By demonstrating compliance with national standards for healthcare quality and safety, Slidell Memorial Hospital has achieved full accreditation from the Joint Commission. The hospital received the Joint Commission's Gold Seal of Approval following an unannounced, on-site evaluation. Joint Commission standards address Slidell Memorial's level of performance in key areas such as patient rights, patient treatment and infection control. The standards focus not simply on the hospital's ability to provide safe, high-quality care, but on its actual performance as well.
I could start with a corny line about the power of the pen, but I'll spare you that for now. Instead, I'm going to share a story that gives me hope that medicine is an industry that not only can change--but is hungry for it.
Earlier this month, the Society of Hospital Medicine launched a letter writing campaign to express its discontent with a ruling made in December 2007 by the Office for Human Research Protections. The ruling stopped a Johns Hopkins University study that examined the use of checklists in intensive care units as a way to curb hospital infections. Days after the letter writing campaign began, the OHRP issued a statement that said it would no longer stand in the way of Michigan hospitals using the checklist, or any other quality improvement efforts that pose minimal risks to patients.
If you're a regular reader of this column, you know that I've written about the benefits of the "checklist study" before. Modeled after lists used in the cockpit of airplanes, the list is made up of common sense actions that when taken together can virtually eliminate a patient's chance of acquiring an infection. It's an easy way to remind caregivers of the small, but important steps they should take when treating patients--steps that are often overlooked when pressure mounts.
Hospitalists--who now number more than 20,000 in the United States--are intimately involved with quality improvement efforts, says Russell Holman, MD, president of SHM's board of directors. That's why more than 160 members of his organization were inspired to send letters to the OHRP and members of Congress, urging the reversal of the "checklist study" shutdown.
"We see ourselves as inpatient leaders of quality improvement, patient safety, and service," he says. "More and more inpatient care is falling under the umbrella of hospital medicine, so we're intimately concerned with the systems of care and how to best deliver quality and safety to the patients that we serve."
The checklist struck a chord with members of SHM, Holman says, because of the intricacies of medicine and the human condition. We all know that Americans are getting sicker each year--with many having multiple conditions that must be considered when they seek treatment. Therefore, doctors juggle multiple thoughts, and it's often the simple, common sense things that get put on the back burner.
"There are too many things to remember and too much complexity for us to not use a tool like a checklist," Holman says. "We should expend our intellectual power on things that are less straightforward and more unique to the individual patient."
Perhaps the most interesting thing about SHM's letter writing campaign is that it debunks the myth that physicians are reluctant to change--and therefore will derail quality improvement efforts that disrupt the status quo. In just a matter of days, more than 160 physicians decided that yes, they would advocate for change in our industry, potentially opening themselves up to scrutiny by nurses, caregivers, and patients. For those 160 physicians, it will be all worth it if we can provide Americans with safer healthcare.
Was it the 160 letters that changed the OHRP's mind? Holman says he's not sure what other influences the OHRP may have had, but he'd like to think SHM's efforts played a part in it.
"We hope it was a contributing factor to the reversal and the recognition that quality improvement work done in a hospital is very different than original research methodologies," he says.
A recent study by the Journal of the American Medical Association suggested that hospital-borne infections are the country's fourth-largest killer. Each year, close to 2 million Americans acquire an infection while in a hospital, according to the Center for Disease Control and Prevention. Of those, almost 100,000 die.
A 72 percent increase in deaths linked to the hospital superbug Clostridium difficile was disclosed by the Office for National Statistics in England. It said the infection was mentioned on 6,480 death certificates in England and Wales in 2006, compared with 3,757 in 2005. The figures showed deaths linked to C difficile were nearly four times more than deaths involving MRSA, which fell slightly in 2006 after rising for 10 years.
In their most recent checkups, Connecticut hospitals have been showing signs of stress: The state's Department of Public Health has announced six regulatory actions by the agency in the first two months of this year, compared with 12 such actions in all of 2007. Regulators say the actions reflect the state's tough rules and political priorities as the Connecticut's population ages. Patient advocates point to hospital management issues even as CEO salaries swell.
A survey taken by Deloitte Center for Health Solutions shows that consumers are hungry for information about their doctors and hospitals online. Of the 3,000 people surveyed, 62 percent report that they would visit a hospital's Web site for cost information. Sixty-four percent say they'd visit a hospital's Web site to find quality information.