by Patrick Binns
Alberta is at the leading edge in developing its electronic health record (EHR), a provincial initiative to provide healthcare providers with immediate access to a patient's medication history and laboratory test results, regardless of where they are in the province, or where the patient's drugs or other treatments were ordered. The Alberta EHR was launched in October 2003. So far 6,000 healthcare providers have voluntarily signed on to use it, and benefits to patient safety have been reported. The EHR is an important part of healthcare renewal that is required to improve patient safety. Read the whole article by clicking here.
Showing posts with label Healthcare Quality and Safety. Show all posts
Showing posts with label Healthcare Quality and Safety. Show all posts
Saturday, April 19, 2008
Monday, December 10, 2007
Some Doctors' Oaths Hypocritical, Study Says
By Jesse Stanchak, CQ Staff | taken from Washington Health Policy Week in Review
December 3, 2007 -- Many doctors have trouble living up to their own professional standards, according to a new study published Monday in the Annals of Internal Medicine.
The study, performed by David Blumenthal and Eric Campbell of Massachusetts General Hospital, surveyed 1,600 doctors across a range of specialties and found widespread agreement among doctors on a range of ethical standards, but considerable disparities in how well they live up to those ideals.
According to the study:
- If a colleague was "significantly impaired," by drugs or alcohol or some other problem, 96 percent of doctors felt they should always report the problem, but 45 percent had let it slide at least once.
- Ninety-three percent of doctors felt all serious medical errors should be reported, but 46 percent said they'd failed to report such an error.
- A quarter of doctors would refer a patient to a facility that presented a clear conflict of interest for the doctor, even though 96 percent of physicians said their duty to their patients outweighed financial concerns.
- While 93 percent of doctors felt they should treat anyone regardless of ability to pay, only 69 percent are currently taking patients who cannot pay for their treatment.
- Only 25 percent of doctors have looked for disparities in care based on patient gender or race in the last three years, even though 98 percent of doctors agreed they should be working to minimize these inequalities.
"There is a measurable disconnect between what physicians say they think is the right thing to do and what they actually do," Campbell said in a news release. "This raises serious questions about the ability of the medical profession to regulate itself."
At a forum Monday at the National Press Club to discuss the study's findings, James Thompson, CEO of the Federation of State Medical Boards, argued that doctors were penned in by the American the health care system, fighting giant bureaucracies while fearing legal action if they make a mistake.
"We need to replace this system of punitive measures with non-punitive remediation," said Thompson, arguing that fear of punishment, for themselves or other doctors, makes it difficult for doctors to act on problems.
Sara Rosenbaum, head of the Health Policy Department at George Washington University, agreed that the problem was best addressed by state medical boards and other private regulatory groups, not with law suits and legislation.
"The social ideal is to avoid heavy-handed use of the law," said Rosenbaum, "It's too slow. By the time the money or the changes are ready to effect the people who made a complaint, its too late for the individual." She added that doctors and hospitals already have difficulty meeting their regulatory burden, limiting the effectiveness of new rules.
Rep. Michael C. Burgess, R-Texas, a physician, was in the audience but did not speak on the panel. He has long taken an interest in limiting medical liability suits. While he found himself agreeing with Rosenbaum that the medical industry would have to work harder to regulate itself to correct the issues brought up by the study, Burgess said he also knows how hard it can be effect change at a medical practice.
"The trouble is that it's almost impossible to bounce a physician out of a practice, no matter what they've done, even if you think you've got just an iron clad case against them," said Burgess. "Of course no one wants a doctor that's been drinking in an operating room, but what about the guy with the anger management problem? It's trickier."
Burgess cited a particularly extreme example. "I knew a doctor, years ago, who'd killed his wife, strangled her in fact. And everyone who worked with him knew it, absolutely. But it took 10 years for a case to be built against him and for him to be convicted and until then there was nothing anyone could do, because you're innocent until proven guilty."
Monday, November 12, 2007
It's time to balance fight for life with ballooning health costs. Robert Cushman
By Andrew Thomson, Ottawa Citizen
Published: Wednesday, October 31, 2007
With acute-care beds being filled at area hospitals with chronically ill seniors, the time for a serious public discussion on the collision of rising medical costs and the "death with dignity" debate is now, says the man charged with co-ordinating health care in Eastern Ontario.
It's the ethical responsibility of doctors to encourage discussion regardless of the painful moral, ethical, and political questions that arise, said Dr. Robert Cushman, CEO of the Champlain Local Health Integration Network, who added that the demand for such health care is likely to rise.
"Do I have personal opinions on this? Yes I do," he told the Citizen editorial board this week during a wide-ranging, candid meeting.
"But my professional and my public opinion is that we need to have this healthy debate."
Legislatures and courts across North America and Europe have long grappled with the right to die.
For Dr. Cushman, it's a matter of money and higher levels of respect and care for seniors. The strain on acute care resources has to be addressed as Canada's population ages and pressure mounts on health services, said the former medical officer of health for the City of Ottawa.
Dr. Cushman described a number of 80- or 90-year-olds on ventilators being sent to intensive care units, some of whom have Do Not Resuscitate orders lost in the system. His own 87-year-old mother "would not be happy" with such a scenario, he said.
"It's bad enough with our parents' (generation) but when we get these it's going to really burst the bubble," he said of himself and fellow baby boomers.
Health care administrators now face a zero-sum ethical game where dollars are used for chronic patients in "high-end" acute-care facilities instead of community programs and home care, Dr. Cushman argued, reminding his interviewers that bottom lines aren't his only motivation for seeking public dialogue.
"What kind of heroics can you do in the last six months or two or three years of a life?" he asked. "For someone who's over the age of 80, a hospital is a pretty scary place, and a pretty dangerous place.
"We're talking about the frail elderly. And we have too much of an emphasis on the cure when the returns for the cure can be very low. I think we need to respect seniors' independence and their dignity."
Dr. Cushman, who oversees health care funding and delivery for more than a million residents between Cornwall and Algonquin Park, hopes the growing popularity of living wills is one solution.
He also wants to stop seniors from bouncing around the health care system like a "ping-pong ball." That includes improving "ordinary" procedures such as basic nursing care, home support, and meal delivery.
For more on this story go here
Published: Wednesday, October 31, 2007
With acute-care beds being filled at area hospitals with chronically ill seniors, the time for a serious public discussion on the collision of rising medical costs and the "death with dignity" debate is now, says the man charged with co-ordinating health care in Eastern Ontario.
It's the ethical responsibility of doctors to encourage discussion regardless of the painful moral, ethical, and political questions that arise, said Dr. Robert Cushman, CEO of the Champlain Local Health Integration Network, who added that the demand for such health care is likely to rise.
"Do I have personal opinions on this? Yes I do," he told the Citizen editorial board this week during a wide-ranging, candid meeting.
"But my professional and my public opinion is that we need to have this healthy debate."
Legislatures and courts across North America and Europe have long grappled with the right to die.
For Dr. Cushman, it's a matter of money and higher levels of respect and care for seniors. The strain on acute care resources has to be addressed as Canada's population ages and pressure mounts on health services, said the former medical officer of health for the City of Ottawa.
Dr. Cushman described a number of 80- or 90-year-olds on ventilators being sent to intensive care units, some of whom have Do Not Resuscitate orders lost in the system. His own 87-year-old mother "would not be happy" with such a scenario, he said.
"It's bad enough with our parents' (generation) but when we get these it's going to really burst the bubble," he said of himself and fellow baby boomers.
Health care administrators now face a zero-sum ethical game where dollars are used for chronic patients in "high-end" acute-care facilities instead of community programs and home care, Dr. Cushman argued, reminding his interviewers that bottom lines aren't his only motivation for seeking public dialogue.
"What kind of heroics can you do in the last six months or two or three years of a life?" he asked. "For someone who's over the age of 80, a hospital is a pretty scary place, and a pretty dangerous place.
"We're talking about the frail elderly. And we have too much of an emphasis on the cure when the returns for the cure can be very low. I think we need to respect seniors' independence and their dignity."
Dr. Cushman, who oversees health care funding and delivery for more than a million residents between Cornwall and Algonquin Park, hopes the growing popularity of living wills is one solution.
He also wants to stop seniors from bouncing around the health care system like a "ping-pong ball." That includes improving "ordinary" procedures such as basic nursing care, home support, and meal delivery.
For more on this story go here
Friday, November 9, 2007
Hospital Standardized Mortality Ratio (HSMR) in Canada
| |
| The hospital standardized mortality ratio (HSMR) is an important new measure of patient safety that compares a hospital's mortality rate with the average Canadian rate. It examines observed versus expected deaths and is adjusted for various factors such as the age, sex, diagnoses and admission status of patients. The ratio provides a starting point to assess mortality rates and identify areas for improvement, which may help to reduce preventable deaths. |
| Developed in the United Kingdom in the mid 1990s, the HSMR has also been used in hospitals in Holland and the United States. When tracked over time, the ratio can be a motivator for change, by indicating how successful hospitals or health regions have been in reducing inpatient deaths - leading to improved patient care. CIHI has led the effort in calculating HSMRs for Canada and later in 2007, will be releasing its first public report on results for facilities in all provinces outside Quebec. To learn more about the HSMR, see the documents below:
To learn more about the public release:
Source: http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=hsmr_e |
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