There is a new risk and safety issue in the world of appendicitis. In this issue of TSG Quarterly, we explore the issue of conservative, antibiotic-first management of acute appendicitis with appendectomy reserved for treatment failures. Is it the new standard? Have you proactively addressed this issue with your emergency medicine and surgical practitioners? It is important to get out in front of this issue to keep our patients safe!
Current strides in improving patient safety in hospitals and medical facilities provide clear evidence that the healthcare industry has the capacity for meaningful change. However, providers continue to face significant obstacles; perhaps the biggest obstacle of all revolves around developing and expanding a vigorous “safety culture.” Indeed, much of the focus has been on technology and incremental process improvement, but building a “culture” is the foundational contributor to ensuring patient safety.
The practice of pediatrics is relatively unique from a risk management perspective. One study placed the risks associated with the practice of pediatrics relative to other specialties as 25th out of 26 specialties with regard to the risk of being sued. However, although the risk of being sued is relatively low, another study found that the risk that a pediatrician may be sued in a given year was 3.1% as compared with 7.4% for all physicians.
Not all chest pain is a heart attack. While acute coronary syndrome (ACS) may be the most common serious cause of chest pain, clinicians must keep other dangerous conditions in the differential diagnosis and eliminate the possibilities based on the patient’s history, risk stratification, physical exam and diagnostic testing. One of the most dramatic and perplexing causes for acute chest pain, other than ACS, is thoracic aortic dissection.
As leaders in the healthcare industry, we spend a great deal of time and resources analyzing patient outcomes and looking for areas of improvement. In triage, this typically translates to a leadership audit of triage decisions and a report back to staff on areas of improvement.
It’s important to periodically evaluate your audit process for effectiveness and sustainability. To evaluate your current process of triage record reviews, consider the following:
Preventable hospital readmissions cost taxpayers billions of dollars each year. As we move further into the age of healthcare reform, practitioners will feel rising pressure to reduce costs and decrease unnecessary and preventable re-hospitalizations.
Providers cannot and should not avoid the readmission of patients when medical or surgical situations require inpatient care. However, a fair percentage of unintended readmissions can and will be reduced by implementation of initiatives that not only improve quality, but support patients as they transition through the care continuum.
February is American Heart Month and an appropriate time to recognize the recent reduction in mortality rate from cardiovascular disease in women. The increased awareness of women and healthcare professionals has resulted in better care and is at least partially responsible for the lower death rate from heart disease seen over the past decade.
However, the battle against women’s heart disease is far from over. Awareness has improved, but the realities of heart disease in women remain underappreciated.
Given that proven effective solutions exist today, why haven't more institutions implemented programs that have proven to reduce diagnostic errors?
I listened with great interest to the interview conducted by Dr. Robert Wachter with Dr. Mark Graber in the January 2016 podcast of “Perspectives on Safety,” also published in the AHRQ PSNet.
Funding a patient safety program can be challenging, especially when the return on investment is constantly under scrutiny. While the ultimate goal of your program is safer care of patients, there are also measurable financial benefits that result from reduction in claims and malpractice litigation. Professional liability carriers, whether commercial or self-insured, also have a vested interest in your patient safety measures.
Depending upon how your organization insures its HPL/MPL coverage, there are several options for funding your patient safety program.
A recent Ob.Gyn. News article reported that the State of Iowa has joined Oregon and Massachusetts in passing a comprehensive disclosure law. The apology laws from these three states go beyond the simple immunity for empathy or apology that exists in 36 other states. Instead, they lay the foundation for the development of actual disclosure programs that help consumers and clinicians communicate and resolve differences post-event, including compensation for serious harm or death caused by malpractice.
