More Information Is Not Always Better: Pulling Consumers Into Active Choices About Testing

Wendy Lynch

Posted 5/01/12 on the Altarum Institute’s Health Policy Forum

“I’m thinking of getting a full-body CT scan,” Jane said. “What do you think?” Here was a healthy, active 72-year-old with no specific symptoms considering an expensive screening test. When asked for a reason, she shared that strokes run in her family and a doctor told her that she might be able to see if there was a possible bulge in a blood vessel in her brain. Plus, while they were looking, the scan could see if there was some other problem.

When asked how it would affect her to know – do you think you would consider brain surgery if there was a problem? (probably not); what might you do differently if you knew? (I don’t know); do you know whether a bulge in her vessel would definitely cause a stroke? (not necessarily); she hadn’t really gone that far. She just thought she should know.

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Why Do Hospitals Still Allow Preventable Adverse Events?

Michael Wong

Posted 5/01/12 on The Doctor Weighs In

Can Hospitals Afford to Give Away Money? If not, then why are Preventable Adverse Events Still Occur in Hospitals?

This are questions that I posed to lawyers, insurers, and healthcare professionals attending a major healthcare conference, the Crittenden Medical Conference.

According to the Institute of Medicine, each preventable adverse event costs about $8,750 — and this excludes potential litigation costs.

Can hospitals afford to give away money? So, why do preventable adverse events still occur in hospitals?

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Hope Lies with Residents

Paul Levy

Posted 3/1/12 on Not Running a Hospital

I remain relatively new to the health care field, but even in that short time, it has become evident to me that the pace of quality and safety enhancements and front-line driven process improvement in hospitals is inadequate given the scale and scope of harm that occurs to patients.  Indeed, it can be viewed as a paradox that the doctors of America, a group of dedicated, well-intentioned, intelligent, and highly trained individuals, constitute one of the top-ranked public health hazards in the county when as they work together in the nation’s hospitals.  That they collectively have not made much of a dent in the problem of reducing harm is, I believe, a product of their training.

As Brent JamesJay Kaplan, and others have noted, doctors are trained to be artists, to apply their intellect, creativity, intuition, and judgment to the care of each patient. That is well and good when the case is complex, but the vast majority of medical care is not complex.  It calls for standardization, adoption of protocols, and scientific experiments of process improvement to modify those protocols to enhance care and reduce harm.

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Flying Blind in Hospitals

Paul Levy

Posted 2/5/12 on Not Running a Hospital

A recent article in Bloomberg Businessweek reminded me about the Commercial Aviation Safety Team, coming out of a commission established by President Clinton, who charged it to come up with a process for reducing the rate of airline accidents by 80% over ten years.  The result:

By 2008 CAST was able to report that by implementing the most promising safety enhancements, the fatality rate of commercial air travel in the United States was reduced by 83 percent.

What’s the current goal?

Reduce the U.S. commercial aviation fatality risk by at least 50 percent from 2010 to 2025 and continue to work with our international partners to reduce fatality risk in world-wide commercial aviation.

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Tracking Adverse Events

Paul Levy

Posted 1/08/12 on Not Running a Hospital

recent report from the Office of Inspector General at the US Department of Health and Human Services finds, unsurprisingly, that hospital incident reporting systems do not capture most patient harm.  A summary of major points:

All 189 sampled hospitals had incident reporting systems to capture events, and administrators we interviewed rely heavily on these systems to identify problems.

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Doing Things Right: Why Three Hospitals Didn’t Harm My Wife

Michael Millenson

Posted 12/04/11 on Kaiser Health News 

My wife was lying in the back of an ambulance, dazed and bloody, while I sat in the front, distraught and distracted. We had been bicycling in a quiet neighborhood in southern Maine when she hit the handbrakes too hard and catapulted over the handlebars, turning our first day of vacation into a race to the nearest hospital.

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