Showing posts with label United States Institute of Medicine. Show all posts
Showing posts with label United States Institute of Medicine. Show all posts

Tuesday, March 1, 2011

Helping Patients Understand Their Medical Treatment - Kaiser Health News

An elderly woman sent home from the hospital develops a life-threatening infection because she doesn't understand the warning signs listed in the discharge instructions. A man flummoxed by an intake form in a doctor's office reflexively writes "no" to every question because he doesn't understand what is being asked. A young mother pours a drug that is supposed to be taken by mouth into her baby's ear, perforating the eardrum. And a man in his 70s preparing for his first colonoscopy uses a suppository as directed, but without first removing it from the foil packet.

Each of these examples provided by health-care workers or patient advocates illustrates one of the most pervasive and under-recognized problems in medicine: Americans' alarmingly low levels of health literacy — the ability to obtain, understand and use health information.

Translating Medical Jargon

Some technical terms and what they mean in plain English:

  • "myocardial infarction" (heart attack)
  • "hyperlipidemia" (high cholesterol)
  • "febrile" (feverish)

A 2006 study by the U.S. Department of Education found that 36 percent of adults have only basic or below-basic skills for dealing with health material. This means that 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower. About 52 percent had intermediate skills: They could figure out what time a medication should be taken if the label says "take two hours after eating," while the remaining 12 percent were deemed proficient because they could search a complex document and find the information necessary to define a medical term.

Click on the "via" link for the rest of the article.

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Wednesday, February 2, 2011

Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis -- Lipitz-Snyderman et al. 342 -- bmj.com

The US Institute of Medicine highlighted the serious problem of patient safety and importance of evidence based quality improvement initiatives to reduce adverse events.1 Evidence that quality improvement initiatives intended to reduce adverse events result in a measurable impact on other important outcomes, such as mortality and length of hospital stay, is limited. Without this evidence, hospitals and healthcare payers face uncertainty about whether investment in any specific quality improvement intervention will significantly benefit patients and represent a good use of limited financial resources.

The Michigan Health and Hospital Association Keystone ICU (intensive care unit) project, developed by researchers at Johns Hopkins and undertaken by the Michigan Health and Hospital Association, about 80 of its member hospitals, and researchers at Johns Hopkins Medical Institutions, is a recent example of a successful, large scale quality improvement initiative.2 3 4 The project adopted a comprehensive approach to improving patient safety that included promoting a culture of safety, improving communication between providers, and implementing evidence based practices to reduce rates of catheter related bloodstream infections and ventilator associated pneumonia. Evidence based interventions for preventing catheter related bloodstream infections were promoting handwashing, full barrier precautions, skin antisepsis with chlorhexidine, avoiding the femoral site during catheter insertion, and removing unnecessary catheters. Interventions to prevent ventilator associated pneumonia included a mechanical ventilator “bundle” consisting of use of semirecumbent positioning, daily interruption of sedation infusions, and prophylaxis for peptic ulcer disease and deep venous thrombosis.5 The project showed that measures of culture and infection rates in the intensive care unit were substantially improved for up to 36 months after implementing the quality improvement measures.2 4 5 6

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