Saturday, March 23, 2013

When My Work is Easy

Patient's Safety and So Much About Communication

A man from the north eastern part of the country speaks to a colleague in the south about his brother’s friend in a Long Island hospital.   He feels that the care is below acceptable standards for a variety of reasons.  Knowing about PULSE of NY, the person in the south recommends that I might be able to help.  The man from the north calls me and I tell him he must have his brother call me directly.  It is not my place to call when I hear a story through someone else.  I am not looking for cases and if the patient or family have worked it out, I have no business getting involved.
Minutes later I hear from the brother, Bill (names are changed).  Bill is visiting Long Island when his friend became hospitalized.  He is concerned about the care.   Bill is not being permitted to stay overnight by the nurses.  He feels there is a shortage of nurses and his friends care is being compromised.  He does not feel he is getting a full accounting of his fiends care so he can be helpful.
I offer to go visit but first I will make a phone call.  I ask him to be honest, has he lost his temper?  Who has he spoken to?   Does he have names and dates?
When we finish this conversation I call to management at the hospital.  Explaining briefly what is happening, within minutes of hanging up the phone they are at the patient’s room clearing up misunderstandings.   The patient’s loved one’s received explanations and apology and days later the patient is released with only positive things to say about the hospital and care received.
The problem; The senior level staff are busy running a hospital expecting the people at the bedside are giving quality and patient centered care.  With the possibility of shortages of staff, overwhelming admissions and paperwork, compassion and communication can easily get lost.
A gentle reminder that there was a communication breakdown happening within the hospital is the best service we can offer.  In this case, as with most, there is a legitimate concern that rules and policies are not being followed.  Patients are permitted to have someone at their side.  There was no reason Bill couldn’t stay, but because that’s the way it’s always been done, no one was looking at how they could make this work so the family could feel safe and satisfied.  It took an outside phone call to help build a bridge to better communication.
How do we measure this success?  Would the outcome have been the same if there was no intervention?  There is no way of knowing.  What we do know is that there was a happy ending to this story.  Another day and the patient may have had a bedsore or been given the wrong medication or worse were the friend not at the bedside.  There is no system in place to count the lives saved by an advocate’s intervention.  If there were, we could start counting.

Friday, March 22, 2013

Safe Doctors

Physician Profiles

An article in Long Island Newsday by Reporter Robert Kessler was released on Wednesday March 20, 2013 that Dr. Gracia L. Mayard, a New York physician surrendered his license to prescribe controlled substance in February but continued to prescribe Oxycodone.  There was a warrant out for his arrest.
Mayard’s license was surrendered on February 7 but a pharmacist reported a prescription written on February 28.  Just yesterday, on March 21, Maynard was “captured”.  The report says that he brought in $1.2 million in less than two years.
It’s safe to say that this physician is a criminal and a drug dealer and a danger to the public.  He had been selling prescriptions for $150.00 the report says.
When we look up the name Garcia L. Mayard on the NY State Physician Profile website,  Mayard comes up that he is a licensed practicing physician in New York State.  He is listed as a practicing general surgeon with two offices in Brooklyn, NY and no discipline against him. 
Healthgrades also has him listed as practicing in Brooklyn and has him listed with a perfect rating from a satisfied patient.
It is appalling that this story has completely gotten past our NY State Patient Safety Center that was developed to protect us from unscrupulous doctors such as this giving fine physicians a bad name.  I understand that we can not play judge and jury and he is entitled to his day in court, but there must be a system in place that patients (and their concerned family members) are better aware of these happenings so new people don't fall victim (in case it is true).

Monday, March 4, 2013

Patient Safety Awareness Week - What's your point?

Patient Safety Awareness Week; Where is it?

In just one hour on the radio today I heard commercials for chronic obstructive pulmonary disease (COPD), breast cancer, diabetes, heart disease and more sickness and ailments than I can remember.  Sometimes these commercials are suggesting medication, sometimes it’s just to raise awareness.  Either way, it works. 
As we are now upon Patient Safety Awareness Week again this year, not a word again to the public about patient safety.  Nothing, Nodda, Zip!
For each of the conditions spoken about on commercials, patients need to be made aware of the possibility that the medication that they receive at the pharmacist can be for someone else if they don’t check the label. There are 1.5 million peopleinjured by medication errors each year.  When diagnosed with a new illness, the patient needs to be sure any new medication works with their other medications.  They can go for a second opinion because according to Dr. Mark Graber, founder of Society to Reduce Diagnosis Errors in Medicine, a New York Times article (Oct 2012) the average emergency room physician during his/her career will send home 17 patients who will die an avoidable death within 7 days due to misdiagnosis.
According to The Joint Commission there are still over 2,000 wrong site surgeries each year.  This can be avoided if the public knows how important it is to mark the site of surgery.  That means breast cancer patients or diabetic patients having surgery.
Patients hospitalized with heart disease should know that according to the Center for Disease Control (CDC) one out of every 20 patients will contract a hospital acquired infection and 99,000 peoplewill die each year.
The outcry this week is about the cost of Medicare or government cutbacks.  But who is paying for the care of those Medicare patients who have the second and corrected surgery, are treated after a medication error or when the patient falls in the hospital adding another few thousand dollars to the hospital bill?  If Medicare no longer pays because they refuse now for hospital errors, at some point we are absorbing the cost either financially or with the risk of our safety because hospitals will have to cut back.
There is the  patient with high blood pressure who doesn’t understand the doctor’s instructions and takes his medication incorrectly, doesn’t keep a follow up appointment or doesn’t share all his symptoms so something may be missed.  These problems could easily be avoided if the patient was encouraged through a patient safety campaign to bring a family member or friend with him to the doctor and help take notes and ask questions.
What about those 99,000 patients who died last year from a hospital acquired infection?  Was their life insurance paid out long before it need be?  We know they are no longer paying into their insurance policies.  Isn’t that another economic loss?  Or, were there 1.7 million lost work days because that’s how many people were said to suffer from a hospital acquired infection each year according to the CDC.
So, we try to get a presidential proclamation again this year.  We visit Senator Charles Schumer’s (NY) office, give them the statistics and nothing.  All we want to do is raise awareness.    Patient Safety Awareness Week is an opportunity to celebrate patient safety and all that is being done.  The media doesn’t cover it, the news doesn’t cover it, the politicians don’t cover it, but when the next wrong site surgery happens and the next misdiagnosis happens and they make the news,  I will just sit back and say “What’s your point”?