How safe is your hospital? - chicagotribune.com

Just before it was disclosed that a medical error at the University of Chicago led to the death of James Tyree, a well-known financier and philanthropist being treated for cancer, I was putting together a presentation examining the quality of care at some of the area's best-known hospitals.

Using publicly available data, I told a meeting of local health care executives that there were warning flags at several institutions, including the U. of C. Tyree, ironically, would have known about any actual problems in far greater detail. He served on the board of the hospital where he died from an air embolism in a dialysis catheter, and hospital officials said in an interview that they regularly report safety data to board members.

There's an important distinction between great doctoring and great safety. The U. of C. has a reputation for outstanding cancer care. That's likely the reason that Tyree, suffering from stomach cancer and pneumonia, had a relatively good prognosis when he entered the hospital and why his death so shocked his family and friends. But as a wise physician once warned, "Every hospital should have a plaque at its entrance that reads, 'There are some patients whom we cannot help; there are none whom we cannot harm.'"

via chicagotribune.com

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Hospital meals make it difficult to control blood sugars, KevinMD.com

My mom doesn’t take any diabetes medicine.  She keeps her blood sugars normal through a combination of common sense and careful carbohydrate consumption.

A few months ago, she had to be hospitalized for what she calls a “minor procedure.”  The procedure went fine, but not the food.  The first meal they brought her consisted of breaded fish (frozen), mashed potatoes (instant), corn (canned), a dinner roll (frozen), and tea (2 sugar packets on tray).  “If I ate that, my blood sugars would have gone through the roof!” she told me.  She drank the tea, and called my dad, who arrived shortly with chopped salad, roasted peppers, and meat loaf.  This week’s post is about hospital food, if you can call it that.  You are not going to believe what it’s like to order meals for hospitalized patients.

Let’s imagine, for example, a diabetic guy in the intensive care unit.  His blood sugars have been completely out of control, up and down, up and down.  He is recovering slowly from a very serious pneumonia, and is only now beginning to eat again.  The nurse asks if I’d like to order an 1800 kcal ADA diet, which I do not.

An “1800 kcal ADA” diet means 1800 calories total each day, in accordance with the recommendations of the American Diabetic Association.  Their recommended diet is loaded (and I am not exaggerating here) with processed carbohydrate items guaranteed to make it nearly impossible to control one’s blood sugar.  No thanks.

via kevinmd.com

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Study: Surgical Delays Have Profoundly Adverse Impact | National Nursing News

A new study emphasizes why caregivers must work to minimize delays in certain elective surgical procedures for patients who have been admitted to the hospital.

Delays substantially increase the risk of infectious complications and raise hospital costs, according to a comprehensive study in the December issue of the Journal of the American College of Surgeons.

Using a nationwide sample of 163,006 patients ages 40 and older between 2003 and 2007, the authors evaluated patients who developed postoperative complications after one of three high-volume elective surgical procedures: coronary bypass graft, colon resections and lung resections.

For each type of procedure, according to the researchers, infection rates increased significantly from those performed on the first day of admission to those performed a day later, two to five days later and six to 10 days later. With each procedure, there was a difference of at least 10 percentage points between infection rates performed on the day of admission and those performed six to 10 days later.

Delays also increased total hospital costs from $36,079 to $47,5237 for CABG, $20,265 to $29,887 for colon resections and $26,323 to $30,571 for lung resections.

The occurrence of infection after surgical procedures remains a major source of ill health and expense despite extensive prevention efforts via educational programs, clinical guidelines and hospital policies, according to the researchers.

The analysis “confirms a direct correlation between delaying procedures and negative patient outcomes,” lead author Todd R. Vogel, MD, MPH, FACS, assistant professor of surgery at the University of Medicine & Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, said in a news release.

“As pay-for-performance models become increasingly prevalent, it will be imperative for hospitals to consider policies aimed at preventing delays and thereby reducing infection rates.”

Patients more likely to experience in-hospital surgical delays were age 80 and older, female and minorities. They had existing health issues such as congestive heart failure, chronic pulmonary disease and renal failure.

via news.nurse.com

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