Read by QxMD icon Read

Health Affairs

Raj M Ratwani, Erica Savage, Amy Will, Allan Fong, Dean Karavite, Naveen Muthu, A Joy Rivera, Cori Gibson, Don Asmonga, Ben Moscovitch, Robert Grundmeier, Josh Rising
Pediatric populations are uniquely vulnerable to the usability and safety challenges of electronic health records (EHRs), particularly those related to medication, yet little is known about the specific issues contributing to hazards. To understand specific usability issues and medication errors in the care of children, we analyzed 9,000 patient safety reports, made in the period 2012-17, from three different health care institutions that were likely related to EHR use. Of the 9,000 reports, 3,243 (36 percent) had a usability issue that contributed to the medication event, and 609 (18...
November 2018: Health Affairs
Rebecca Gale
As health care becomes more complex, health systems have sought to enlist those who can engage patients outside the hospital walls.
November 2018: Health Affairs
Linda H Aiken, Douglas M Sloane, Hilary Barnes, Jeannie P Cimiotti, Olga F Jarrín, Matthew D McHugh
The Institute of Medicine concluded in To Err Is Human in 1999 that transformation of nurse work environments was needed to reduce patient harm. We studied 535 hospitals in four large states at two points in time between 2005 and 2016 to determine the extent to which their work environments improved, and whether positive changes were associated with greater progress in patient safety. Survey data from thousands of nurses and patients showed that patient safety remains a serious concern. Only 21 percent of study hospitals showed sizable improvements (of more than 10 percent) in work environment scores, while 7 percent had worse scores...
November 2018: Health Affairs
Shawna Smith, Ashley Snyder, Laurence F McMahon, Laura Petersen, Jennifer Meddings
Chart-based surveillance reviews indicate that the incidence of hospital-acquired pressure ulcers (HAPUs) declined 23 percent during 2010-14, equating to an estimated savings of $1 billion during that period. Yet it remains unclear whether the administrative data used to implement three Medicare value-based purchasing programs that target HAPUs indicate similar improvements, and how success varied by HAPU severity. These programs measure and penalize only for more severe ulcers (stage 3 or 4 or unstageable), which are much more costly than less severe cases (stage 1 or 2)...
November 2018: Health Affairs
Traber Davis Giardina, Helen Haskell, Shailaja Menon, Julia Hallisy, Frederick S Southwick, Urmimala Sarkar, Kathryn E Royse, Hardeep Singh
Diagnostic error research has largely focused on individual clinicians' decision making and system design, while overlooking information from patients. We analyzed a unique new data source of patient- and family-reported error narratives to explore factors that contribute to diagnostic errors. From reports of adverse medical events submitted in the period January 2010-February 2016, we identified 184 unique patient narratives of diagnostic error. Problems related to patient-physician interactions emerged as major contributors...
November 2018: Health Affairs
Morgan C Shields, Maureen T Stewart, Kathleen R Delaney
Behavioral health care has been slow to take up robust efforts to improve patient safety. This lag is especially apparent in inpatient psychiatry, where there is risk for physical and psychological harm. Recent investigative journalism has provoked public concern about instances of alleged abuse, negligence, understaffing, sexual assault, inappropriate medication use, patient self-harm, poor sanitation, and inappropriate restraint and seclusion. However, empirical evidence describing the scope of unsafe experiences is limited...
November 2018: Health Affairs
(no author information available yet)
No abstract text is available yet for this article.
November 2018: Health Affairs
Robert Berenson, Hardeep Singh
Diagnostic accuracy is essential for treatment decisions but is largely unaccounted for by payers, including in fee-for-service Medicare and proposed Alternative Payment Models (APMs). We discuss three payment-related approaches to reducing diagnostic error. First, coding changes in the Medicare Physician Fee Schedule could facilitate the more effective use of teamwork and information technology in the diagnostic process and better support the cognitive work and time commitment that physicians make in the quest for diagnostic accuracy, especially in difficult or uncertain cases...
November 2018: Health Affairs
Anjana E Sharma, Natalie A Rivadeneira, Jill Barr-Walker, Rachel J Stern, Amanda K Johnson, Urmimala Sarkar
Patients and caregivers play a central role in health care safety in the hospital, ambulatory care setting, and community. Despite this, interventions to promote patient engagement in safety are still underexplored. We conducted an overview of review articles on patient engagement interventions in safety to examine the current state of the evidence. Of the 2,795 references we evaluated, 52 articles met our full-text inclusion criteria for synthesis in 2018. We identified robust evidence supporting patients' self-management of anticoagulation medications and mixed-quality evidence supporting patient engagement in medication and chronic disease self-management, adverse event reporting, and medical record accuracy...
November 2018: Health Affairs
David W Bates, Hardeep Singh
The Institute of Medicine's To Err Is Human, published in 1999, represented a watershed moment for the US health care system. The report dramatically raised the profile of patient safety and stimulated dedicated research funding to this essential aspect of patient care. Highly effective interventions have since been developed and adopted for hospital-acquired infections and medication safety, although the impact of these interventions varies because of their inconsistent implementation and practice. Progress in addressing other hospital-acquired adverse events has been variable...
November 2018: Health Affairs
William R Berry, Lizabeth Edmondson, Lorri R Gibbons, Ashley Kay Childers, Alex B Haynes, Richard Foster, Sara J Singer, Atul A Gawande
Proven patient safety solutions such as the World Health Organization's Surgical Safety Checklist are challenging to implement at scale. A voluntary initiative was launched in South Carolina hospitals in 2010 to encourage use of the checklist in all operating rooms. Hospitals that reported completing implementation of the checklist in their operating rooms by 2017 had significantly higher levels of CEO and physician participation and engaged more in higher-touch activities such as in-person meetings and teamwork skills trainings than comparison hospitals did...
November 2018: Health Affairs
Richard M Scheffler, Daniel R Arnold, Christopher M Whaley
No abstract text is available yet for this article.
November 2018: Health Affairs
Daniel Brauner, Rachel M Werner, Tetyana P Shippee, John Cursio, Hari Sharma, R Tamara Konetzka
The past several decades have seen significant policy efforts to improve the quality of care in nursing homes, but the patient safety movement has largely ignored this setting. In this study we compared nursing homes' performance on several composite quality measures from Nursing Home Compare, the most prominent recent example of a national policy aimed at improving the quality of nursing home care, to their performance on measures of patient safety in nursing homes such as pressure sores, infections, falls, and medication errors...
November 2018: Health Affairs
Carmela Coyle
No abstract text is available yet for this article.
November 2018: Health Affairs
Pascale Carayon, Abigail Wooldridge, Bat-Zion Hose, Megan Salwei, James Benneyan
Despite progress on patient safety since the publication of the Institute of Medicine's 1999 report, To Err Is Human, significant problems remain. Human factors and systems engineering (HF/SE) has been increasingly recognized and advocated for its value in understanding, improving, and redesigning processes for safer care, especially for complex interacting sociotechnical systems. However, broad awareness of HF/SE and its adoption into safety improvement work have been frustratingly slow. We provide an overview of HF/SE, its demonstrated value to a wide range of patient safety problems (in particular, medication safety), and challenges to its broader implementation across health care...
November 2018: Health Affairs
Alan R Weil
No abstract text is available yet for this article.
November 2018: Health Affairs
Allen Kachalia, Kenneth Sands, Melinda Van Niel, Suzanne Dodson, Stephanie Roche, Victor Novack, Maayan Yitshak-Sade, Patricia Folcarelli, Evan M Benjamin, Alan C Woodward, Michelle M Mello
To promote communication with patients after medical injuries and improve patient safety, numerous hospitals have implemented communication-and-resolution programs (CRPs). Through these programs, hospitals communicate transparently with patients after adverse events; investigate what happened and offer an explanation; and, when warranted, apologize, take responsibility, and proactively offer compensation. Despite growing consensus that CRPs are the right thing to do, concerns over liability risks remain. We evaluated the liability effects of CRP implementation at four Massachusetts hospitals by examining before-and-after trends in claims volume, cost, and time to resolution and comparing them to trends among nonimplementing peer institutions...
November 2018: Health Affairs
Anjali Joseph, Kerm Henriksen, Eileen Malone
There is a lack of awareness regarding the pervasive influence of the built environment on caregiving activities, and how its design could reduce risks for patients and providers. This article presents a narrative review summarizing key findings that link health care facility design to key targeted safety outcomes: health care-associated infections, falls, and medication errors. It describes how facility design should be considered in conjunction with quality improvement legislation; projects under way in health systems; and the work of guideline-setting organizations, funding agencies, industry, and educational institutions...
November 2018: Health Affairs
(no author information available yet)
The Institute of Medicine's landmark report To Err Is Human drew attention to the large number of avoidable medical errors in the US health care system. Much of the response to the report was focused on hospitals, but safety concerns can arise in many settings. This month's DataGraphic highlights patient safety ranging from adverse events in the hospital to the safety performance of nursing homes and complaints made by patients in inpatient psychiatric settings. It also examines safety concerns regarding electronic health records and reports the results of an experiment using a surgical safety checklist in South Carolina...
November 2018: Health Affairs
Jessica Bylander
Funded in part by taxpayer dollars, Dell Medical School has a mandate to improve community health. It's also identifying novel ways to reward value.
November 2018: Health Affairs
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"