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Surgical never events: How to stop these preventable medical errors once and for all

June 18th, 2015

by Ilene MacDonald

As a longtime healthcare reporter, I am shocked every time I read about a surgeon who operated on the wrong site or wrong patient or accidentally left a surgical instrument inside a patient's body. It seems hard to believe that in 2015 these "never events" could occur at all. Yet they do, and, if recent studies are correct, they occur far too often.

One way to solve this problem in the operating room once and for all is to eliminate distractions and adopt best practices followed by the aviation industry--basically turning the operating room into a cockpit, Kimberly Danebrock, R.N., senior risk management and patient safety specialist for the Cooperative of American Physicians' "CAPAssurance" program, told me during an exclusive interview.

We spoke shortly before the release this week of a study conducted by researchers at the Mayo Clinic that found never events occurred at their campus during 1 of every 22,000 procedures. But the national rate for never events is much higher. A 2013 study published in Surgery estimated it to be closer to 1 in 12,000 procedures.

And JAMA Surgery published another study this week that took a systematic review of surgical never events, including wrong-site surgery, retained surgical items and surgical fires, to try to determine why they still happen despite the implementation of patient safety efforts at hospitals across the country.

The study found that poor communication is behind most of these catastrophic events, a problem also identified by Mayo Clinic researchers. The Mayo study also identified a series of as many as nine missteps that can lead to a surgical error.

>> Read the full commentary at FierceHealthcare

What my 'summer vacation' taught me about US healthcare

June 11th, 2015

by Lynn McVey

My recent trip was actually a spring vacation rather than a summer one, but I still learned a lot. After a three-week trip to nine European countries, I learned Americans are not healthy. I'm not surprised that of 198 countries in the world, America spends the most on healthcare. The average Medicare patient costs us $6,700 per year while the super-users spend $67,000 per year. The "why" became as clear as the nose on my face.

Living in America is particularly efficient. Our flat driveways are next to our homes. Some garages allow us to walk straight into our homes without stepping outdoors. Most suburbs are surrounded by strip malls and convenient shopping. As I visited Dubrovnik, Croatia, I climbed at least one million steps--no exaggeration. The most astonishing thing was to witness Dubrovnik's senior citizens climbing the steps faster than younger Americans. Not only did they move a lot and fast, they only ate a fraction of what we eat in American restaurants.

=> Read more!

The importance of inspiring daily innovation within hospitals

June 11th, 2015

by Joe Randolph

As president and CEO for The Innovation Institute, an incubator for healthcare ideas for hospital systems, I have the opportunity to meet regularly with hospital leaders. Many are dealing with significant challenges as they strive to manage rising costs while improving care. I empathize with their situation and suggest innovation as a solution and a different approach that could bring about positive cultural change as well as new revenue streams.

Although advances in technology and new therapies have helped drive down costs, improve productivity and extend patient lives, there is much still to accomplish, and billions more dollars to cut to reduce waste and missed prevention opportunities. If other prices had grown as much as healthcare costs have grown since 1945, a gallon of milk would cost $48, according to the Institute of Medicine.

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How hospital leaders can improve the patient experience and demonstrate value

June 11th, 2015

by Mina Ubbing

Most hospital leaders have become acutely aware of the importance of compliance with Core Measures, National Patient Safety Goals and with Hospital Consumer Assessment of Healthcare Providers and Systems scores. Often they quantify the importance of these metrics in terms of the cost of penalties incurred when the organization falls below the established standards. Some organizations have deemed staying above the penalty line as sufficient performance because of the uniqueness of their patients, challenges with their medical staff and the logistics inherent in their physical plant. The problem is that the line for acceptable performance is constantly moving higher.

Attempts to increase awareness of the importance of these scores may involve sharing of scores with staff and creating internal competitions to motivate improvement by sharing internal best practices. Boards see scorecards and hear about improvement efforts or rationalizations for why their organization is not a top performer. Scores often affect leadership compensation and organizational bonuses. Many organizations have sought outside assistance to train their staff in customer service and process improvement techniques to improve these scores.

=> Read more!

Maryland results prove healthcare partnerships can improve care quality

June 4th, 2015

by Carmela Coyle

Collaboration and care coordination have been buzzwords for decades. But, until recently, those words were little more than rhetoric.

Now, with the nation's healthcare leaders laser-focused on value rather than volume, these admirable pursuits are transforming from ideas into action, as providers across the healthcare continuum reinvent the way they work together to succeed in the 21st century.

This is no accident. The shift from volume to value is occurring by design and through transformative national initiatives. Consider some the recent efforts from the federal government:

  • 50 percent of payments will be tied to these models by the end of 2018.
  • The U.S. Department of Health and Human Services has a goal of tying 90 percent of all traditional Medicare payments to quality or value by the end of 2018 through programs like Hospital Value Based Purchasing and the Hospital Readmissions Reduction programs.

=> Read more!

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