Boston health interviews: Spotlight on surgery, Lown and Berwick

You correspondent has been tooling around the city lately asking a lot of questions. Three recent Q&A column in Health Leaders with Boston, Brookline and Cambridge, Mass. links.

Also, the staff at the Brigham had a few questions when a VIP guest make some special requests. Check out the story from the Sunday Globe

When state investigators interviewed an employee identified as “nurse director #1’’ in the report, she said the patient interpreted the use of protective gowns as an indication they thought he was “dirty’’ and asked that staff not wear them. A physician told inspectors that he visited the patient five to seven times a week and did not wear protective gear because the patient “found it offensive.’’ And the hospital had no infection control policies in place for the patient’s personal staff, it told the state. 

sox win 07
Go Sox!

Concurrent Surgery Gets the Spotlight treatment: The editor of The Boston Globe’s investigative reporting unit discusses his team’s series raising questions about the practice of concurrent surgeries and patient safety.

 

Vikas Saini, MD, president of the Lown Institute:”There really needs to be an alliance among patients, families, and communities. At the end of the day, they get to decide what is the right care,”

 

Donald Berwick: The former head of CMS says “we will never solve the problem of cost and finance by focusing on cost and finance.” Instead, it will be resolved “by focusing on the design and redesign of healthcare and the improvement of its quality.”  Part 2

 

 

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Compare Massachusetts doctors via quality reports and patient feedback

CR MA. Doc Ratings Insert_300Searching for health care services on the Internet can be like searching info about food, hotels or pets. You have to sort through a lot of low quality or scraped sites that don’t offer much.

Healthcare Compass looks like a good destination for Bay Staters.

On this website, there are two different ways to compare doctors’ offices:

  • A survey of more than 40,000 patients across Massachusetts that collected details about the care they receive at their own doctors’ offices.
  • Reports that measure how well the doctors’ offices achieve nationally recognized standards for high-quality primary care…

This website helps patients answer two questions about their health care quality:

Are primary care doctors giving their patients the correct preventive care services (such as cancer screenings) and chronic disease care (such as asthma or diabetes care)? The Clinical Quality report looks at how this of care was given to patients at doctors’ offices.
Learn more about the Clinical Quality Report

 How are patients’ experiences with their doctor office? Does their doctor’s office know about them and the care that they should be receiving? The Patient Experience Survey is a statewide survey that asks patients to report about their experiences with a specific primary care doctor and with that doctor’s office. 

Learn more about the Patient Experience Survey report

 

Also, click here for a source of raw data: Patient HealthDecider 

 

Health Leaders Media: What hospitals learned from the Boston Marathon Bombing

From Health Leaders Media

A year after the two bombs went off near the finish line of the Boston Marathon, killing three and injuring scores, the city is making final preparations for the 2014 marathon on Monday, April 21. 

First responders and healthcare workers in particular have learned a number of lessons from the events of April 15, 2013. For example, since the bombing, Boston hospitals have changed the way they receive unidentified trauma patients in the emergency department. Members of the city’s police force are now equipped with military-quality tourniquets.

More lessons, perhaps further-reaching, will come as researchers begin to analyze data on the injuries, surgeries, and outcomes for each of the more than 240 people injured.

Dr King’s Marathon from Tinker Ready on Vimeo.

A primer on using data to stay healthy and get well

medicare compare ss

 

How do you choose a new doctor or a nursing home? Get information on toxins in your neighborhood.? Search an index of reliable, up-to-date medical findings? Ask friends, do a web search or brave an impenetrable government database?  The HealthDecider data links to the left are designed to help.

Most are national, but some are local to Boston. Most are easy to use. However, the Medicare fee database is not consumer-friendly. More on that below.

A few general tips on how to use them:

  •  Always cross reference. Different  sources may rank the same hospital differently
  • Pay attention to sources of information.
  • Look for most recent data.
  • Learn a little about spread sheets to keep track of your research and to    crunch your own numbers.
  • Comment here on the usefulness of this data.
  • Talk to your doctor about “shared decision making.



medicare-ss

The Medicare fee database is rather complex. One way to make sense of it is to simply search on the hospital or provider name. It will then give you a list of procedures you can click on.  We include it here because it contains valuable information. Do know that this is not a consumer database. You  need to know a bit about payer jargon and databases to make sense of it.

Best in the biz in new book on medical errors

We’re saps for top ten lists, even though we find the gimmick annoying. But, we are big fans of Joe and Terry Graedon. We’ve been following both the print and radio versions of “The People’s Pharmacy” since our days in the NC’s Research Triangle. They offer solid advice about meds
and also know the difference between quackery and home remedies. And where else
can you get Milk of Magnesia deodorant?

So we can forgive all  18 top ten lists in their new book “Top Screwups Doctors Make and How to Avoid Them.” Joe Graedon believes his mother’s 1996 death was caused by medical errors at Duke Hospitals. But, instead of suing, he tells the tale of how he and his partner/wife worked with Duke to improve care. They describe it as a “slow and frustrating” process, but think that Duke Hospital is now a safer place.

So, we offer this link and note the Boston contributors to the book. They include Harvard’s Jerry Avorn and David Bates, the head of The Center for Patient Safety Research and Practice at the Brigham.  Also contributing, couple of the best sources on drug safety around – Curt Furberg of the Wake Forest School of Medicine and Thomas Moore of the Institute for Safe Medicine Practices.

We refer you to these Demon Deacons and the Blue Devils with one caveat: Go Heels! We’ve got a UNC grad/NC native in the family. So, while he’s a Tar Heel born and a Tar Heel bred, here’s hoping that medical mistake will never render him Tar Heel dead.

‘Fessing up to medical errors

In the old days, hospitals were not allowed to admit medical errors to patients and families. Today, at some hospitals, that has changed. Today’s Globe story on a lawsuit over a fatal overdose of blood thinner contains this statement from Mass General.

A spokeswoman for Massachusetts General Hospital said in a statement yesterday that the hospital regrets the error, and “our hearts go out to Mrs. Oswald’s family.’’

Spokeswoman Peggy Slasman said that the hospital has enacted new guidelines for the administering of Lepirudin. One plan, according to a hospital report, is to improve the way doctors review and approve new dose infusions.

“As soon as we understood what had happened, we apologized and explained the situation to Mrs. Oswald’s family,’’ said Slasman. “We undertook a thorough and extensive internal review of the case, and we communicated with family members throughout this process. As a result of this event, we have made some specific changes to our practices to reduce the chance of such an event from occurring again.’’

Could this be a new approach to the hospitals case in a malpractice suit? Worth checking into. In the meantime,  there is now a group that recognizes that medical errors are hard for both clinicians and their patients. They’ve generated a nasty bit of jargon, but their approach is unprecedented.

Medically Induced Trauma Support Services (MITSS), Inc. is a non-profit organization founded in June of 2002 whose mission is “To Support Healing and Restore Hope” to patients, families, and clinicians who have been affected by an adverse medical event.

Medically induced trauma is an unexpected outcome that occurs during medical and/or surgical care that affects the emotional well being of the patient, family member, or clinician.

Hoping every week is patient safety week

Here at BHN, we don’t go much for National… Fill in the Blank…Week. But, we offer this video on patient safety by the Boston-based National Patients Safety Foundation anyway.