WHO partners with JCAHO to eliminate errors
The World Health Organization (WHO) has designated the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Joint Commission International (JCI) as the first WHO Collaborating Center dedicated solely to patient safety.
The collaboration will focus worldwide attention on patient safety and best practices that can reduce safety risks to patients and coordinate international efforts to spread those solutions as broadly as possible, according to an announcement from the three groups.
Human error inevitable
The center will work internationally with ministries of health, patient safety experts, national agencies on patient safety, health care professional associations, and consumer organizations. "Human error is inevitable," said Sir Liam Donaldson, MD, chair of the World Health Alliance for Patient Safety and WHO, on making the announcement.
"We can reduce its impact, but we cannot eliminate it. Instead, with help from the center, health care professionals must improve the systems that create the potential for errors before those systems create costly medical mistakes. The center also will disseminate helpful information about errors to combat the health care industry’s culture of blame, so health care professionals can learn from past mistakes."
For more information, go to www.jcaho.org or www.who.int.
Experienced docs get better angioplasty results
A new study in the Journal of the American College of Cardiology finds that the risk of major complications from angioplasty and related procedures is much lower among patients whose doctors perform a large number of those procedures each year.
In fact, the risk of major cardiovascular problems was 63% higher among patients treated by doctors who performed fewer than 90 procedures each year, compared with those who did more than 90.
Risk of death
However, the study, by a team from the University of Michigan Cardiovascular Center, Blue Cross Blue Shield of Michigan and a consortium of Michigan hospitals, found no difference in the risk of death before leaving the hospital among patients treated by low- and high-volume doctors.
And, it found that a few doctors who performed fewer angioplasties each year still had very good patient outcomes, suggesting that "practice makes perfect" isn’t the whole story for the minimally invasive procedures known as percutaneous coronary interventions (PCI).
The researchers say their data, from 18,504 artery-opening procedures done in 14 Michigan hospitals by 165 physicians during 2002, reflect current angioplasty care, including advanced clot-preventing drugs and stents, which hold arteries open after they’re cleared.
Both advances and better technology for deploying stents within an artery have helped make PCI procedures safer.
"The relationship between physician volumes and patient outcomes is not as strong as it used to be, but it’s still present," according to Mauro Moscucci, MD, the paper’s lead author. "While a cutoff number may not be enough by itself to predict how well a patient will do, it’s still a useful tool."
The new study suggests that 90 procedures a year may be a better threshold than 75, the current standard used by national heart groups.
Study: High-quality care helps elderly survive
A study in Annals of Internal Medicine indicates that providing high-quality care based on established quality indicators can significantly increase survival for elderly patients.
The authors of "Quality of Care Is Associated with Survival in Vulnerable Older Patients" found that 28% of older patients who receive substandard care according to quality indicators for 22 clinical conditions died within a three-year period, compared to 18% of their peers who received a higher quality of care. The findings also indicate a "dose response" relationship between quality of care and mortality: As the amount of high-quality care increased, survival increased.
The study is "the first to show the predictive validity of a broad-based, process-of-care quality measurement system using patient survival among community dwelling older persons," the authors wrote.
The authors suggest that an important next step is to "evaluate whether interventions can be implemented that improve the delivery of these processes," and whether they actually improve survival for vulnerable older patients.
Study models bird influenza outbreak
Using a computer model to simulate an outbreak of avian flu in humans in Southeast Asia, a study in the August issue of Science suggests a combination of strategies including targeted administration of antivirals, quarantine, and pre-vaccination could contain a threatened global flu pandemic under many circumstances.
The researchers at Emory and Johns Hopkins universities and the Ministry of Public Health in Thailand said the response must be rapid, and that health officials would be most likely to contain an outbreak within a community if they were able to respond with quarantine and geographically targeted use of antiviral medication within 14 days of when the first infected person in the community becomes symptomatic. They said the World Health Organization’s current stockpile of 120,000 courses of antivirals would probably be sufficient to contain an outbreak if it remained localized, but that up to 1 million courses of medication might be required if there were several major centers of infection.
The World Health Organization (WHO) has designated the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Joint Commission International (JCI) as the first WHO Collaborating Center dedicated solely to patient safety.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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