Saturday, November 17, 2012

A Message from America’s Hospitals
It may seem a strange principle to enunciate as the very first requirement in a Hospital that is should do the sick no harm.
Florence Nightingale (1820-1910), Notes on Hospitals (1850)
November 18, 2012 - I have never commented on an advertisement before  but an ad in the November 15 WSJ, written by Rich Umbdenstock, President and CEO, American Hospital Association, deserves comment.
“America’s hospitals are working smarter every day.  Faced with the daunting challenge of delivering biter, sifter care at the same time they tackle costs, hospitals are aggressively amassing knowledge and forging new connections.  And they are putting it all to work for patients.”
“Hospitals have tapped into the expertise of industry to identify safer and more efficient ways to deliver care.  It’s allowed them to develop checklists so that caregivers consistently take the right steps, backed by science.  A recent report found participating g hospitals consistently delivering every critical aspect of care measured for heart attack, heart failure and pneumonia patients more than 96 percent of the time.”
“By reengineering the say clinician’s work together with their patients, hospitals have dramatically reduced some preventable infections. More than 1,000 hospitals participating in one project reduced central line-associated in adult intensive care units by 40 percent over four years, saving more than 500 lives and $534 million in health care costs.  Similar techniques are being used to help patient avoid trips and falls and to make hospitals safer for patients, their families and workers.”
“Drawing on the knowledge of the retail distribution  and customer service sectors,  hospitals are using bar codes to track  mediations and tests, and electronic health records so share knowledge and proven duplications of services.  About 90 percent of hospitals now use technology to check for drug interactions and allergies when medications are ordered, a major step in cutting medication errors.”
“Innovation, coordination and continuous improvement in the quality of care – that’s how hospitals are reinventing health care. “
Comment:   Hospitals remain dangerous places, for it is there elderly fragile patients and terminal cancer patients with compromised immune systems. many with antibiotic  resistant infections,  are concentrated.  And it is there patients are often discharged quicker and sicker to avoid Medicare payments for overstaying their time due to Diagnostic Related Group requirements, only to re-admitted even sicker.  But in no small part to a 1999 Institute of Medicine report “To Err is Human, “ reporting hundreds of thousands of prevenatable  deaths and  Doctor Donald Berwick’s campaign to save 100,000 lives,  hospitals are working harder to save lives, often through such rudimentary ways as frequent hand washing and frequent  catheter checks and changes,  hospitals are safer.  There are other safety measures as well, such as the hiring of full-time hospitalists.   It may also be as hospitals have more doctor employees,  coordination of care will be more practical.   Finally,  more procedures and  therapy is being provide outside hospital walls in outpatient settings where the likelihood of hospital-acquired infections and complications is less.

Tweet:  Due to efforts to avoid infections, computer use  to track drug interactions, and handwashing and other techniques,  hospitals are safer.   

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