Perioperative Pressure Injuries: Protocols and Evidence-Based Programs for Reducing Risk
By Susan M. Scott, BSN, MSN, RN, WOC Over the past five years, the incidence of perioperative hospital-acquired pressure injuries (HAPI) has increased (Chen, Chen, & Wu, 2012), causing patients pain and suffering and costing the U.S. healthcare system $11 billion per year (Brem et al., 2010). Pressure injuries (previously referred to as pressure ulcers) … Continued
ISMP: Turn Short-Term Fixes Into Long-Term Remedies
Healthcare practitioners are repeatedly challenged by unexpected problems they encounter due to both large and small work-system failures that hinder patient care. The list of failures is varied and quite long, often making it difficult or impossible to execute tasks as designed (Edmondson, 2004).
Reducing Falls by Engaging Patients
When clinicians walk into a patient’s room at Brigham and Women’s Hospital in Boston, they only need a quick glance at a laminated, color-coded sheet of paper next to the bed to understand the fall risks of that patient.
ACS Releases New Standards for Overlapping and Conurrent Surgeries
The American College of Surgeons (ACS) released a much anticipated update to its “Statements on Principles” addressing both concurrent and overlapping surgeries. More than six months after a Spotlight Report from the Boston Globe into the concurrent surgeries at Massachusetts General Hospital, the ACS updates stipulate “a primary attending surgeon’s involvement in concurrent or simultaneous surgeries on … Continued
Viewpoint: The Surgical Learning Curve
By William A. Hyman, ScD It should come as no surprise that the ability to do a particular surgery is likely to improve over some number of early attempts. A surgeon’s skill could be evaluated in part by measuring his or her complication rate for a given procedure and watching it decrease to a … Continued
Department of Homeland Security Issues Ransomware Warning to Hospitals
In response to a series of ransomware attacks that crippled healthcare systems across the country, the Department of Homeland Security (DHS), the U.S. Computer Emergency Readiness Team (US-CERT), and the Canadian Cyber Incident Response Centre (CCIRC) released a warning on specific types of ransomware used in recent attacks. The warning is directed at all organizations … Continued
Mercy Selects Datix Patient Safety and Risk Managment Solution
Mercy, the seventh largest Catholic health care system, has selected patient safety and risk management software from Datix to give a comprehensive view of incidents, complaints and claims across the organization. After a thorough evaluation, Datix was selected as a result of its ability to aggregate patient safety data in real time. Datix’s powerful dashboards … Continued
Exploring the Intersection of Concurrent Surgeries and False Claims Enforcement
Renewed focus on concurrent surgeries underscores patient safety concerns. Newspaper investigation has thrust issue into national spotlight, prompting American College of Surgeon Updates
The practice of concurrent surgeries has become a top concern for hospitals across the country following a Boston Globe investigation into the practices of a reputable Massachusetts hospital.
In October, the Globe published a lengthy exposé into the practice of “concurrent” or “double-booking” surgeries at Massachusetts General Hospital (MGH), ranked as the top hospital in the nation by U.S. News and World Report in 2015-2016. The Globe’s investigation revealed an ongoing battle within the health system that pitted one long-time surgeon against the hospital’s top brass in his quest to eliminate concurrent surgeries. The investigation also described specific incidents in which patients were harmed or even paralyzed during double-booked procedures.
The Globe investigation has pushed the issues of concurrent surgeries – a common practice among many academic medical systems across the country – to the surface, drawing criticisms from patient safety advocates and prompting organizations like the American College of Surgeons (ACS) to review current policies on concurrent or overlapping surgeries.
Massachusetts medical board proposes rules on simultaneous surgeries
Surgeons in the state of Massachusetts will have to document each time they enter and leave the operating room according to a new regulation approved by the Massachusetts Board of Registration in Medicine, according to a recent report in The Boston Globe. Patients rarely know if they are sharing their surgeon with another patient, and … Continued
Improving Safety and Reducing Harm from Fluoroscopy
Fluoroscopy is a powerful tool that has been used over the past century in many medical disciplines. If asked, ”What is an X-ray?”, many patients would say it is like a photograph—a picture of a body taken at a moment in time. Following this analogy, if a conventional X-ray is similar to a photograph, fluoroscopy is like a video. Instead of capturing only a moment in time, fluoroscopy shows the movement of catheters, devices, and contrast within the body over an extended period of time as part of a procedure performed directly by a physician. Fluoroscopically-guided interventions (FGI) refers to specific uses of fluoroscopy where devices or instruments are inserted through the skin (i.e., percutaneously) and are guided using fluoroscopy to complete a medical procedure.