What will it take for patients to feel safe during their hospital stays? According to a report published last month in The New England Journal of Medicine, hospitals need an increase of corrective actions in order to prevent patients from getting sicker before they get better.
A team of researchers, led by Charles P. Landrigan, MD, MPH, of Harvard Medical School, declared that that the rate of patients suffering harm — from errors, hospital-borne infections or other problems — continues to plague hospitals. These findings are based on research they conducted from 2002-2007 at ten hospitals, in both urban and rural areas in North Carolina.
Some of the recurring problems involved patients who were given the wrong dosages of medication. Others involved patients contracting hospital-borne infections such as sepsis or other blood stream infections. And still others involved patients suffering from strokes, severe bleeding or organ failures as a result of human error.
But within this dire report there is hope: many of these risks can be prevented if hospitals institute corrective measures, such as these three examples:
1. Automated medication dispensing. Known as a "closed-loop" automated system, now used by Lifespan’s five hospitals in Rhode Island, automated dispensing requires the nurse or physician to scan a patient's bracelet barcode before medication is to be administered. If the medication for that patient and the dosage correspond, a green light appears on the electronic device, indicating the medication can be dispensed. If there is an error, a red light appears and no medication is administered. The result: the right patient receives the correct dosage of medication at the right time. According to Dr. Landrigan, only 17 percent of hospitals nationally use this system.
2. Rapid diagnostics. Bacterial and yeast infections in patients' bloodstreams caused the deaths of 19,000 Americans in 2005 alone, according to the U.S. Centers for Disease Control and Prevention. Many hospitals continue to send patients' blood samples to labs, where it may take days before the results come back. In the meantime, patients are often prescribed a regime of inappropriate antibiotics, which may exacerbate their conditions. New tests available to hospitals rapidly detect these blood stream infections within hours and help to get the patient more quickly on the road to wellness. One test, called PNA FISH, and offered by AdvanDx in Woburn, Mass., rapidly detects Staphylococcus aureus, of which Methicillin-resistant Staphylococcus aureus (MRSA) is an antibiotic-resistant strain.
3. Physician Order Entry System. By using a computerized physician-order entry system, also being used by Lifespan’s hospitals in Rhode Island, physicians and healthcare personnel ensure the accurate and efficient transmission of orders and patient medical histories, replacing a reliance on using pen and paper, which invites human error caused by illegibility or inaccuracy. All requests for testing, from blood work to X-rays, are entered into a computerized system which can be programmed with built-in prompts to remind the physician of medical conditions associated with their diagnoses.
None of these systems can effectively eliminate all human error. But these and other corrective measures are proven and effective safeguards that should be instituted to enhance patient wellbeing at our nation’s hospitals.
Robert Israel is a health informatics and content management consultant living in Arlington, Mass. He can be reached at risrael_97@yahoo.com. His website is www.bobisrael.com.
A team of researchers, led by Charles P. Landrigan, MD, MPH, of Harvard Medical School, declared that that the rate of patients suffering harm — from errors, hospital-borne infections or other problems — continues to plague hospitals. These findings are based on research they conducted from 2002-2007 at ten hospitals, in both urban and rural areas in North Carolina.
Some of the recurring problems involved patients who were given the wrong dosages of medication. Others involved patients contracting hospital-borne infections such as sepsis or other blood stream infections. And still others involved patients suffering from strokes, severe bleeding or organ failures as a result of human error.
But within this dire report there is hope: many of these risks can be prevented if hospitals institute corrective measures, such as these three examples:
1. Automated medication dispensing. Known as a "closed-loop" automated system, now used by Lifespan’s five hospitals in Rhode Island, automated dispensing requires the nurse or physician to scan a patient's bracelet barcode before medication is to be administered. If the medication for that patient and the dosage correspond, a green light appears on the electronic device, indicating the medication can be dispensed. If there is an error, a red light appears and no medication is administered. The result: the right patient receives the correct dosage of medication at the right time. According to Dr. Landrigan, only 17 percent of hospitals nationally use this system.
2. Rapid diagnostics. Bacterial and yeast infections in patients' bloodstreams caused the deaths of 19,000 Americans in 2005 alone, according to the U.S. Centers for Disease Control and Prevention. Many hospitals continue to send patients' blood samples to labs, where it may take days before the results come back. In the meantime, patients are often prescribed a regime of inappropriate antibiotics, which may exacerbate their conditions. New tests available to hospitals rapidly detect these blood stream infections within hours and help to get the patient more quickly on the road to wellness. One test, called PNA FISH, and offered by AdvanDx in Woburn, Mass., rapidly detects Staphylococcus aureus, of which Methicillin-resistant Staphylococcus aureus (MRSA) is an antibiotic-resistant strain.
3. Physician Order Entry System. By using a computerized physician-order entry system, also being used by Lifespan’s hospitals in Rhode Island, physicians and healthcare personnel ensure the accurate and efficient transmission of orders and patient medical histories, replacing a reliance on using pen and paper, which invites human error caused by illegibility or inaccuracy. All requests for testing, from blood work to X-rays, are entered into a computerized system which can be programmed with built-in prompts to remind the physician of medical conditions associated with their diagnoses.
None of these systems can effectively eliminate all human error. But these and other corrective measures are proven and effective safeguards that should be instituted to enhance patient wellbeing at our nation’s hospitals.
Robert Israel is a health informatics and content management consultant living in Arlington, Mass. He can be reached at risrael_97@yahoo.com. His website is www.bobisrael.com.