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Best Quality Columns of 2012 from A to Z

Cheryl Clark, for HealthLeaders Media, January 3, 2013

I is for Serial Infector
This column describes what must be every hospital's absolute nightmare. In May and June, this tiny Exeter Hospital, a 100-bed facility in New Hampshire, discovered that a tech in its cath lab was suspected (and later charged) with stealing the drug fentanyl, injecting the drug in himself, and then replacing the injectables for use on dozens of patients awaiting catheterization.

David Kwiatkowski had worked in dozens of other hospitals, and documents say he had even been caught "diverting drugs" before. But because he worked for a registry, and because he traveled from state to state, he eluded subsequent employers. In November, the New Hampshire U.S. Attorney indicted Kwiatkowski, and said that the investigation into who at Exeter knew what, and when, is still very much underway.

Perhaps just as disturbing is the idea that because these patients didn't get the full dosage of fentanyl, they may have endured suffering during their procedures, but were unable to convey it to their anesthesiologists.

P is for Patient Information
We blame patients for not following instructions, not doing their healthcare homework, and relying on an ads or corner gossip to choose providers and procedures.  But this novel idea, which would result in patients taking classes recommended by primary care doctors before undergoing invasive procedures—before even seeing a surgeon—prompted numerous comments and criticism.

I didn't think surgeons, or even primary care doctors, would like the idea described in this column.  But will it work to reduce unnecessary procedures or at least improve outcomes by educating patients about their expectations?

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