The information technology (IT) plan in most hospitals is beginning to look like the wish list of your average American teenager — software, PDAs, wireless infrastructure. Healthcare is amidst a revolutionary game of catch-up when it comes to applying information technology to the business of patient care.
The demand for telephone interpreting (TI) services — and on-demand interpretation (ODI) in general — begins the moment a person enters a new language setting and cannot adequately communicate without outside support. Whether it is a patient trying to schedule an appointment with a doctor or an automobile accident victim dialing 9-1-1, interpreting services are critical to society, business, and government. As new arrivals pour into the United States, the influx of new languages fuels the demand for interpreting services.
The medical staff organization traditionally focuses on credentialing and peer review, primarily addressing physicians’ individual skills, qualifications, and practice patterns. Promoting quality and safety in healthcare today requires a break from this narrow focus into a more global view of processes and systems that are the significant determinants of outcomes. With this transformation, the physicians’ role in patient care is in transition.
Home use of medical equipment continues to grow, including both equipment expressly designed for the lay user and equipment adopted for home use but where the layman may not be the original intended user. Some of this equipment is rented to the home user directly and some through the insurer. Because of the increase in home use, there has been increasing attention to the design of this equipment with respect to its usability by non-professional users.
As the number of days that patients spend in the hospital continues to drop, the need for thoroughly planned and clearly explained post-hospital care has risen dramatically.
In 2006, the average hospital stay for patients of all ages was 4.8 days, compared with 7.5 days in 1980, according to government statistics (National Center for Health Statistics, 2007). The drop in hospital days has been even more dramatic for patients 65 years and older….
The American Reinvestment and Recovery Act 2009 (ARRA) earmarks more than $800 million toward research on comparative effectiveness of medical treatments. In addition, more than $700 million is directed to the Agency for Healthcare Research and Quality, a research institution with a long history of evaluating effectiveness of treatments. With healthcare reform at the top of the agenda for the 111th Congress and the Obama administration, will a NICE-like entity be part of the reform package?
My 20-something friend Colby observed recently that her younger brother unwittingly scares away girlfriends by jumping too quickly to the “define the relationship” conversation. I thought of Colby at a conference I attended in April, where the topic of changing roles for physicians and patients infused all proceedings. Rather than scaring people away, interest in “defining the relationship” packed the house.
John Smith is admitted late Monday afternoon to the post-surgical ward after a total knee replacement. John is overweight, though not morbidly obese, and has an undeclared history of snoring. He wakes up at 5:30 Tuesday morning with considerable pain; over the next hour he exhausts the opiate supply in his PCA pump, and his nurse inserts a new syringe before her shift ends at 7 a.m.
Talking about the hospitalized patient’s role in medication safety may suggest shifting responsibility away from the provider, but that is not my intent. This dialogue is intended to foster the development of approaches to care that lead to partnering with patients in care delivery and in sharing responsibility. A decade ago, a survey by the Canadian Institute for Health Information found that Canadians give high priority to enhanced information regarding health. Martin’s survey (2002) of patient views on the patient-provider relationship found that more than 50% of patients believe they have primary responsibility for decisions regarding their health; an additional 35.6% expect to share decision-making with their healthcare providers.
The surge of voluntary regional and national initiatives to improve patient safety demonstrates the momentum building to unite the healthcare community. Recently, the Institute for Healthcare Improvement’s 100,000 and 5 Million Lives Campaigns enrolled thousands of hospitals in a concerted effort targeting patient safety. Regionally, states such as Maryland have established networks to encourage peer-to-peer collaboration and learning. Now, the federal government has set the groundwork for a national network of organizations working to reduce harm to patients.