In the age of the Internet, you can do almost anything wirelessly. This is especially intriguing in the health care field where professionals can monitor the data of patients without having to be in the room.
Bring hand sanitizer with you and use it when you leave the office, get off the elevator, leave the building and one last time when you’re safely in your car. You are touching thousands of sick people each step of the way.
If you don’t have to touch things in a hospital or doctors office, don’t. Magazines are probably the worst things to handle – your phone or tablet is a safer option.
To a certain extent you need exposure to everyday germs to stay healthy, but not at that level.
If you’re lucky enough to be able to choose your hospital and have time to research your choices, you’d naturally take mortality rate into account. There’s a problem with that, and one change in how mortality rates are calculated could help solve it.
I think the authors may have missed a larger point. The variation in DNR patients may track facilities who serve more acutely ill populations. Without a more sophisticated look at the populations served, acuity of patients presenting for care, and level of patients kept versus being transferred out due to acute illness – incorporating DNR orders in the score weighting may not make them more accurate.
The interesting point for further research is whether or not DNR orders are a useful indicator or perhaps substitute measure for the other complex variables I noted above. Not having access to the study, I can’t tell whether the authors considered the point.
Last month, we received the cool and totally non-alarming news that drug infusion pumps manufactured by Hospira could be easily hacked over a network. The company has stopped making the pumps, and now the FDA has concluded that yes, hospitals should probably stop using them too.
It was in the 90s that a string of friends had to have their appendix removed. For at least one, the appendix had already burst… 😦
More to the topic onhand though, one of the friends remarked when I visited that they knew the code to their IV drug dispenser after having watched the nurse. It was “1234”, or some such. It’s funny to recall, but I really would not recommend altering your dose.
There are numerous stories about people expiring in ambulances because traffic won’t allow the ambulance through. I was shocked to find that our local law that requires traffic to pull over when an ambulance is coming from behind is not universally implemented, even more to encounter people whose culture was not to move in this event.
In light of the traffic and ambulance location issues, cities like New York turned to making more people first aid attendants. The response time was something like 3 minutes, but there’s no way these people are going to have access to the portable CT scanner, or make the judgement call to employ the clot busting medication TPA.
I appreciate that the team did it, but logistics said it was a useless effort a long time ago.
In recent years, perhaps in response to an uptick in inquiries about hospital performance and its effect on patient outcomes, a number of programs have been developed to help hospitals track how the patients they care for do. The most prominent of these is the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). This system allows hospitals to compare their performance relative to that of other participating hospitals and provides them with detailed descriptions of patient outcomes as adjusted for the patients’ risks.
Since 1994, the ACS NSQIP has been tracking data on 135 patient-related variables. As its name implies (Quality Improvement Program), the hope is that this will lead to improvements for patient care—having this information will hopefully motivate hospitals to improve their outcomes and reduce the payments charged to Medicare. However, there has not been a study examining whether this expectation has been met until now. The new study published in JAMA seems to indicate that a hospital’s participation in this outcomes/costs-tracking program does not directly lead to improved patient care or reduced Medicare costs.
… the precise cause of this enhanced weekend mortality has been hard to determine; is it the reduced staff, a more leisurely approach to care, or some other factor? To try to get at the cause, some researchers obtained records of heart patients who had a critical event during a time when hospitals were at full staff, but heart specialists were likely to be out of town. Unexpectedly, they found that the patients did significantly better when the relevant specialists were unavailable.
The study relied on medicare records to track patients that were admitted to a hospital with a serious heart condition: acute myocardial infarction, heart failure, or cardiac arrest. The key measure was simply whether the patient was still alive 30 days later.
That may sound simple, but the rest of the analysis was remarkably sophisticated. To figure out when heart specialists were most likely to be present at hospitals, they selected two large cardiology meetings: the American Heart Association and the American College of Cardiology, both of which attract over 10,000 participants. Patients admitted during the meetings were compared with groups admitted three weeks before and after. Reasoning that researchers are more likely to attend these meetings, they analyzed teaching hospitals separately from regular ones.