There are 29 medically based fitness and wellness centers all over Greater Cleveland, according to the Medical Fitness Association, a nonprofit organization whose board of doctors reviews the centers and offers advice to make them more effective. They range from loose affiliations between hospitals and local recreation centers, to rehabilitation centers where patients can continue to use the facilities at low cost, to full-service free-standing monuments of fitness that compete with, and can cost more than, most health clubs. The increasing popularity of these centers mirrors a national trend toward an appreciation of the wellness concept, that prevention is indeed the best possible medicine. There are now more than 800 fitness centers affiliated with hospitals in the country, according to the MFA, a number that continues to rise each year.
California for the first time is requiring that hospitals report to local health authorities certain kinds of staph infections that result in death or a stay in the intensive-care unit. Until now, there has been no state requirement for reporting staph infections. As a result, disease trackers have had a hard time calculating the severity of the problem. The new reporting requirement, however, is limited to cases that start outside hospitals or nursing homes in otherwise healthy people--leaving out about 85 percent of life-threatening encounters with the most feared bug, methicillin-resistant Staphylococcus aureus, or MRSA.
In the year since a Prince George's County boy died of a dental infection, lawmakers say Maryland has begun addressing the structural problems and funding shortages that are blamed for breakdowns in the state's Medicaid system. At a congressional hearing, Maryland officials won praise for initiating changes in the troubled program, which in recent years provided dental services to fewer than one-third of the 500,000 poor children statewide entitled to care.
Baxter International Inc.'s investigation into the cause of deaths and allergic reactions linked to its blood-thinner heparin is focusing on variations in batches of the active ingredient for the drug, most of which were supplied by a Chinese manufacturing facility co-owned by a Wisconsin company. Baxter said the active ingredient for its heparin was supplied by Scientific Protein Laboratories LLC, a Waunakee, WI, company with a manufacturing facility there and a joint-venture operation called Changzhou SPL in Changzhou, China.
In the February edition of HealthLeaders magazine, I write about how some hospitals are learning from the high-profile errors of others and taking steps to make sure that those same errors don't occur at their facilities.
Dan Sheridan, medication safety pharmacist at the Marion (OH) General Hospital, says part of his organization's strategy to prevent medical errors has been an environment where staff members are encouraged to report mistakes.
"If people think that they're going to be punished when they report an error, they won't report the error, and then we can't prevent it. We strongly encourage people to report errors and thank them for doing so," he says.
This strategy has worked for many hospitals, and now the U.S. Department of Health and Human Services (HHS) is hoping that the establishment of patient safety organizations (PSO) will further encourage doctors and other caregivers to voluntarily report medical mistakes and other dangers to patients' wellbeing. The rule--that would allow the Agency for Healthcare Research and Quality to certify public and private organizations as PSOs--was announced earlier this week.
This is a very big step for healthcare in the United States. It's a way to change the secretive cultures that exist in our hospitals--created by a litigious society that suppresses the ability for physicians and other caregivers to admit mistakes and discuss with others how to prevent future errors.
PSOs will not only confidentially collect information about mistakes, but also work with the erring physician and his or her colleagues to make sure that this particular error is prevented in the future. PSO members will act as "consultants" suggesting changes in routine procedures that can make the hospital a safer place for patients.
The organizations will also make it more likely that physicians and healthcare organizations will collect and report patient safety data--giving the industry a better handle on what errors are occurring and what can be done nationwide to prevent recurrences. Knowing what's happening in the industry and being able to sit down with your own staff to discuss it is important for any hospital's effort to eliminate medical errors.
Take what happened to three newborns at Cedars-Sinai Medical Center in November 2007. The infants received 10 times the recommended dose of the blood thinner herapin--the same exact error that occurred at in September 2006 at Clarian's Methodist Hospital. In my HealthLeadersarticle, Kurt Patton, former executive director of accreditation services for The Joint Commission (formerly JCAHO) and principal of Patton Healthcare Consulting, LLC, in Glendale, AZ, says keeping track of what's happening in other healthcare organizations and using that information to discuss patient safety with your staff is key.
"I think many hospitals probably are looking at these occurrences in other organizations. When you hear about something like this, you bring the information to your staff meeting and ask, 'How vulnerable are we?' and 'What can we do to prevent it happening here?' " he says.
Communication is key to problem solving in any organization and HHS' proposed rule will go a long way in encouraging healthcare providers and organizations to not only share what's going wrong at their hospital, but to talk about it in a way that will prevent future mistakes.
Freya Gilbert is the director of quality and clinical practice at Hughston Orthopedic Hospital, recently promoted from the position of operating room analyst. That means she is responsible for finding ways to improve hospital quality and performance, which, in turn, can improve patient safety and outcomes. Gilbert took some time out to tell the Ledger-Enquirer about what her title exactly entails, how she moved up the ladder in health care and her experience teaching surgical nursing in Tbilisi, Georgia.