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.
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.
It is certainly a good idea to avoid readmissions that are deemed unnecessary. However, from the vantage point of risk and patient safety, the sword of readmissions reduction has another sharp and dangerous edge. Plain and simple, along with sensible system solutions, there will be irrational but powerful pressures exerted on the gatekeepers of inpatient admission to send sick patients home rather than readmit them.
The following case is from an online CME course by Dan Sullivan, MD, JD, FACEP. The course, Batch Events - Catastrophic System Risk, explores the question:
What is a batch medical incident or batch claim and why read a course on this subject?
Batch medical incident is a term coined by the insurance industry to recognize and manage a certain type of legal claim.
In pursuit of our mission to improve patient safety and reduce risk, The Sullivan Group (TSG) held our semi-annual gathering of the Risk, Safety, and Quality (RSQ™) Collaborative in mid-November. The RSQ Collaborative, formed in 2010, is an elite group of nationally and internationally recognized clinical champions that share TSG’s passion for reducing medical risk, the frequency of medical errors, and ultimately saving patient’s lives.
Fifteen years ago, the Institute of Medicine (IOM) published a landmark report “To Err is Human: Building a Safer Health System.” The IOM shocked the world revealing that up to 98,000 humans may die each year as a result of medical errors. That actually came as no surprise to those of us dedicated to patient safety and medical error reduction for the last two decades.As a healthcare provider, one need only pay attention to see that the frequency of errors is obvious. As a healthcare worker with a family member in the hospital, a tally sheet is required if you want to know the real frequency of medical error. Count them up.
This presentation will be a bit of a departure from our typical clinical case presentation-discussion format. But the time has come to offer a look at the medical marketplace from 20,000 feet, how healthcare organizations are responding, the regulatory changes that are tied to clinical performance, and the support TSG provides to facilitate this clinical transformation to achieve success.
