AUTHORS ASSESS STATE OF HEALTHCARE FIVE YEARS AFTER IOM REPORT

Since the release of the institute of medicine’s landmark report on medical errors in 2000, some important changes have occurred, including a shift in thinking about error prevention from personal responsibility to systemwide accountability.

Even so, a number of issues keep the pace of improvement at a crawl, such as the complexity of the medical industry, the commitment to professional autonomy, fear of malpractice, lack of leadership at the hospital and health plan level, and a paucity of definable measures to demonstrate that improvement is being achieved.

“While the progress that has been made in improving patient safety is encouraging, it has been much too slow,” said Lucian Leape, adjunct professor of health policy and management at the Harvard School of Public Health. “To accelerate progress, we need to align the forces for change. The best way to do that would be for the major national organizations, federal and private, to set explicit, ambitious, quantitative national goals and call for all healthcare organizations to meet them. We will not make healthcare safe until we choose to make it safe.”

STUDY: NURSES HANDLING CHEMO MAY POSE RISKS TO THEIR BABIES

A recent article from the Ivanhoe Newswire reports that oncology nurses who regularly handle chemotherapy may be increasing their likelihood of having complications during pregnancy and bearing a child with learning disabilities.

The article is based on results of a survey of oncology nurses presented at the Oncology Nursing Society’s annual conference in April. Researcher Susan Martin, RN, of Sumart Healthcare Consulting, distributed surveys to 7,500 oncology nurses in the Oncology Nursing Society. Half of them responded, and of those, 90 percent reported handling chemotherapy regularly. Among them, they gave birth to 5,336 children. About one-third of the children were born prior to the nurses’ careers, and about 70 percent were born during their nursing careers. Martin found significant associations among handling chemotherapy before age 25 and infertility, miscarriages among women with a high number of chemotherapy exposure years, and preterm labor and births among nurses who administered at least nine doses of chemotherapy a day.

CRITICAL BARRIERS PERSIST TO IMPROVING WOMEN’S HEALTH

For American women, being healthy means far more than getting a good checkup or being disease-free. According to “Women Talk,” the first annual national women’s health survey from the National Women’s Health Resource Center, being healthy means both physical and emotional wellness and having a healthy family. In fact, the survey’s findings strongly suggest that women place a greater priority on the health of their family than their own health. The data that show women’s perceptions of why their health has improved or declined over the past five years are strongly linked to lifestyle issues, such as changes in stress levels and exercise. In fact, women reported that having more time and reducing stress would most help improve their health. The data suggest that healthcare professionals can more effectively use office visits to explain how wellness strategies, such as stress management and medical screenings, can help improve women’s health. The data also suggest that women need to better prepare themselves to get the most from their checkups. When it comes to taking care of their own health, American women say their decisions are limited by the demands on their time and money. Based on the survey findings, the resource center is launching an educational initiative called Take 10 to T.A.L.K. The campaign features a wallet-size card with four important questions that women should ask when visiting their healthcare professional. For copies of the executive summary and the Take 10 to T.A.L.K. card, visit www.healthywomen.org.

HOSPITAL-ACQUIRED INFECTIONS ON THE RISE IN THE U.S.

Infections picked up at hospitals are worsening in the United States, according to a report from HealthGrades Inc. What’s more, a hospital’s infection rate provides a good indication of which hospitals are prone to errors overall.

The study, which looked at 5,000 hospitals, is based on 13 patient-safety indicators devised by the Agency for Healthcare Research and Quality (AHRQ). According to the study, hospital-acquired infections correlated most highly with overall performance and performance on patient-safety incidents, suggesting that hospital-acquired infection rates might indicate overall hospital patient safety.

Hospital-acquired infection rates worsened by about 20 percent from 2000 to 2003 and accounted for 9,552 deaths and $2.6 billion in unnecessary costs, says the report.

Many hospitals emerged with good overall records on patient safety. They seem to have a “culture of safety,” said HealthGrades’ vice president of medical affairs and author of the study Samantha Collier. Such a culture requires rapid identification of errors and root causes, and the successful implementation of improvement strategies.

“For patients, it’s important to know which hospitals meet this standard, as they are nearly 200 percent less likely to have an incident at hospitals in the top 10 percent,” according to the study. The full report is available online at www.healthgrades.com.