January/February 2014 Quality Conundrums Lynn Helmer, MD, MBA, CHCQM • ABQAURP Diplomate since 1998 • http://www.drdnj.com Healthcare.gov — A Quality Conundrum? Regardless of your politics, we can all agree that leveraging technology in some way to enhance the quality and decrease the cost of health care is a logical approach. Although disagreement remains, recent … Continued

A new set of guides and interactive tools to help healthcare providers use electronic health information technology products, such as electronic health records (EHRs), more effectively are now available at www.HealthIT.gov.

If we have known that hand hygiene was necessary for patient safety and wellbeing since the 1860s, why has it taken so long to instill the habit of washing before and after treating a patient? Perhaps, as Adam McMullin, vice president and general manager, Hill-Rom IT Solutions, says, “Hand hygiene has been an established practice that unfortunately just didn’t catch on for the first 50 years because a gentleman’s hands were always clean.” And, of course, all doctors are gentlemen. Or were, for the most part, in the 1800s, at least.

Automated alerts can provide an effective means of communicating essential information about drugs and patients to clinicians who prescribe, dispense, and administer medications. Alerts are typically communicated through warning messages that pop up on a screen and can cause either a soft or hard stop. A soft stop provides information to the clinician about a potential drug safety or efficacy problem and may offer alternative suggestions for the clinician to consider.

The topic of population health often comes up in conversations about healthcare quality as organizations aim to leverage information about their patient populations to improve the quality of care they provide. However, a focus on population health goes beyond just improving quality—at its core, population health management enhances the fundamental safety of patient care.

During the dot-com boom, many new companies based their business plans upon the volume of website visits. The revenue models assumed that by capturing the attention of users as measured by clicks on the company website, the organizations would generate wild profits through…something. Companies offered free products and services claiming that these Internet visits would deliver market share and revenue. In fact, many of these companies never thought through their business models nor understood their real costs.

There has been an intense and ironic debate surrounding the request to delay Stage 2 Meaningful Use or at least postpone the assessment of compliance. Instead of charging forward to engage patients in the digital space, much of the industry is looking for opportunities to further postpone the assessment of compliance.

 The Occupational Safety and Health Administration (OSHA) has created an online resource of information about work-related injuries and illnesses among people who work in hospitals and other healthcare settings. These workers face hazards that range from needlesticks to muscle strains, falls, and communicable diseases as well as violent injury and death caused by angry or deranged patients, family members, or other members of the public. And they are injured on the job more often than workers in any other profession.

When technology seems too big for its britches, or we let it run the show, many of us remind ourselves that “it’s just a tool,” hoping that observation will help us put technology in its place and restore the world’s balance. The bandwidth currently consumed by health information technology (IT), especially electronic health records (EHRs), has increased to such a point today that we all might wish that intoning, “It’s just a tool,” were enough to regain control.

Medication shortages have steadily increased over the past decade due to a number of factors affecting drug supply. Perhaps the first and worst hit has been the hematology/oncology area, which has been dealing with shortages and the need to redesign chemotherapy protocols for a number of years. Within the past three years we have seen an increasing trend of drug shortages that have occurred and continue with no resolution or intermittent supplies returning to the market.