5 Stories You Need: Helping Second Victims RISE, War on Sepsis

We know you’re busy, but we don’t want you to miss important healthcare quality and patient safety news. Here’s a roundup of stories you may have missed but need to take a look at before calling it a week. (Subscribe today if you’d like these news alerts delivered to you.)

  1. Supporting ‘Second Victims’ Also Helps Hospital Budgets
    Read about the Resilience in Stressful Events (RISE) team that clinicians at Johns Hopkins Hospital developed to provide emotional support to colleagues following medical errors, near misses and other worrisome patient events. Armstrong Institute – Voices for Safer Care
  2. Hospitals Ramp Up Hyperbaric Therapy For Diabetics, Despite Concerns
    The American Diabetes Association does not support the use of hyperbaric therapy in treating diabetic wounds. Some experts even say that doing so is more about a hospital’s desire to receive Medicare revenue than following a protocol that really works. Kaiser Health News
  3. Patients With Mental Disorders Get Half Of All Opioid Prescriptions
    A new study published in the Journal of the American Board of Family Medicine shows that nearly 19 percent of Americans with mental health illness use prescription opioids. Access the study and read why researches say we need a new approach for addressing these vulnerable patients’ needs. Kaiser Health News
  4. To err is human. To speak up? It depends, study says
    A new study published in BMJ Quality & Safety shows residents are more likely to speak up when they witness a safety breach made by a nurse or peer than one committed by an attending physician. That’s why, according to the study’s authors, a true culture of safety can only exist in an environment where leaders at the highest level encourage and support speaking up.  AMA Wire
  5. The New War On Sepsis
    Sepsis is the leading cause of death in hospitals in the United States, according to Sepsis Alliance, a nationwide advocacy group based in San Diego. More than 1 million people get severe sepsis each year in the U.S, and up to 50 percent of them die from it. It is also one of the most expensive conditions for hospitals to treat, costing $24 billion annually. Kaiser Health News

 

4 Stories You Need: Overlapping Surgeries, Handshake-Free Zones, Good Catch Awards

We know you’re busy, but we don’t want you to miss important healthcare quality and patient safety news. Here’s a roundup of stories you may have missed but need to take a look at before calling it a week. (Subscribe today if you’d like these news alerts delivered to you.)

  1. Virginia Mason to inform patients about overlapping surgeries
    Seattle’s Virginia Mason Medical Center will soon begin including a one-page form in its consent-for-surgery process to make patients aware of the chances of overlapping procedures. The Seattle Times
  2. Handshake-Free Zone: Keep Those Hands — And Germs — To Yourself In The Hospital
    According to the Centers for Disease Control and Prevention, 1 in 25 patients across the United States contracts a hospital-acquired infection each day. While most hospitals promote better hand hygiene protocols in combating these outbreaks, UCLA has opted to turn its focus toward elimination of a time-honored greeting.Kaiser Health News
  3. Hospitals Now Tap Lawyers To Fulfill Patients’ Legal Needs
    Understanding that legal issues often develop into problems that result in poor medical outcomes, more hospitals are including attorneys in the teams of professionals made available to assist patients. Kaiser Health News
  4. ADNPSO Presents Inaugural Good Catch Awards to Arkansas Clinicians
    American Data Network Patient Safety Organization (ADNPSO) named the first two recipients of the Good Catch Award, being presented quarterly this year to outstanding Arkansas clinicians participating in ADNPSO’s statewide near miss campaign. ADN News Blog

ADNPSO Presents Inaugural Good Catch Awards to Arkansas Clinicians

American Data Network Patient Safety Organization (ADNPSO) named the first two recipients of the Good Catch Award, being presented quarterly this year to outstanding Arkansas clinicians participating in ADNPSO’s statewide near miss campaign.

The Good Catch campaign, which aims to help hospitals foster a growing culture of safety by encouraging the recognition and reporting of potential risk, is based on the belief that a near miss or close call reported today can prevent an error from happening tomorrow. The campaign offers participating organizations opportunities to significantly increase near miss reporting, reveal process and system vulnerabilities, and develop and implement proactive data-driven improvement activities.

Chloe Baldwin with her unit team, left to right: Ginger McEarl, RN, Patient Care Manager; Angela Scott, APRN, Clinical Nurse Specialist; Chloe Baldwin, RN; Bailey Williams, RN; Heather Kreulen, RN, Nursing Director; and Crissy Benson, RN, Clinical Educator.

Chloe Baldwin, BSN, RN at Arkansas Children’s Hospital received the Individual Good Catch Award for the campaign’s first quarter. Baldwin demonstrated courage and persistence when she raised questions and concerns after a patient’s physical assessment. Her tenacity led to further diagnostic testing and ultimately to changes in the patient’s care plan. Baldwin’s Good Catch has been shared hospital wide and incorporated into employee safety trainings as an exemplary illustration of situational awareness and advancement of error prevention techniques.  

Dr. Don Howard with leadership, left to right: Stacey Matthews, Quality/Safety Coordinator; Beth Murff, Director of Patient Safety; Dr. Don Howard, Intensivist; Emily McGee, Director of ICU; and Michael Givens, Administrator.

Don Howard, MD, an intensivist with St. Bernards Medical Center in Jonesboro, received the Physician Good Catch Award for the first quarter. Dr. Howard’s Good Catch came during a thorough review of medication orders prior to a patient’s transition to a lower level of care. He expressed concern when he found no documentation for discontinuing a high-risk medication restricted to use in the intensive care unit. Dr. Howard’s Good Catch prompted a hospital-wide gap analysis of verbal order practices especially those in high-risk areas such as the emergency department and ICU. In addition, SBMC added an electronic trigger within its medical record system to force a review of high-risk medications during transitions of care to help mitigate human error.

Because empowering hospital staff to speak up stands as one of the most impactful ways of fortifying a trustworthy organizational culture of safety, ADNPSO will recognize individual clinicians and departments demonstrating outstanding efforts to drive change and enhance patient safety on a quarterly basis throughout its year-long Good Catch campaign.

The Good Catch campaign is endorsed by the Arkansas Hospital Association, Arkansas Health Executives Forum, Arkansas Organization of Nurse Executives, Arkansas Association for Healthcare Quality and Arkansas Foundation for Medical Care.

To learn more about the Good Catch program, click here.

 

 


American Data Network PSO, established in 2009, was the first federally designated Patient Safety Organization established in Arkansas and authorized to work with hospitals to improve patient care through voluntary reporting of patient safety events and professional analysis of shared data.

 

 

6 Stories You Need: Using Time to Treat Patients, Why Sepsis Checklists Save Lives

We know you’re busy, but we don’t want you to miss important healthcare quality and patient safety news. Here’s a roundup of stories you may have missed but need to take a look at before calling it a week. (Subscribe today if you’d like these news alerts delivered to you.)

 

  1. Health Care Providers Must Stop Wasting Patients’ Time
    Researchers at Kaiser Permanente are innovating to create a care system in which every workflow is created for, and with, patients in mind. For instance, they predict that 50 percent of their elective hip and knee surgeries will not require an overnight stay in the hospital —  meaning more clinician time will be devoted to real patient care. The authors’  final paragraph provides compelling testimony as to why. Harvard Business Review
  2. ‘Rory’s Regs’ on sepsis require hospital checklists, save lives
    A report in the New England Journal of Medicine shows that swift use of a sepsis checklist paired with appropriate administration of antibiotics, the better chance a patient has of surviving sepsis. USA Today    Plus, to download ADN’s free Sepsis Tipsheets, click here.
  3. Putting A Lid On Waste: Needless Medical Tests Not Only Cost $200B
    Financial incentives and fear of malpractice litigation continue to fuel physician orders of duplicated lab tests, unnecessary preoperative testing and even risky surgeries or procedures. Read how initiatives like the Choosing Wisely campaign are helping clinicians reverse this trend while preventing harm and cutting costs. Kaiser Health News
  4. Report Targets Health IT-Related Patient Safety Problems
    Access a new report released by the Bipartisan Policy Center that explores the relationship between patient safety and health IT and suggests actions steps that providers, policymakers and health IT developers can take to strengthen it. EHRIntelligence 
  5. Obstacles to Patient Safety
    Link to a series of 13 brief blog posts, each  which suggests a compelling reason why improving patient safety may be much harder than one might assume. PatientSafe Network
  6. DeSalvo: Interoperability crucial to patient safety
    Former assistant secretary for health and national coordinator for health IT, Karen DeSalvo, MD, recently discussed cultural changes, including more engaged, tech-savvy patients, that are impacting interoperability. HealthcareITNews