations, including the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), the Centers for Disease Control and Prevention (CDC), the Society for Healthcare Epidemiology of America (SHEA), the World Health Organization (WHO), the Institute for Healthcare Improvement (IHI), and the National Foundation for Infectious Diseases (NFID).
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.