Patient Safety Monitor Journal answers your most important patient safety questions and offers field-tested compliance strategies to ensure your patient safety efforts measure up to The Joint Commission.
As the threat of sepsis intensifies, experts push for a faster response
A deadly infection that has lingered throughout healthcare for the last several decades is finding a foothold at the national level thanks to recently updated definitions that offer clinicians a more targeted approach for detection and prevention.
Although sepsis has existed within healthcare for decades, until recently, definitions surrounding the illness have varied. In recent years, however, sepsis has become increasingly prevalent accompanied by serious complications. According to data collected by the National Center for Health Statistics in 2011, the rate of hospitalizations for sepsis more than doubled between 2000 and 2008. Furthermore, the infection is associated with sometimes shocking death rates. In 2008, just 2% of hospitalizations were for sepsis, but represented 17% of in-hospital deaths.
The true number of sepsis-related deaths varies tremendously. For example, information derived from death certificates indicates that sepsis is the underlying cause in less than 50,000 deaths each year, and one of multiple causes in more than 182,000 deaths each year.
Amid technological and cultural barriers, patient-reported outcomes poised to make a splash
A quality measurement that focuses on patient symptoms and overall quality of life is poised to take on a greater role in patient safety. In some parts of the country, it already has.
Patient reported outcomes (PRO)?defined by the National Quality Forum (NQF) as "any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else"?have been generally underutilized by the healthcare industry. According to a survey published by HealthCatalyst in August, fewer than two in 10 hospitals use PROs even though the measurement can provide a new and valuable perspective into each patient's condition and, when adequately tracked, offer a more detailed look at the potential for quality improvement within specific areas of care.
Payers and providers overcome distrust to create quality improvement partnerships
Historically, insurers and healthcare providers haven't had the most harmonious relationship. Competing business interests typically left representatives from each industry on opposite sides of the table.
In fact, Greg Maddrey, a director with The Chartis Group and leader of the firm's Value-Based Care group in Chicago, refers to the sometimes contentious relationship as a "war"?one that stretches back 30 to 40 years and includes any number of perceived slights that can fuel a decades-long grudge.
At the same time, healthcare providers are entering into structured quality partnerships that take aim at reducing healthcare costs and improving patient outcomes. This growing trend is due in part to the industry's push toward value-based payments, but it's also fraught with potential roadblocks, many of which stir up old feelings around long held dynamics.
Four years after fungal meningitis outbreak, compound pharmacy safety concerns linger
In 2012, a fungal meningitis outbreak was linked to the New England Compounding Center (NECC) in Framingham, Massachusetts, that would eventually lead to more than 750 infections in 20 states and 64 deaths, according to the CDC.
The publicized outbreak thrust compounded medicine into the public eye, prompting many facilities and states to review oversight of quality and safety.
But four years later--and three years after the federal government finalized a law that placed tighter restrictions on the compounding industry--state oversight varies considerably and safety concerns still linger among compounded medications.
The next wave of patient safety? High reliability
Healthcare experts say the industry may have squeezed all it can from technological advancements and standardization, giving way to a new patient safety movement that will shift the focus toward high reliability.
Four patient safety experts from Johns Hopkins University and the University of Michigan outlined this patient safety trajectory in an article for the Harvard Business Review in August (https://hbr.org/2016/08/the-next-wave-of-hospital-innovation-to-make-patients-safer). The authors identified three distinct waves (technological advancements, standardizing procedures, high reliability organizations) of patient safety and quality improvement dating back to the 1980s and pinpointed new, emerging shifts in care practices in which hospitals will focus on ways to organize the approach to patient care to improve outcomes while making cultural changes aimed at changing clinician behavior.
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