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Content ArticleThis webcast highlighted how the Indiana Hospital Association (IHA) used AHRQ’s Surveys on Patient Safety Culture® (SOPS®) Hospital Survey and Workplace Safety Supplemental Item Set to assess patient safety culture and workplace safety in 41 Indiana hospitals. Speakers discussed their member organisations’ survey results, how SOPS resources were used, and their focus on initiatives to address workplace safety, including burnout. This webcast showcased recent research about the relationship between hospital workplace safety culture and patient safety culture, job satisfaction and intent to leave.
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Content ArticleImplementing levels of maternal care is one strategy proposed to reduce maternal morbidity and mortality. The levels of maternal care framework outline individual medical and obstetrical comorbidities, along with hospital resources required for individuals with these different comorbidities to deliver safely. The overall goal is to match individuals to hospitals so that all birthing people get appropriate resources and personnel during delivery to reduce maternal morbidity. This study examined the association between delivery in a hospital with an inappropriate level of maternal care and the risk of experiencing severe maternal morbidity.
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News Article
USA: Leaked documents reveal patient safety issues at Amazon’s One Medical
Patient Safety Learning posted a news article in News
Patient safety issues have increased since One Medical shifted care to a call centre staffed by contractors, employees say Since Amazon acquired the primary care service One Medical, elderly patients have been routed to a call centre — staffed partly by contractors with limited training — that failed on more than a dozen occasions to seek immediate attention for callers with urgent symptoms, according to internal documents seen by The Washington Post. When one patient reported a “blood clot, pain and swelling,” call centre staff scheduled an appointment rather than escalating the matter for medical evaluation, according to a note in an internal incident tracking spreadsheet dated 19 February. Over the following two days, clinical staffers flagged four more call-centre errors involving elderly patients with urgent complaints, including stomach pain and blood in stool, a spike in blood pressure, an insect bite and sudden rib pain, according to the internal spreadsheet. The call-centre incidents were among dozens flagged by doctors, nurses and assistants at One Medical Seniors between 19 February and 18 March in the documents, a year after Amazon acquired the primary-care service. Read full story (paywalled) Source: The Washington Post, 15 June 2024 -
News Article
'I don't ever trust Epic to be correct'. Nurses in the US raise more AI concerns
Patient Safety Learning posted a news article in News
Nurses in the United States continue to voice concerns about artificial intelligence and its integration into electronic health records (EHR), saying the technology is ineffective and interferes with patient care. Nurses from health systems around the country spoke to National Nurses United, their largest labor union, about issues with such programmes as automated nurse handoffs, patient classification systems and sepsis alerts. Multiple nurses cited problems with EHR-based programs from Epic and Oracle Health that use algorithms to determine patient acuity and nurse staffing levels. "I don't ever trust Epic to be correct," Craig Cedotal, RN, a paediatric oncology nurse at Kaiser Permanente Oakland (Calif.) Medical Center, told the nurses' union. "It's never a reflection of what we need, but more a snapshot of what we've done." He said the technology does not account for the hours of preparing and double-checking the accuracy of chemotherapy treatments before a pediatric patient even arrives at the hospital. Read full story Source: Becker's Health IT, 14 June 2024 -
Content ArticleDrug shortages are a chronic and worsening issue that compromises patient safety. Despite the destabilising impact of the Covid-19 pandemic on pharmaceutical production, it remains unclear whether issues affecting the drug supply chain were more likely to result in meaningful shortages during the pandemic. This study estimated the proportion of supply chain issue reports associated with drug shortages in the USA overall and with the Covid-19 pandemic. It found that supply chain issues associated with drug shortages increased at the beginning of the Covid-19 pandemic. Ongoing policy work is needed to protect US drug supplies from future shocks and to prioritize clinically valuable drugs at greatest shortage risk.
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Content ArticleInfections due to multidrug-resistant organisms (MDROs) are associated with increased morbidity, mortality, length of hospitalisation, and health care costs. Regional interventions may be advantageous in mitigating MDROs and associated infections. This study evaluated whether implementation of a decolonisation collaborative is associated with reduced regional MDRO prevalence, incident clinical cultures, infection-related hospitalisations, costs, and deaths. It found a regional collaborative involving universal decolonisation in long-term care facilities and targeted decolonisation among hospital patients in contact precautions was associated with lower MDRO carriage, infections, hospitalisations, costs, and deaths.
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Content ArticleThis cohort study in JAMA Network Open aimed to assess how patients receiving radiation treatment for cancer rated their satisfaction with fully remote management by doctors. It also identified the associated safety events, financial implications and environmental consequences. The authors found that: more than 99% of safety events did not reach patients or caused no harm to patients. 98% of patient ratings of satisfaction with fully remote management were good to very good. out-of-pocket cost savings associated with fully remote management totalled approximately $612 913 ($466 per patient). estimated carbon dioxide emissions decreased by 174 metric tons.
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Content ArticleThe Patient Safety Authority's 2023 Annual Report.
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Content ArticleThe United States continues to have the highest rate of maternal deaths of any high-income nation, despite a decline since the Covid-19 pandemic. And within the U.S., the rate is by far the highest for Black women. Most of these deaths — over 80% — are likely preventable. With policies and systems in place to support women during the perinatal period, several high-income countries report virtually no maternal deaths. As policymakers and health care delivery system leaders in the U.S. seek ways to end the nation’s maternal mortality crisis, these countries may offer viable solutions. This brief updates an earlier Commonwealth Fund study of differences in maternal mortality, maternal care workforce composition, and access to postpartum care and social protections between the U.S. and other high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. In this edition, we have also included data on Chile, Japan, and Korea — all high-income countries with universal healthcare systems.
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News ArticleThe United State's largest nurses union is demanding that artificial intelligence tools used in healthcare be proven safe and equitable before deployment. Those that aren’t should be immediately discontinued, the union says. Few algorithms, if any, currently meet their standard. “These arguments that these AI tools will result in improved safety are not grounded in any type of evidence whatsoever,” Michelle Mahon, assistant director of nursing practice at National Nurses United, told Fierce Healthcare. NNU represents 225,000 nurses in the US and has a presence in nearly every state through affiliated organisations, like the California Nurses Association, which protested the use of AI in healthcare in late April. NNU nurses also represent nearly every major hospital and health system in the nation. Most AI nurses interact with is integrated into electronic health records and is often used to predict sepsis or determine patient acuity, union nurses said at an NNU media briefing last month. EHRs cause an estimated 30,000 deaths per year, which is the third leading cause of death in the nation, Mahon said. Adding what they call “unproven” algorithms to EHRs is not how the health system should be spending dollars, NNU says. The union is demanding that all AI used in healthcare meet the precautionary principle, a philosophical approach that requires the highest level of protection for innovations without significant scientific backing. Any AI solution that does not meet this principle, which NNU claims is most of the AI currently on the market and deployed in hospitals, should be immediately discontinued, they say. Read full story Source: Fierce Healthcare, 3 June 2024
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Content ArticleThis multihospital prospective study in Surgery aimed to determine whether strict adherence to an enhanced recovery after surgery protocol leads to improvement in outcomes, compared with less strict compliance. The study looked at all consecutive anatomic lung resection patients on the thoracic enhanced recovery after surgery pathway from May 2021 to March 2023 and compared this cohort with a historical control from January 2019 to April 2021. The authors found that enhanced recovery after surgery protocols improve outcomes after anatomic lung resection, and that increasing compliance to individual elements further improves patient outcomes. They argue that continued efforts should be directed at increasing compliance to individual protocol elements.
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Content ArticleThis report commissioned by the US Agency for Healthcare Research and Quality aims to identify major themes related to the current state of diagnostic safety and highlight key gaps in knowledge. Through a rapid narrative review methodology to evaluate multiple resources in the literature and interviews with experts, it presents several findings that have implications for future resource investments to reduce harm from diagnostic errors. The report looks at the following key themes: Incidence and Contributing Factors Measurement: Data and Methods Cognitive Processes Culture, Workflow, and Work System Issues Disparities Health Information Technology Patients and Families Testing Interventions Implementation
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News ArticleThe Patient-Centered Outcomes Research Institute (PCORI) awarded Patients for Patient Safety US (PFPS US) a $100,000 Eugene Washington PCORI Engagement Award for a new project called “Patients Involved in deVeloping Outcomes Together” or “Project PIVOT.” Project PIVOT is a novel patient-led initiative to advance the integration of patient-centred patient-reported outcomes (PROs) and patient-reported experiences (PREs) into Patient-Centered Outcome Research (PCOR), Comparative Clinical Effectiveness Research (CER) and quality assessment measurement tools to improve patient safety, diagnostic quality, and equity. “This award will allow us to identify opportunities to capture—directly from patients and families—their care experiences and challenges, filling key gaps in the traditional data sources used to evaluate healthcare quality and safety,” stated Sue Sheridan, co-founder of PFPS US. In contrast to traditional tools, such as clinical outcome measures and hospital readmission rates, Project PIVOT’s long-term goal is to make healthcare safer and more equitable by capturing and learning from patients’ experiences related to patient safety, diagnostic quality and bias. Project PIVOT will have a special focus on historically underserved communities to help define which questions and outcomes are most important to capture. Priority areas of focus include maternal/newborn health in communities of colour, the physical, intellectual and developmental disability communities and older adults. Read full story Source: Newswire, 13 May 2024
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Content Article
Project PIVOT is a new initiative led by Patients for Patient Safety US (PFPS US) that aims to advance the implementation of patient-centred patient-reported experiences (PREs) and patient-reported outcomes (PROs) to improve patient safety, diagnostic accuracy and equity in healthcare. Project PIVOT will provide an opportunity for diverse patients, communities of patients and patient organisations to collaborate with national and international experts and provide input via novel engagement methods to identify and prioritise PREs and PROs which are related to patient safety, diagnostic accuracy and equity–things that matter most to patients. Patients will also have opportunities to identify how and when they prefer to report their experiences and outcomes. Additionally, Project PIVOT will engage healthcare system leaders to identify and prioritise their PREs and PROs to explore possible synergies and integration with the PROs and PREs identified by patients. Project PIVOT is accepting applications from individuals interested in joining the project via the PFPS US website. -
Content ArticleThe Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest repository of patient safety data in the United States and one of the largest in the world, with over 4.7 million acute care event reports dating back to 2004. This article in the journal Patient Safety analyses the patient safety event reports submitted to PA-PSRS in 2023.
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Content Article
Healthcare disparities in the US (21 March 2024)
Patient-Safety-Learning posted an article in Health inequalities
Healthcare access, quality of care received and social factors such as income, housing and food insecurity, all impact the health outcomes of US residents. Growing evidence has pointed to wellness gaps and disparities among the different racial and ethnic populations that make up the country. This research by Innerbody takes a closer look at: what groups are the most uninsured across the US healthcare quality and life expectancy across races. -
News Article
Flu vs Covid: Stark disparity in vaccination and deaths
Patient-Safety-Learning posted a news article in News
In the first half of 2023, Covid-19 killed 42,670 people in the United States, while the flu killed about half that amount. Yet half as many people received the updated covid booster as those who got the flu shot — even though covid is twice as deadly as influenza. In all, around 22% of people have received the new covid booster, while 47% of people have had a flu vaccine. Experts said much of that covid-shot resistance is due to the continued polarizing nature of the pandemic and of the covid vaccine, which has been shown to reduce the risk for Long Covid as well as serious acute viral infections and deaths. "Public health messaging is also to blame for the lower-than-normal covid vaccine rates," said Dr Al-Aly, a global expert on Long Covid and chief of research and development at the VA Saint Louis Health Care System. "Patients need to better understand that the role of the vaccine isn't to completely prevent covid but to reduce the likelihood of hospitalisation and death, similar to that of a flu shot. By reducing the risk for severe disease, the vaccine also reduces the risk for Long Covid, a debilitating condition that's still poorly understood, has no cure, and has already caused thousands of American deaths," he said. Botched public health messaging also allowed for misinformation to run rampant. Rare adverse events associated with the COVID vaccine have been severely overplayed and spread like wildfire on social media. "Patients need to know that like any vaccine, vaccine injury does occur, but these vaccines have a better safety profile than almost any others," Al-Aly said. "The rewards of getting the vaccine far outweigh the risks, and patients need to understand that." Read full story Source: Medscape, 2 May 2024 -
News Article
Hospitals grapple with radiologist shortage
Patient-Safety-Learning posted a news article in News
Increased reliance on imaging for diagnosis and efficient patient care mixed with higher volumes of patients has left US hospitals scrambling to meet demand with the few radiologists they have. There are over 1,400 vacant radiologist positions posted on the American College of Radiology's job board, according to a bulletin posted on its website. The total number of active radiology and diagnostic radiology physicians has dropped by 1% between 2007 and 2021, but the number of people in the U.S. per active physician in radiology grew nearly 10%, according to the Association of American Medical Colleges. An increase in the Medicare population and a declining number of people with health insurance adds to the problem. "Demand for imaging services is increasing across the country, creating longer worklists for radiology staff at the same time the healthcare system is experiencing a workforce shortage in radiology," Michigan Hospital Association CEO Brian Peters told The Detroit News in an April 28 report. "The combination of vacancies and increased demand can force imaging delays measured from days to upwards of two weeks." CMS also cut fees for both diagnostic (3%) and interventional radiology (4%) this year, according to an article published on healthcare technology company XiFin's website. This leaves many hospitals having to use external groups to stay on top of demand. Mr. Peters told Detroit News, "Hospitals and health systems are also competing with practices offering remote-only positions, which allows Michigan radiologists to work for out-of-state providers at higher rates." Read full story Source: Becker's Hospital Review, 29 April 2024 -
News Article
Biden administration imposes first-ever staff minimum for nursing homes
Patient-Safety-Learning posted a news article in News
The Biden administration set a first-ever minimum staffing rule for nursing homes Monday, making good on the president’s promise more than two years ago to seek improvements in care for the nation’s 1.2 million nursing home residents. The final rule, proposed in September, requires a registered nurse to be on-site in every skilled nursing facility for 24 hours a day, seven days a week. It mandates enough staff to provide every resident with at least 3.48 hours of care each day. And it beefs up rules for assessing the care needs of every resident, which will boost staff numbers above the minimum to care for sicker residents. For a facility with 100 residents, it translates to a minimum of two or three registered nurses and at least 10 or 11 nurse aides per shift, as well as two additional staffers who could be nurses or aides per shift, according to the administration’s interpretation of its new formula. Set to phase in over the next few years, the mandate will replace the current vague standard that gives operators wide latitude on how to staff their facilities. While the administration has said the rule will improve care, industry lobbyists have said it’s unworkable, with staffing goals that will be impossible to achieve because of a shortage of workers. The administration received 47,000 public comments on the rule since it was proposed last September. They included observations of people lying in their own filth for hours, not being fed appropriately and being left on the floor too long after falling, Secretary of Health and Human Services Xavier Becerra said in an interview Monday. Read full story Source: Washington Post, 22 April 2024 -
Content ArticleDiagnostic errors cause substantial preventable harms worldwide, but rigorous estimates for total burden are lacking. Newman-Toker and colleague previously estimated diagnostic error and serious harm rates for key dangerous diseases in major disease categories and validated plausible ranges using clinical experts. In this study they estimated the annual US burden of serious misdiagnosis-related harms (permanent morbidity, mortality) by combining prior results with rigorous estimates of disease incidence. They found that an estimated 795 000 Americans become permanently disabled or die annually across care settings because dangerous diseases are misdiagnosed. Just 15 diseases account for about half of all serious harms, so the problem may be more tractable than previously imagined.
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Content ArticleIn this report for Stat, technology correspondent Casey Ross looks at the dangers involved in using AI to predict patient outcomes, especially in life-or-death situations such as suspected sepsis. He looks at the recent case of US electronic health record provider Epic who were force to rewrite the algorithm being used by tens of thousands of US clinicians to predict sepsis.
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Content ArticleThe US Leapfrog Group has released Recognizing excellence in diagnosis: Leapfrog’s national pilot survey report, which analyses responses from 95 hospitals on their implementation of recommended practices to address diagnostic errors, defined as delayed, wrong or missed diagnoses or diagnoses not effectively communicated to the patient or family. The National Academy of Medicine has warned that virtually every American will suffer the consequences of a diagnostic error at least once in their lifetime and noted that 250,000 hospital inpatients will experience a diagnostic error every year. While progress varies considerably, more than 60% of hospitals responded that they were either already implementing or preparing to implement each of 29 evidence-based practices known to prevent harm from diagnostic error. The practices were identified in an earlier Leapfrog report, Recognizing excellence in diagnosis: Recommended practices for hospitals. The hospitals reported barriers to putting the practices in place that include staffing shortages and budgetary pressure.
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News Article
UK swapped to fatal US blood products to save money, minutes suggest
Patient Safety Learning posted a news article in News
The British government was willing to risk infecting NHS patients to get “lower-priced” blood products, according to a document that campaigners claim proves state and corporate guilt in one of the country’s worst ever scandals. A public inquiry into the deaths of an estimated 2,900 people infected with conditions such as HIV and hepatitis will publish its final report in May, four decades after the NHS started prescribing blood and blood products – including from drug users, prisoners and sex workers – sourced from the USA. Within the thousands of documents disclosed to the inquiry, internal company minutes have emerged that campaigners say provide the final compelling piece of evidence of the commercial greed and state negligence that destroyed thousands of lives. In November 1976, Immuno AG, an Austrian company that was a major supplier to the Department of Health, was seeking a licence change to allow it to supply a blood product from those paid to donate in the US rather than donors without a financial incentive in Europe. According to the minutes of a meeting of medics in the company, it had been “proven” that there was a “significantly higher hepatitis risk” from a concentrate known as Kryobulin 2 made from US plasma compared with that from Austria and Germany. The company had concluded there was a “preference” in the UK for the cheaper US option. The memo of the meeting said: “Kryobulin 2 will be significantly cheaper than Kryobulin 1 because the British market will accept a higher risk of hepatitis for a lower-priced product. In the long-term, Kryobulin 1 will disappear from the British market.” Read full story Source: The Guardian, 14 April 2024 -
EventThis Grand Rounds session will cover three reports from the AHRQ Evidence-based Practice Center program focusing on making healthcare safer. Opioid stewardship interventions. Rapid response systems. Engaging family caregivers with structured communication for safe care transitions. Industry stakeholders will discuss the impact of these reports. Register
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EventuntilThe federal Patient Safety and Quality Improvement Act was created in 2005 and established a national patient safety database and a system of Patient Safety Organizations (PSOs) in the US. Although PSOs have existed for more than 15 years, healthcare organisations still struggle to identify the best reporting structure and how to most effectively utilise protections in relation to patient safety work. In this ECRI webinar, Partner and Owner of Bolin Law Group, Andrew Bolin, will discuss: The establishment of a Patient Safety Evaluation System and how it relates to PSOs The differences between state protections and federal protections How to work with surveyors who request information protected under the Act Register for the webinar The webinar will take place at 13:00 ET (18:00 BST)
