Thursday, November 7, 2013
Institute for Patient and Family Centered Care
Gentle, compassionate, caring, warm, friendly, kind are just some of the ways patients and their families describe the care they receive at hospitals that are patient and family centered. The skills of the medical team seem to never be addressed. It is the way people are treated that we remember. We expect when flying in a plane to get to the destination. So, when the service is extraordinary, the staff friendly and the seating comfortable, that’s what stands out. The same goes for hospitals, clinics and at doctor’s offices. Ask almost anyone what they think of their doctor and they will tell you they like him / her because they are nice, listen or are friendly.
I had the opportunity to hear similar stories at the IPFCC conference held in Minnesota last week. It was uplifting, educational and moving. It was a week of learning ideas that “work” or have worked to make a hospital patient and family centered. Making for better outcomes often is based on communication and the better communication, feeling of acceptance, respect and treated with dignity builds relationships. Honest, open relationships can mean better outcomes.
One woman shared the story of going to radiation with a friend and they dressed up in costumes. (An appropriate story for Halloween eve). Soon the others receiving radiation were also dressing up in costumes and instead of no one talking to each other, at each treatment there was laughter and friendship. The presentation ended with a slide show of patients in costumes hugging and laughing. There wasn’t a dry eye in the room of over 400 people.What does patient centeredness mean? It was a common theme of medical professionals, patients and family members at this conference. Most were representing patient and family advisory councils where the patient or the family members of patients come together and talk about improvements to the hospitals or healthcare system they use.
Visiting policy, the human touch, talking eye to eye, how patients share their stories were some additional topics. Work groups were formed over lunch to develop an action plan helping to move each person’s or groups agenda forward.
Breakfast roundtables were for researchers, PFAC members, nurses, social workers or any group you may want to start, a sign would be ready at a table for you. Patient and family centeredness can mean something different to anyone, or it can mean a lot to one.
Posted by Ilene at 8:45 AM
Sunday, November 3, 2013
Who to Vote For When Your Issue Doesn't Count?
As election-day comes upon us, it is hard for me to choose who I want to vote for. Campaign promises come and go but my issue is patient’s safety and no one wants to take that up. This year, I approached the county administration to support the Designated Medication Manager (DMM). This would offer a tool for the general public to understand how they can help each other reduce medication errors, dependency and misuse of prescriptions, vitamins and herbs. I was told that that for the county to support a DMM it needs approval from the medical society. The medical society’s role is not to protect the public, it’s to protect the physicians (who protect the public). So, we can be sure Nassau County Executive Ed Mangano is not going to protect the public unless it’s approved by the special interest.
Tom Suozzi on the other hand was approached when he was in office too. We asked him to get involved in patient safety. That too never happened. As long as $1.00 of Nassau County funds is going to healthcare costs, safety must be part of the conversation.
A recent meeting hosted at C.W. Post campus of Long Island University about the future of healthcare on Long Island didn’t address patient safety. The conversation didn’t turn to safety until members of PULSE of NY, a community based patient safety organization brought it up privately and interviewed some of the panel members.
There is a tremendous cost to the economy that can be reduced. Are you tired of hearing that 98,000 people die each year from preventable medical errors? Well good, because the new number is 440,000.
Costs of medical errors in the United States of $19.5 billion during the year 2008 according to the report by The Economic Measurement of Medical Errors Sponsored by Society of Actuaries’ Health Section.
Imagine that with each death there is the loss of an employee, now someone new needs to be hired and trained. A patient who misses work and needs a temporary replacement because of a hospital acquired infection, a second surgery or a missed diagnosis. Life insurance policy payments stop but are now distributed to the patient’s family. A misdiagnosis is costly when tests must be redone.
Patient’s health can get worse and not better when there is simple communication problems. Patient’s who don’t understand what the doctor meant when he said “come back in two weeks” or a patient who doesn’t take his medication because he forgot, didn’t understand instructions or can’t afford the pills for his chronic condition.
Medical errors are not about blaming anyone. We need the public to know how they happen and how they can be avoided. Medication errors injure 1.5 million people a year creating huge healthcare costs. A Designated Medication Manager can help change those numbers but it’s not important enough this year I suppose.
Posted by Ilene at 2:51 PM
Wednesday, October 16, 2013
Jeffrey Cooper PhD
Remember when the biggest fear of dying in a hospital was the anesthesia? We don’t hear about anesthesia deaths anymore – or at least not too much. Maybe that’s because the Anesthesia PatientSafety Foundation was formed in 1985. Through research and the sharing of information, advances have been made and lives have been saved. Jeffrey Cooper PhD is the founder and Executive Director of the Center for Medical Simulation, which is dedicated to the use of simulation in healthcare. He is also a founding member of the NationalPatient Safety Foundation and a colleague of mine on the board of governors of the NPSF for many years.
I remember years ago when I visited the simulation lab run by Dr. Cooper in Massachusetts. I stood behind the glass and watched the physicians as they did “surgery” on mannequins. The person behind the glass with me would make things go wrong so the anesthesiologist would have to find the problem. I still remember that it was a mucous plug clogging the breathing tube. The young physician couldn’t find the problem. In this case, the patient would have died if it were real. But it wasn’t real – no one died and I bet that doctor never made that mistake again. This is what they do daily there – save lives through education in one very important area.
Dr. Cooper received the highest honor from his colleagues at the The American Society of Anesthesiologists, The Distinguished Service Award. It’s my personal honor knowing him all these years and knowing what an impact he has made in safe patient care. Congratulations Dr. Cooper on this recognition. I wish it could have come from me!
Posted by Ilene at 8:19 AM
Saturday, October 12, 2013
Your Telling it to The Choir
Dr. Bob Wachter wrote in his blog Wachter’s World about the recent conference in Chicago on diagnostic errors. Dr. Mark Graber, a trusted physician and advisor to PULSE of NY for many, many years has been passionate about diagnostic errors in medicine since I have known him. He founded the Society to Improve Diagnosis in Medicine. The only thing I think Dr. Graber is almost as passionate about is disclosure to the patient and / or their family when something goes wrong.
There are a few good, no great medical professionals like Dr. Wachter and Dr. Graber out there who are passionate about patient’s safety. Some, because of their own experience and some because their fear that their number may be up soon. With numbers like the recent study that there are as many as 400,000 deaths in hospitals due to preventable medical errors it seems to be only a matter of time that everyone will experience either an unplanned outcome to themselves, a friend or family member.
What I don’t get is why are there constantly conferences for medical professionals to learn better ways of doing things. There is some improvement, but the focus needs to be more on the public. When the public learns what WE are supposed to expect, we can start expecting no less.
A recent program I did for the community of about 20 people brought together a mix of homemakers, business people and blue collar workers. They were learning for the first time that things can go terribly wrong in hospitals. I am careful to explain that for every “bad” thing that happens, there are thousands of good outcomes too. But, would our government and medical societies be pumping patient safety money into a system that works? I just fear it’s being pumped into the wrong place!
Here is something that can be done: Cautious Patient Communities
Posted by Ilene at 4:29 PM
Wednesday, October 9, 2013
I Will Miss Him
A great man died today. Jerod Loeb worked for the JointCommission. He was the Executive Vice President for Healthcare Quality Evaluation. A researcher, scientist, PhD, he was brilliant at his work. But what made him most special was his humor, the way he explained things and way of speaking to me, a lay person at TJC, in terms and words I understood. He was always sure to make sure I knew what he was talking about. Funny and lively, Jerod was a brilliant, but very approachable and not in the least bit intimidating.
The last few years, even more powerful, he became a patient - openly fighting cancer. He was gutsy enough, time after time to tell his audience, usually of medical professionals, what it was like to now be on the receiving end of sometimes questionable care. Each time I saw him, he would have stories about his care. He recorded the past few years on a website so his friends, colleagues and loved ones could follow along.
I didn’t see Jerod often, but I always knew he was someone I can count on. He had a loyalty to the patients that the customers of the Joint Commission serve - because he was one of us.
Rest in peace Jerod.
Posted by Ilene at 8:23 AM