Helping patients take charge of their own health care through education and awareness.
News and Media
Welcome to Quality Buzz. Quality Buzz is dedicated to bringing you all the latest news and information to help you improve the quality of your health care. We update this section weekly and hope that it will become an important resource for you.
September 14, 2009 — Spotlight on Transparency
Jim Conway, our Board Chairman, will participate in a special forum on health care transparency moderated by journalist and community leader Liz Walker. The panel will take place on September 24th from 7:00 PM to 8:30 PM at The Mount Auburn Hospital in Cambridge and is open to the public.
Our nation's health care system is plagued by medical errors and infections that each year harm more than 1 million Americans. As a result, there is a growing demand for honest and open public dialogue about keeping consumers safe.
The goal of this forum, which is part of a 4-part series called Better Living with Liz Walker airing on WCVB-TV, is to ignite a conversation within the health care community that will help create patient provider dialogues that inform and empower.
In other news, our online directory has a new section to help consumers find credible resources to compare nursing homes. One new resource, Advancing Excellence in America's Nursing Homes, is a coalition-based campaign to improve the quality of life for residents and staff in America's nursing homes. More than 2,000 consumers have already signed on to the campaign. You can too!
Alice Bonner of the MA Senior Care Foundation informs me that 70% of Massachusetts nursing homes participate in the campaign. If the facility your family is using for a loved one is not participating in the campaign, you may want to ask them why!
And finally, a recent New England Journal of Medicine study reported that, on average, almost one in five Medicare beneficiaries in Massachusetts who are discharged from a hospital will re-enter it within a month. Some re-admissions are planned, but the majority are not. Among the reasons is a lack of communication among hospitals, nursing homes, physicians and patients/family caregivers. Patients and caregivers have a critical role to play in reducing re-admissions by engaging with their physicians about follow up care, particularly use of medications, and expectations for recovery and resumption of activities.
September 01, 2009 — New Partnership Fact Sheet on Preventing H1N1 Flu
This past weekend, college students began moving into their dorms– a sure sign of fall here in the Boston area!
The fall also marks the start of the flu season. This year, we are also concerned about the expected return of H1N1 swine flu.
Experts disagree over predictions of how bad H1N1 will be this winter. Last week, a White House Advisory panel estimated that there may be as many as 90,000 deaths in the US. The following day, the Centers for Disease Control (CDC) suggested that this prediction may have been overstated.
What is known, however, is that H1N1 disproportionately impacts younger people while typical (or seasonal) flu disproportionately impacts older people. It is important for parents to pay particular attention to guidelines and recommendations for flu vaccines this year.
In addition to getting the vaccine, common sense prevails – wash your hands regularly, cover your mouth and nose if you sneeze or cough and, if you feel sick, stay home.
The Partnership has prepared a fact sheet on preventing H1N1 flu and other infections. It is available on our website in English, Spanish and Portuguese.
I don't want to close without acknowledging the passing of Senator Edward M. Kennedy. Senator Kennedy was a tireless advocate for health care coverage and quality and for patients rights. Those of us advocating patient involvement to improve the quality of care for all Americans will miss his leadership, commitment and vision.
August 26, 2009 — MA Hospitals Implementing Patient Family Advisory Councils, But What Will They Do?
An article in the national press this week highlights the potential positive impact of a new regulation here in Massachusetts.
The article in today's Wall Street Journal describes how a medical accident of an 18-month old baby led Baptist Health South in Florida to adopt a "full disclosure" policy with respect to communicating to patients and family members about medical errors. Most notably, the six-hospital system engaged the child's parents to help educate physicians and other staff on the critical importance of patient safety and asked the child's mother to serve as a community liaison on the hospital's quality-and-patient-safety committee. This hospital system has taken very seriously the need for consumer engagement to improve quality of care.
In Massachusetts, all hospitals are working to establish Patient Family Advisory Councils if they do not have one already. These efforts are not the result of medical accidents or planning efforts of the hospitals, but passage of Chapter 305 by the Legislature last year. Massachusetts hospitals are required to have a Patient Family Advisory Council by October 2010 and have until September 30th to file their plans for establishing these Councils with the MA Department of Public Health.
The intent of these Councils is to engage consumers in health care quality improvement similar to what Dana Farber had done with its Council for many years.
However, one cannot legislate or mandate intent. I hope that Massachusetts hospitals will embrace the idea of the Councils. I hope they make good use of the patients and family members who will volunteer to serve on them without compensation.
Kudos to Leadership Council members — the MA Hospital Association, the MA Coalition for the Prevention of Medical Errors and Health Care for All — which have been working to educate hospital staffs about effective Patient Family Advisory Councils.
I look forward to reviewing the plans that the hospitals submit next month to see if the hospitals are indeed embracing the potential of the Councils.
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Calling consumers with an interest in patient safety!
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August 18, 2009 — Better Health Care is Within Reach
The Partnership will occasionally share stories of engaged patients so we can all learn from their experiences. The first is an interview with e-Patient Dave. Dave deBronkart spoke to the Partnership about why electronic medical records are important to patients' health care. Dave became an advocate for greater patient engagement after he found errors in his medical records. The experience motivated him to educate others about the importance of medical records and what you can do to get better care. His blog regularly covers developments in electronic medical records. You can read his entire interview with the Partnership here.
Last week, the New York Times discussed how communities across the country are focusing on system changes which deliver better, safer, and lower cost care. A willingness for transparency helped one hospital in Cedar Rapids discover that they were overusing CAT scans. The overtreatment not only cost the system more, but exposed people to possibly harmful radiation.
For many Americans with internet access, there appears to be a growing trend of utilizing online resources to interact with doctors. It marks a potential new chapter in how patients and doctors interact. As the Los Angeles Times reports, more doctors are using Twitter to connect both with patients and other medical professionals. Some hospitals have 'live-Tweeted' surgery, allowing the public a virtual glimpse into the operating room and an opportunity to ask real-time questions on topics that may even impact their own health. The new trend towards online interaction also increases the amount of patients that a doctor can treat and advise over a shortened amount of time.
August 11, 2009 — Preventable Errors in Hospitals
This November marks the 10th anniversary of "To Err Is Human," The Institute of Medicine's landmark report on hospital safety. This report, which estimated that 98,000 people die from preventable medical errors in US hospitals annually, spurred development of the patient safety movement. However, despite the hard work of legions of individuals and organizations, we have not seen significant reductions in the number of patient deaths and injuries. In fact, the Agency for Healthcare Research and Quality (AHRQ) reported to Congress last year that preventable medical injuries had increased by 1%.
The Hearst newspaper chain recently wrote an investigative series (unfortunately entitled "Dead by Mistake") on the issue of hospital safety. Among the points raised in the series, is the fact that a national reporting system for medical errors, which was recommended in the report, has never been implemented. We have more accurate data on traffic accidents than we do on hospital safety.
Massachusetts is one of twenty states that require reporting of medical errors and one of just a handful of states that make hospital-specific data available to consumers. Many organizations on the Partnership's Leadership Council can – and should – take credit for making this happen.
What will it take to bring this kind of transparency to a national level? Engaged patients need data to make informed decisions when choosing hospitals and physicians. Websites that compare hospitals, provide comparisons of care at different medical groups and offer other resources are available here.
August 04, 2009 — Lessons from the Hudson: The Value of Repetition
What can the airline industry teach health care about consumer engagement to improve safety? The recent NYC jet crash, the so-called "Miracle on the Hudson," perhaps offers some lessons. A recent article published by the National Patient Safety Foundation, suggests that potential catastrophe was avoided thanks to the aviation industry's long-standing history of engaging consumers in safety. Passengers remained calm and knew evacuation procedures by heart thanks, in part, due to the fact that instructions are repeated verbally, visually, in audio and in written format. The article makes several recommendations for standardizing communications in health care. Information should ensure patients understand their role in their own safety; it needs to be provided in multiple formats and repeated often. It urges health care organizations to set and use industry standards for routine procedures so patients will know what to expect in any institution in which they receive care.
Frequent fliers know what to do in the case of "sudden loss of air pressure" from hearing it dozens of times from multiple airline carriers saying the same thing and not simply from the flight attendant working on one particular flight. Perhaps there are lessons for hospitals and physician offices to learn.
Heading out on vacation? Remember to pack a medication safety list in your wallet. For other vacation tips, check out this article from The New York Times.
The Partnership is in New Bedford tonight at the Alfred Gomes School for "National Night Out." The community event will provide tips and tools for preventing infections and taking medications medication safely. Come on by!
July 28, 2009 — Reform and Improving Quality of Care
People across the country are wondering how health care reform will affect them and the care they receive. There are several promising measures in the reform bills that may improve quality of care. There are plans for comparative effectiveness research to determine which treatments are best, but would not force doctors to use them. Reformers hope to reduce needless readmissions to hospitals. And there is a call for pilot programs in Medicare to test the best ways for doctors to manage and coordinate a patient's total care. These are promising changes for more patient-centered care.
An article in The New York Times last week looks at the benefits of preventive care. Studies have shown that preventive care has limited net cost savings. However, preventive care has been shown to have a large positive impact on value as measured by QALY, a measurement used by economists to determine the cost to save a comparable year of life. QALY may sound harsh, but it helps policy makers think through the relative value of services. For example, childhood immunizations, as measured by QALY are bargains — less than $5000 per QALY gained. As long as the focus of the health care debate stays on savings and not value, it's unlikely that preventative care will take on a greater role in patient care.
The CDC estimates that up to 40% of Americans could get swine flu through next year and several hundred thousand could die if the U.S. doesn't implement a successful vaccine campaign and other public health measures. Health officials said they expect cases of the flu to increase substantially after school begins in the fall, about the time the first vaccines will be ready. The Partnership is planning to work with local health officials in New Bedford and Worcester on infection prevention programs for the fall. For fact sheets and materials on how to prevent infection visit our website. If you are a member of a PTO or other community group that's interested in getting the word out about infection prevention please be in touch with us at info@partnershipforhealthcare.org.
A new website for rating doctors is being launched by Consumers' Checkbook, an independent non-profit that rates other consumer services. What possibly sets this website apart from other sites is the fact that it surveys consumers using questions developed by the Agency for Healthcare Research and Quality. The website is starting out small — in just Denver, Memphis and Kansas City. We'll be monitoring it to see if it's successful and if it comes to the Northeast.
July 21, 2009 — “Best Hospital” Rankings Now Include Patient Safety Index
U.S. News & World Report recently released its annual report on the "Best Hospitals." For the first time, "Patient Safety" criteria were considered in determining ranking. The new Patient Safety Index, which represents only 5% of the score this year, includes unexpected deaths and incisions that reopened after surgery. We hope that more patient safety factors are included in the coming years and that the Patient Safety Index gets larger weight. Nonetheless this change to these widely cited rankings is welcomed. It shows that increasingly institutions are recognizing the importance of patient-centered care that improves the quality of care and delivers better outcomes.
When doctors make mistakes, it is important that they learn from the experience and focus on continuing sound patient care practices. An article in the Boston Globe uses a poignant "real life" story to illustrate ways to improve patient outcomes and strengthen the patient-doctor relationship. Greater support for doctors from both medical training and patient experiences could help to improve patient outcomes and strengthen the patient-doctor relationship.
The ability to research diseases and drugs on the Web has empowered patients in managing their health. More than 160 million U.S. adults visited online resources during the past year to look for health information. However, as USA Today reports, some popular sites including Wikipedia are not always accurate and some are subject to intentional manipulation. The danger of accessing inaccurate information over the web applies to doctors as well as patients. Both doctors and patients should question the sources of information on the web in terms of their reliability and credibility.
July 14, 2009 — An “Audacious Goal” for Eliminating Infections
After a week hiatus for the July 4th holiday, "The Buzz" returns with news to help you improve the quality of your health care. In this edition, we focus on two areas in which patient and family involvement can help improve quality and potentially save the U.S. health care system billions of dollars annually.
In an op-ed in the New York Times, Paul O'Neill, Former Secretary of the Treasury, proposes an "audacious goal" (his words and not mine) – ask providers to eliminate all hospital acquired infections within two years. Not only would this reduce suffering and death, but it would also save tens of billions of dollars a year. As Mr. O'Neill notes this does not require legislation or regulation, but simply commitment on the part of hospital staff to handwashing and other infection prevention practices.
Mr. O'Neill does not mention the role of the patient and family. Patients and visitors to hospitals need to wash their hands regularly. Patients should not be afraid to remind everyone on their medical team to wash their hands before and after they touch you.
There is new information on the U.S. government's website comparing hospitals. The U.S. Department of Health and Human Services has added information on readmission rates for three common conditions – heart attack, heart failure and pneumonia. A readmission is defined as when a patient unexpectedly returns to a hospital within 30 days of being discharged. A higher than average readmission rate is considered an indicator of poor quality of care. Plus, unnecessary readmissions cost more than $12 billion annually. Patients and family members have a role to play in reducing unnecessary readmissions. It is important to understand the directions you receive at discharge, particularly around medications. If you are prescribed new medications, make sure they do not interact negatively with medications you are already taking.
Finally, Linda Kenny of Medically Induced Trauma Support Services (MITSS) was profiled on WCVB-TV as part of a story on the slow progress being made in reducing hospital harm. MITSS is a member of the Partnership's Leadership Council. Kudos to Linda for getting coverage for this important issue.
June 30, 2009 — Stopping the Spread of Infection, Two Hands At a Time
This weekend, more than 500 people learned how to prevent infections at education programs organized by The Partnership at Worcester Technical High School and the Channel 7/Partners Health Expo at the Hynes Convention Center in Boston. People, particularly the kids, had fun learning about the importance of hand washing. Thanks to North Shore Medical Center for providing the Partnership with space in its booth at the Health Expo. And a shout out to Erin from Salem, MA who won a gift certificate for stopping by our table. To learn more about how to prevent infection, view our fact sheet here.
A recent study indicates that doctors don't always share test results and their significance with patients. As the leader of the research team said, "Don't assume that 'no news is good news' when you have tests done. That's a very dangerous assumption. If you've had a test done and you don't hear about it after a week or two goes by, call the doctor's office." The study shows that in many offices there is no clear path for doctors to receive, analyze and disseminate test results to patients. As a result, it's important for patients to ask questions and not assume that they are necessarily being given all of the information.
In last week's Boston Globe, CVS President and CEO Thomas Ryan makes the case that patient-centered care is the best way to reduce health care costs. In his op-ed, Mr. Ryan cites research showing that a quarter of prescriptions for chronic conditions never get filled, leading to increases in surgeries and hospital stays. He advocates for strategies that increase the likelihood that patients will take medication as prescribed and for broad adoption of electronic health information systems to avoid medication errors.
Finally, last week the MA Legislature's Joint Committee on Public Health heard testimony by Health Care for All's Consumer Health Quality Council in favor of three bills to improve quality of care. One of the bills would promote greater use of checklists by hospitals to reduce medical errors and prevention infection. To view the testimony by Partnership Board Member Lucilia Prates and others members of the Consumer Health Quality Council, please click here.
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