AHRQ News And Numbers: Medication Side Effects, Injuries, Up Dramatically

From the 13 April 2011 Medical News Today article

The number of people treated in U.S. hospitals for illnesses and injuries from taking medicines jumped 52 percent between 2004 and 2008 – from 1.2 million to 1.9 million — according to the latest News and Numbers from the Agency for Healthcare Research and Quality. These medication side effects and injuries resulted from taking or being given the wrong medicine or dosage.

The federal agency also found that in 2008:

– The top 5 medicines that had more than 838,000 people treated and released from emergency departments were: unspecified medicines (261,600); pain killers (118,100), antibiotics (95,100), tranquilizers and antidepressants (79,300), corticosteroids and other hormones (71,400).

– For patients admitted to the hospital, the top five medicines causing side effects and injuries were corticosteroids (used for such illnesses as asthma, arthritis, ulcerative colitis, and other conditions–283,700 cases), painkillers (269,400), blood-thinners (218,800), drugs to treat cancer and immune system disorders (234,300), and heart and blood pressure medicines (191,300).

– More than half (53 percent) of hospitalized patients treated for side effects or other medication-related injuries were age 65 or older, 30 percent were 45 to 64, 14 percent between 18 and 44, and 3 percent under age 18. Children and teenagers accounted for 22 percent of emergency cases.

– About 57 percent of the hospitalized patients and 61 percent of emergency department cases were female.

This AHRQ News and Numbers is based on data in Medication-related Adverse Outcomes in U.S. Hospitals and Emergency Departments, 2008. The report uses data from the agency’s 2008 Nationwide Inpatient Sample and 2008 Nationwide Emergency Department Sample. For information about these two AHRQ databases, go here.

Report: Hospital Errors May Be Far More Common Than Suspected

New tracking system uncovers 10 times as many medical mistakes

From the April 7 HealthDay news item

THURSDAY, April 7 (HealthDay News) — A new method for identifying medical errors contends that as many as 90 percent of hospital mistakes are overlooked.

The actual error rate is 10 times greater than previously thought, despite a recent focus on reducing error rates and improving patient safety, a new study suggests.

“The more you look for errors, the more you find,” said lead researcher Dr. David C. Classen, an associate professor of medicine at the University of Utah.

“There is a large opportunity for improvement, despite all the work that’s been done,” he said. “And we need better measurement systems to assess how we are doing in patient safety.”

One factor in the high number of errors is that hospital patients tend to be sicker than they were years ago, Classen noted. With the advent of outpatient treatment, “the healthier patients are no longer in hospitals,” he said…..

The report is published in the April issue of Health Affairs.
The abstract is here.
For suggestions on how to get this article for free or at low cost, click here.

 

 

Reluctance to Speak up Encourages Medical Errors

Reluctance to Speak up Encourages Medical Errors

From the March 22 2011 Health Day news item by Robert Preidt

TUESDAY, March 22 (HealthDay News) — Nurses often don’t speak up about incompetent colleagues or when they see fellow health-care workers making mistakes that could harm patients, new research finds.

In recent years, many hospitals have taken steps to reduce medical errors through measures such as checklists, patient handoff protocols, computerized order entry systems and automated medication-dispensing systems.

But the study***, which included 6,500 nurses and nurse managers across the United States, found that too often, nurses don’t alert their colleagues when they see a safety measure being violated…..

 

*** An executive summary of the study may be found here

[For suggestions on how to get this article for free or at low cost, click here]

 

Elsevier/MEDai enhances real-time clinical surveillance system for hospitals

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Elsevier/MEDai enhances real-time clinical surveillance system for hospitals

From the February 15, 2011 Eureka news alert

(Elsevier) Elsevier/MEDai, a leading provider of advanced clinical analytic health-care solutions, announced today the launch of the latest version of Pinpoint Review, its real-time, clinical surveillance system for hospitals. The new version will feature an expanded set of clinical watch triggers, expanded core measure alerts and three new predictions: ICU Admission Prediction, Length of Stay Prediction and Mortality Prediction.

ORLANDO, FL – 14 February, 2011 – Elsevier / MEDai, a leading provider of advanced clinical analytic healthcare solutions, announced today the launch of the latest version of Pinpoint Review®, its real-time, clinical surveillance system for hospitals. The new version will feature an expanded set of clinical watch triggers, expanded core measure alerts and three new predictions: ICU Admission Prediction, Length of Stay Prediction and Mortality Prediction.

“Hospitals are facing an enormous amount of pressure to provide better, safer care with fewer complications while managing costs,” said Swati Abbott, President of Elsevier / MEDai. “Elsevier / MEDai has enhanced its predictive analytics product to continuously give hospitals and clinicians the most up-to-date tools they need to lower mortality rates and healthcare costs, provide a higher quality of care, increase patient safety and maintain regulatory compliance.”

Pinpoint Review generates predictions for acute-care patients, focusing on the likelihood of a patient developing a complication, contracting a healthcare-acquired infection or being readmitted within 30 days of discharge, while patients are still in the hospital and there is time to adjust care to avoid a negative outcome.

With the expansion of Pinpoint Review’s new predictions, care givers are able to enhance their efforts in proactive care management. Pinpoint Review unlocks the power of clinical and administrative hospital data by utilizing predictive technologies to turn data into actionable information. Empowering today’s hospitals with the ability to predict whether or not a patient will be admitted to the ICU or higher intensity care unit, a predicted length of hospital stay or patient expiration goes a long way in driving down the cost of care and brings a proactive approach to quality improvement.

Pinpoint Review addresses the increasing pressure on hospitals from entities such as the Agency for Healthcare Research and Quality and the Joint Commission on Accreditation of Healthcare Organizations to deliver a higher quality of care and fewer medical errors. Pinpoint Review alerts care providers to patients at risk for developing several of the conditions that the Centers for Medicare and Medicaid Services (CMS) no longer reimburse.

Despite Efforts, Study Finds No Decline in Medical Errors

But experts say some safety initiatives may take time to bring results

From a November 24, 2010 Health Day news item

WEDNESDAY, Nov. 24 (HealthDay News) — Despite intensive efforts to improve patient safety, a six-year study at 10 North Carolina hospitals showed no decline in so-called patient “harms,” which included medical errors and unavoidable mistakes.

Sorting through patients’ medical records from more than 2,300 randomly selected hospital admissions, teams of reviewers found 588 instances of patient harm, which included events such as hospital-acquired infections, surgical errors and medication dosage mistakes.

While most harms were minor and temporary, 50 were life-threatening, 17 resulted in permanent problems and 14 people died, said the researchers, who selected North Carolina hospitals because the state has shown a strong commitment to patient safety. The admissions records spanned the period from January 2002 to December 2007.

Study author Dr. Christopher Landrigan said the results likely reflect what’s happening nationwide. A 1999 Institute of Medicine report publicizing high medical error rates spurred many U.S. hospitals to implement safety-promoting changes, but no uniform set of guidelines exists to direct facilities which changes to tackle, he said.

“What has been done right is that regulatory agencies have begun prioritizing patient safety,” said Landrigan, an assistant professor of pediatrics and medicine at Harvard Medical School. “But these efforts have largely been a patchwork of unconnected efforts and so far have not been as strong as they can be.”

Slightly more than half of the errors were avoidable, Landrigan said. They were detected by investigators who scanned patients’ charts for “trigger” events that suggested mistakes had occurred, such as a prescription for an anti-opioid drug that could remedy a morphine overdose.

The study, published in the Nov. 25 issue of the New England Journal of Medicine [free full text article], is important because health-care professionals “really haven’t had a good sense of what’s going on with safety over time,” said Dr. David Bates, a professor of health policy and management at the Harvard School of Public Health, where he co-directs the program in clinical effectiveness.

“It’s very useful to have robust estimates of the frequency of harm over time in a relatively large sample,” said Bates, who also serves as medical director of clinical and quality analysis for Partners Healthcare System in Massachusetts and is associate editor of the Journal of Patient Safety.

Like Landrigan, Dr. Jeffrey Rothschild of Brigham and Women’s Hospital in Boston believes patient safety has likely improved since the study concluded three years ago.

“But lots of opportunities for improvement are still out there,” said Rothschild, also an assistant professor of medicine at Harvard Medical School. “One of the challenges is gaining a really good handle on the extent of the problem.”

The researchers, who were from Brigham and Women’s Hospital, Stanford University Medical School and the Institute for Healthcare Improvement, pointed out that several practices proven to improve patient safety take much time and money to implement.

These practices include work-hour limits for medical staff as well as the use of electronic medical records and computerized work-order entries for prescriptions and procedures.

“It takes awhile for these improvements to happen,” Landrigan said. “My suspicion is, if we go five years hence, we’re going to see these improvements over time.”

Related Web Sites

• Patient Safety (Medlineplus)
• Patient Safety: Ten Things You Can Do to Be a Safe Patient(Centers for Disease Control and Prevention)
• Speak Up (Joint Commission) links to information on preventing errors in your health care, preventing medical test mistakes, avoiding mistakes in surgery, knowing your rights, and much more
• Where Medical Errors Occur and How to Avoid Them (AHRQ video)
• Getting Safer Care (AHRQ Web page with links)