Re: Hospital aims to eliminate mistakes

[Guest guest]

Every time I go to the hospitol they ask me if I am up to date on my Tetanus

shot??????Are you kidding me.One time my husband got conned into getting the

heppatitus shot because we were truck drivers and used alot of public rest rooms

and ate at alot of restraunts.I could have slapped him after we had talked about

how bad vaxing was.He never did go back for the rest,thank god.Can you get

Hepatitus from the vaxes???Please let me know.This was about 5 years

ago.Lori-love that baby brendon

lordeeme@... wrote: Well. I guess if they would quit trying to

inject everyone that walks in

with flu or pneumonia vaccines (not to mention all the others) then they would

truly be aggressive in this attempt " to eliminate all preventable harm " !

_Beth Israel Deaconess aims to end preventable mistakes - The Boston Globe_

(http://www.boston.com/business/healthcare/articles/2008/01/17/hospital_aims_to

_eliminate_mistakes?mode=PF)

(http://www.boston.com/business/healthcare/articles/2008/01/17/hospital_aims_to_\

eliminate_mistakes?mode=PF)

(http://www.boston.com/news/globe/)

Hospital aims to eliminate mistakes

Strategy to end preventable harm considered a model

By Krasner, Globe Staff | January 17, 2008

Beth Israel Deaconess Medical Center has launched an ambitious

quality-improvement effort aimed at eliminating within four years all harm to

patients

that it considers preventable, such as falls, infections caused by intravenous

lines, and medication errors.

The Harvard teaching hospital in Boston and its suburban hospital in Needham

have already begun measuring ways in which they endanger patients and plan

to publish the results quarterly. The goal is to reach the top 2 percent of

hospitals in patient satisfaction. Currently, Beth Israel Deaconess ranks in

the top 12 percent for patient satisfaction, according to nationwide surveys.

" This is aggressive, " said Levy, chief executive of Beth Israel

Deaconess. " We're pushing beyond the level of care at which regulators are

comfortable. "

Many hospitals have worked for years to eliminate medical errors and reduce

the number of preventable infections. Beth Israel Deaconess's program is

different from most in that it sets a specific goal. It hinges on training the

board of directors about healthcare quality and medical errors and getting them

personally involved in making clinical improvements. In addition, a portion

of senior managers' bonuses will be tied to making improvements.

The hospital is one of five healthcare organizations that have signed on to

a program originated by Blue Cross Blue Shield of Massachusetts, the state's

largest health insurer. The others are Mt. Auburn Hospital in Cambridge, New

England Baptist Hospital in Boston, Cooley Dickinson Hospital in Northampton,

and Atrius Health of Newton, the parent of physicians groups that include

Harvard Vanguard Medical Associates. Beth Israel Deaconess became the first of

the group to finalize its commitment when the board passed a resolution last

month saying it would " eliminate all preventable harm " by the end of 2011 and

be in the top 2 percent of hospitals for patient satisfaction by the same

date. The board of Beth Israel Deaconess Needham Hospital adopted the same

goals.

" We want to create and support examples of transformational change in

hospital quality and safety, " said Dreyfus, executive vice president for

healthcare services at Blue Cross Blue Shield of Massachusetts. " We're looking

for shining examples of organizations willing to take risks and make changes. "

Preventing medical errors in hospitals is seen as one of the ways to improve

healthcare and control costs, which continue to increase at a rate of about

10 percent a year. Cleve L. Killingsworth, chairman and chief executive of

Blue Cross Blue Shield of Massachusetts, has long championed such improvements.

Blue Cross set up two-day workshops for the participating institutions'

directors to spend time with hospital staff and watch how errors happen.

" If hospital trustees place the same scrutiny on clinical performance as

they do on financial performance, that would accelerate change, " Dreyfus said.

" Preventable harm should be just as important a measure as an institution's

bond rating, operating margin, or endowment size. "

The group is part of a two-year " demonstration program " that could be

expanded across Massachusetts, he said. The insurer gave each institution a $1.5

million grant to cover some of the costs of making the changes, including

hiring a consulting firm to perform an initial assessment of each hospital's

performance.

" The program developed in Massachusetts is the first such program in the US,

and the whole country wants to know how they can get this training, " said

Jim Conway, senior vice president of the Institute for Healthcare Improvement,

a Cambridge nonprofit. " These institutions are absolutely at the leading

edge. "

Conway's group developed part of the curriculum presented to directors at

Beth Israel.

Dr. Ken Sands, Beth Israel Deaconess's senior vice president of healthcare

quality, said the first step in the new program will be to gauge the

hospital's current performance to determine " all the differing ways patients get

hurt. "

He said the hospital would express errors in stark terms that can easily be

understood by the public.

" It's one thing to say our central line infection rate was 2.3 percent and

our fall rate was 3 per 1,000 patient days, " he said, using hypothetical

statistics. " It's another to say we harmed 49 people last month. It makes it

more

tangible. "

Its first report will be published this spring.

Like many other hospitals, Beth Israel Deaconess has long sought new ways to

prevent harm. For instance, in an attempt to stop infections from central

intravenous lines, it devised a kit that includes all the equipment to install

the line, and a checklist of steps to follow. A central line is a large

needle inserted into a major blood vessel and used as a portal for infusions,

injections, or to withdraw blood. A slip in protocol - such as forgetting to

sterilize the skin - can leave a patient vulnerable to infections that can be

life-threatening. The rate of central line infections at Beth Israel Deaconess

fell from 2 per 1,000 patient days in the fourth quarter of 2006 to 1.44 per

1,000 patient days in the fourth quarter of 2007.

Using the hospital's website to show how well the program is going " serves

as a management tool so people hold themselves accountable to a higher

standard, " said Levy. " When you have that outside target, it cuts through the

bureaucracies and the petty jealousies. "

Efforts to eliminate preventable harm have already had success at some

hospitals. Cincinnati Children's Hospital Medical Center gives itself a public

report card on quality measures. For instance, in September patients on a

ventilator or breathing tube contracted pneumonia at a rate of 1.1 for every

1,000

ventilator days, compared to nine for every 1,000 ventilator days in the

second quarter of 2005, according to that hospital's website.

Dr. Uma Kutagal, Cincinnati Children's senior vice president of quality and

transformation, said that over the last six years, the hospital has reduced

infections and pneumonia, " virtually eliminated " infections from central

intravenous lines, and reduced mortality in the pediatric intensive care unit.

Krasner can be reached at _krasner@..._

(mailto:krasner@...) .

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