Americas

Citation

(2005), "Americas", International Journal of Health Care Quality Assurance, Vol. 18 No. 7. https://doi.org/10.1108/ijhcqa.2005.06218gab.008

Americas

Americas

CanadaPatient safety guidelines can save lives

Keywords: Health and safety, Patient care, Health services

An Alberta-based patient safety campaign is urging hospitals across the country to change their procedures to prevent medical errors that kill an estimated 24,000 people in Canada every year.

The Canadian Patient Safety Institute’s campaign aims to reduce errors in hospitals, mainly by:

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  giving antibiotics during surgery to prevent infection;

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  keeping better track of medications; and

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  ensuring that patients get quick help when they start going downhill.

Just over half of Canada’s hospitals have agreed to follow the institute’s voluntary guidelines, called Safer Healthcare Now.

“This is grassroots,” said the institute’s Phil Hassen. “These are people wanting care to be better. I think the passion in people is to improve health care and safety for the patients.”

If the estimate of preventable medical mistakes is accurate, the errors are the third leading cause of death in Canada.

But the Alberta guidelines alone won’t prevent errors unless the culture within health-care system also changes. Mistakes are seldom acknowledged and too often repeated, said Ross Baker, one of authors of the Canadian Adverse Events Study on the high rate of medical errors.

“We have to create a sense that if we report these issues and learn from them, that individuals will not be sued in such a way that will drive reporting of these events underground,” said Baker, a professor of health policy, management and evaluation at the University of Toronto.

Jeanette Johnson of Red Deer, Alta., is still looking for someone to accept at least some of the blame for her mother’s death. Mary Randall died at the city’s regional hospital several weeks after being admitted for hip surgery after developing an infection.

“One of the things that we learned more than anything else is, you can’t have any trust in the system at all,” said Johnson, who said it will take more than a few voluntary changes to win back the trust of her family.

The hospital has never accepted responsibility in Randall’s death. Investigations at the time concluded that no clinical errors were made during her care.

More information at: www.mytelus.com/news

USAQuality Improvement Organization: National Collaborative cuts surgical infection rates

The American Journal of Surgery has published a study that credits the 2002-2003 National Surgical Infection Prevention Collaborative with making significant reductions in surgical site infection rates for the 56 hospitals from 50 states that participated in the collaborative.

The year-long collaborative involving 35,000 surgical cases was sponsored by the Centers for Medicare & Medicare Services (CMS) and led by Qualis Health, the Quality Improvement Organization (QIO) for Washington, Alaska, and Idaho.

The 44 hospitals that provided full data on their participation in the collaborative reduced their surgical site infection rate by 27 per cent.

All teams in the Collaborative agreed to focus on improving performance on three processes that CMS uses as national quality measures: administration of antibiotics within 60 minutes prior to surgical incision, use of appropriate antibiotics, and discontinuation of antibiotics within 24 hours of the end of surgery.

Most of the teams also worked on improving performance on one or more of the following: control of glucose levels during surgery, avoiding hypothermia during surgery, use of supplemental oxygen during surgery and recovery, and clipping rather than shaving the surgical site.

Over the course of the collaborative, the median performance of participating hospital teams improved on all process measures. The overall infection rate fell more than a quarter, from 2.3 per cent in the first three months of the collaborative to 1.7 per cent in the last three months.

“These are landmark achievements in getting individuals in hospitals to work with one another and with other hospitals to share their data and good ideas,” said an American Journal of Surgery editorial that accompanied the article.

Results of the collaborative drew praise from CMS administrator Mark McClellan and IHI president Don Berwick, who said: “This project shows how hospitals working together and with QIOs can quickly make changes that save lives.”

QIO co-authors of the study, “Hospitals Collaborate to Decrease Surgical Site Infections,” include Jonathan Sugarman, CEO of Qualis Health; Dale Bratlzler, Principal Clinical Coordinator at Oklahoma Foundation for Medical Quality; and Susan Hausmann, Rosa Johnson, Donna Daniel, Kathryn Bunt, and Greg Baumgardner of Qualis Health. The lead author is E. Patchen Dellinger, a surgeon at the University of Washington.

While the final results of QIO statewide SIP efforts have not yet been announced by CMS, QIOs in more than 30 states have reported that hospitals taking part state SIP collaboratives have shown significant improvement.

More information at: www.ahqa.org