Editor’s Notebook
Editor’s Notebook
‘Do No Harm’ to Clinicians, Too
In her work as president of MITSS (Medically Induced Trauma Support Services), Linda Kenney has always included clinicians among those who may need support following traumatic events in the course of medical care. She has steadily increased her efforts on behalf of clinicians in recent years, publishing a toolkit in 2010 to help organizations design and implement programs.
Getting a Feel for Better Infection Control
Getting a Feel for Better Infection Control
For every 100 patients admitted to U.S. hospitals in 2002, 4.5 patients developed a nosocomial infection, also known as a hospital-acquired infection (HAI) (Graves & McGowan, 2008), and many experts believe the percentage has risen in recent years. Under new Centers for Medicare and Medicaid Services (CMS) guidelines, healthcare providers may risk partial or full denial of reimbursement for procedures where staff medical errors such as infections arise from a lack of training.
MRI Safety 10 Years Later
MRI Safety 10 Years Later
In the summer of 2001, the radiology world was shocked to learn of an accident at Westchester Medical Center in New York state in which 6-year-old Michael Colombini was killed while being prepared for an MRI exam. Sedated and positioned in the scanner, the child’s oxygen saturation levels began dropping quickly.
Story Power
Editor’s Notebook
Story Power
The patient safety community generally understands the value of stories as a way to honor the experience of people who have been harmed by medical error, to humanize efforts to improve safety, and to inspire the will to change. I had an experience in August that demonstrated just how powerful and disarming these stories can be.
Eliminating CLABSI: Progress on a National Patient Safety Imperative
AHRQ
Eliminating CLABSI: Progress on a National Patient Safety Imperative
At any given time, about 1 in every 20 patients has an infection related to his or her hospital care. These infections cost the U.S. healthcare system billions of dollars each year and lead to the loss of tens of thousands of lives.
Web 3.0 Data-Mining for Comparative Effectiveness and CDS
Health IT & Quality
Web 3.0 Data-Mining for Comparative Effectiveness and CDS
“Turbulent times” accurately describes the state of the American healthcare system. The list of critical challenges is well known—upward spiraling healthcare costs now approaching 17% of GDP, healthcare payment reform, shortage of clinical professionals, aging population, and the economic downturn.
Scanner Beep Only Means the Barcode Has Been Scanned
ISMP
Scanner Beep Only Means the Barcode Has Been Scanned
You might find it hard to believe that wrong patient and wrong drug/dose/time errors can still happen when using a bedside barcode scanning system. One source of error stems from the fact that, regardless of whether the correct product has been scanned or an associated warning has been issued, audible barcode scanners produce the same beeping sound.
Working Together for Patients with Limited Proficiency in English
Medical Interpretation
Working Together for Patients with Limited Proficiency in English
Effective communication between the patient and the medical provider plays a vital role in the delivery of high-quality medical care. But what if that patient is a non-English speaker? Not only do healthcare facilities have a duty to provide language assistance services to limited-English proficient (LEP) patients to ensure quality medical care, but currently there are requirements for equal language access that recipients of federal funding must adhere to.
Medication Reconciliation in Daily Rounds in the NICU
Medication Reconciliation in Daily Rounds in the NICU
There is a major thrust for patient safety nationwide. With an estimated 1.5 million preventable adverse drug events (ADEs) occurring annually in the United States, there is still a need for better error prevention systems (Institute of Medicine, 2007).
State-wide Leadership Creates a Culture of Patient Safety in Rhode Island
State-wide Leadership Creates a Culture of Patient Safety in Rhode Island
To provide a safer environment for patients in Rhode Island, 13 hospitals in the state have initiated a program to improve the way data on adverse medical events is reported, analyzed, shared, and utilized.