By the Institute for Safe Medication Practices

Now that 2016 is underway, the Institute for Safe Medication Practices (ISMP) would like to extend its sincere thanks to the many healthcare providers, consumers, advocacy groups, organizations, agencies, and companies that have allowed us to be part of their journey to reduce patient harm from medication errors. It has been both a distinct privilege and a profound responsibility to touch the lives of so many during the past year. Since becoming a charitable organization more than two decades ago, ISMP has pursued a singular mission to advance patient safety worldwide by empowering the healthcare community, including consumers, to prevent medication errors.

By Anne V. Irving, MA, FACHE, CPHRM, DFASHRM

Human factors studies indicate that distractions and multitasking increase the likelihood of error (Feil, 2013; Wiegmann, ElBardissi, Dearani, Daly, & Sundt, 2007). Allowing personnel to bring their cell phones, smartphones, or other mobile devices into a surgical suite introduces a new distraction into an already complex, noisy, high-stakes environment.

By Barry P. Chaiken, MD, MPH

Although I’m a physician, not a technology expert, I’m jazzed about the FHIR® (Fast Healthcare Interoperability Resources) specification. Organizations struggle to share patient information with each other due to data structure and definition incompatibilities. This lack of interoperability forces physicians to treat patients without the benefit of a complete patient record, which leads to duplicate testing, unnecessary procedures, misdiagnoses, and medical errors.

By Hardeep Singh,MD, MPH; and Dean F. Sittig, PhD

It’s rare to attend a conference on quality, safety, or informatics without feeling the excitement of “big data,” a loose term referring to large volumes of interconnected (and often unverified) data that may be updated and processed rapidly.

Caring for patients is fraught with hazards and risks. As physicians, every time we approach the bedside we bring the potential for benefit and the possibility of harm. Benevolent intentions do not guarantee safe and effective care or highest-quality outcomes. Problems with our systems and processes of care, as well as personal lapses, often result in preventable and even death.

Improving Diagnosis in Health Care, a new report by the Institute of Medicine, inspired artists at VisualDx to produce the infographic shown below. VisualDx is a widely used web-based clinical tool used to enhance diagnostic accuracy, aid therapeutic decisions, and improve patient safety. Art Papier, MD, co-founder and CEO of VisualDx, is a member of the board of the Society to Improve Diagnosis in Medicine, which petitioned the IOM to produce the report.

Some hospitals use McKesson’s InterQual admission criteria; some use MCG (formerly Milliman). Some managed care plans use InterQual, and some use MCG. The Centers for Medicare & Medicaid Services (CMS) has said it and its contractors may refer to either InterQual or MCG, but they don’t recognize either as the deciding factor in establishing payment.

Patient and family advisory councils (PFAC) are groups of patients, family members, community members, and hospital staff who work together to bring the unique perspectives of patients and families to a hospital’s operations, especially its efforts to improve care. According to one estimate, more than 2,000 hospitals in the United States have PFACs. They are also slowly becoming more common in outpatient settings.

For patients with severe, disabling rheumatoid arthritis (RA), oral methotrexate is often the preferred disease-modifying antirheumatic drug, unless it is specifically contraindicated (Bykerk et al., 2012; Saag et al., 2008; Singh et al., 2012). compared to dosing for antineoplastic indications, methotrexate for RA is administered once weekly as low-dose therapy (Sing et al., 2012). According to official prescribing information, the recommended starting dose is a single oral dose of 7.5 mg once weekly or divided oral doses of 2.5 mg every 12 hours for three doses per week. The dosing schedule may be adjusted to achieve optimal response, with doses up to about 25 mg weekly.