Fwd: HEALTH TIPS FROM REDFLAGSDAILY.COM, OCTOBER 21, 2003

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Tue, 21 Oct 2003 09:17:43 -0700

HEALTH TIPS FROM REDFLAGSDAILY.COM, OCTOBER 21, 2003

 

" Nicholas Regush "

 

 

TUESDAY, OCTOBER 21, 2003

 

REDFLAGSDAILY.COM

 

GO TO FLASH! NEWS

 

JUST ONE CLICK TO THE SPECIAL EXTRA! PAGE AT RFD

 

HEALTH TIPS

 

HELPING TO PREVENT MEDICAL INJURIES IN HOSPITALS

 

A study published this week in the Journal of the American Medical Association

concluded that in the U.S. " medical injuries incurred by patients while in

hospital result in longer hospital stays, increased hospital charges, and more

than 30,000 deaths each year. "

 

That’s likely the tip of the iceberg, given the inexact methods hospitals use in

tabulating problems.

 

Note that in the article cited below that there has been very little information

on the impact of hospital injuries. Isn’t this insane? In a so-called advanced

health care system?

 

And obviously medical errors are not limited to U.S. hospitals.

 

 

 

One of the researchers had this to say: " We need more research to identify why

medical injuries occur and find ways to prevent them from happening. "

 

Here are some very basic and important reasons why accidents likely occur — and

these points should guide research if the medical community has the guts to do

so because it would mean significantly restructuring the hospital environment:

 

The absence of doctors on wards. In some cases, surgeons who are almost

always doing surgery have little or no time to look in on " their " patients.

The emphasis on medical crisis management rather than prevention. This is

what happens when doctors show up on wards for quick and dirty look-ins on

" their " patients.

The shortage of nurses. Again crisis management reigns. Hard-pressed to meet

basic needs, relatively little thought is given to watching signs indicating

problems may be brewing.

 

For starters, every ward should have a doctor on duty and in charge 24 hours a

day. Someone who will respond to the kinds of detailed care that patients

require and who can order treatments on the spot, rather than have patients wait

for hours for " their " doctors to show up. And when these doctors do show up,

they should not have the authority to overrule the doctor in charge of the ward.

 

Meanwhile, here are some suggestions for anyone who is about to be admitted to

hospital. Family members and friends, if they care enough, and if they can find

the time, should also take note:

 

Don’t assume for a moment that the hospital staff can take adequate care of

the patient. To think so is to bury your head in the sand.

Make plans, if possible, to have regular visitors — family and friends —

including some " take-charge " person who will ask detailed questions about the

kind of care that is required and also try to determine if it is being provided.

This also means confronting absentee doctors who think they can waltz into the

ward for a few minutes and go back to their " real " work.

Make sure that a friendly but nonetheless aggressive position is adopted by

the " take-charge " person and family members and friends. Milk-toasts need not

apply. They can buy the flowers.

Demand regular family meetings which include everyone involved in the

patient’s care. This is a good time to raise questions, coordinate care and air

grievances.

Have someone keep a check list of the patient’s " management plan. " And the

" take-charge " person should become aggressive when some elements of the plan are

not addressed (such as changing bandages or removing catheters, etc).

Since medication errors are all too common, someone needs to periodically

check with the nursing staff to determine why certain drugs are being given and

if drugs have been added to the schedule. Do not let the hospital change

medications without providing a rationale for this change. Nothing should be

done without proper surveillance.

 

The above is a list of " tips " that should be taken very seriously. Life is at

stake. This is not time to wash your hands of the kind of preparation and

diligence required when someone is in hospital.

 

And get rid of these foolish programmed notions that you are going into a

" great " hospital or that your doctor " is terrific " or that the staff is

" wonderful. " Maybe they are all what you think — but do not take that chance

with your life or the life or a family member or friend.

 

The system will not likely repair itself and will only require help from people

like you.

 

Of course, you can only do what is possible, but a little ingenuity and

determination can go a long way.

 

MEDICAL INJURIES IN U.S. HOSPITALS

 

 

 

-Nicholas Regush

 

http://bmj.bmjjournals.com/cgi/content/full/327/7420/887

Medical injuries in US hospitals cause more than 30 000 deaths each year

Susan Mayor

 

London

Medical injuries incurred by patients while in hospital result in longer

hospital stays, increased hospital charges, and more than 30 000 deaths each

year, a study published this week says ( JAMA 2003;290: 1868-74[Abstract/Free

Full Text]).

The study analysed patient safety indicators—measures recording incidences

related to patient safety while in hospital—from the Agency for Healthcare

Research and Quality to identify medical injuries in 7.45 million hospital

discharge abstracts from 994 acute hospitals across 28 states for the year 2000.

This was equivalent to a 20% stratified sample of non-federal acute hospitals in

the United States.

Results were assessed for the impact of medical injuries on length of hospital

stay, hospital charges, and deaths attributable to medical injuries during

hospitalisation, although the researchers noted that their findings were likely

to represent an underestimate compared with other reporting systems for medical

injuries.

Results showed that postoperative sepsis—which was recorded in 2595 patients—had

the biggest impact, resulting in hospital stays of almost 11 days longer than in

patients without this complication. This increased charges by $57 727 (£34 700;

€49 000) per patient and the risk of death after surgery by 21.9%.

On the basis of these findings, the researchers estimated that about 3000

Americans died each year due to postoperative sepsis. The next most serious

medical injury was postoperative reopening of a surgical incision, resulting in

an average increase in hospital stay of 9.4 days, $40 323 in added charges, and

a 9.6% increase in the risk of death. Infection due to medical care was

associated with 9.58 extra days of hospital stay, $8656 in excess hospital

charges, and 4.31% attributable mortality.

Carolyn Clancy, director of the Agency for Healthcare Research and Quality,

said: " This study gives us the first direct evidence that medical injuries pose

a real threat to the American public and increase the charges of health care.

The nation's hospitals can use this information to enhance the efforts they are

already taking to reduce medical errors and improve patient safety. "

One of the research group members, Chunliu Zhan, also from the agency, added:

" Although medical injuries are recognised as a major hazard in the healthcare

system, there has previously been little information on their impact. This study

shows that some injuries incurred during hospitalisation pose a significant

threat to patients and costs to society. We need more research to identify why

medical injuries occur and find ways to prevent them from happening. "

In an accompanying editorial in JAMA (pp 1917-9), Saul Weingart, assistant

professor of medicine, and Lisa Iezzoni, professor of medicine, both from

Harvard Medical School, Boston, argued that clear measures and definitions of

medical injuries were needed before the problem could be improved. They

suggested that developing and validating a robust set of measurement tools was

essential to " move patient safety information out of the shadows and into the

light, " pointing out that these should focus on preventable injuries in order to

be maximally useful.

 

 

 

 

 

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