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If you read it in a peer reviewed journal, it must be right right? And if there is an evidence-based practice, then the evidence must be stellar. Not so fast, says Lisa Spruce, DNP, RN, ACNS, ACNP, ANP, CNOR, director of evidence-based perioperative practice at the Association of periOPerative Registered Nurses (AORN) in Denver. Spruce is a big advocate of healthcare stakeholders becoming critical readers and understanding exactly what kind of data makes for good evidence. Doing so can make anyone better at determining what practices to mimic or adapt to local needs, and what can just be ignored.
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It is well known that healthcare organizations have access to a vast amount of data, and that a lot is unused and more is of little use. But what can be done about it? A June workshop at the Institute of Medicine (IOM) called Counting What Counts came to some conclusions and may mark the start of a new initiative to streamline data collection and make better use of what is collected.
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The Health Research and Educational Trust (HRET), an affiliate of the American Hospital Association (AHA), has created a series of checklists as part of the Partnership for Patients (PfP) campaign of the Centers for Medicare & Medicaid Services (CMS) that, if implemented, might help reduce patient harm by 40% and unplanned hospital readmission rates by up to 20%.
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Hospitals are barely keeping up with the last round of changes in healthcare, but already there are people calling for another overhaul.
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Late in 2011, the Institute of Medicine (IOM) released a report outlining the potential benefits of health information technology, as well as the potential perils associated with it. "Health IT and Patient Safety: Building Safer Systems for Better Care" included specific recommendations, including that the government should find an independent organization to determine what use of technology could potentially harm patients and how to prevent those scenarios.
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The American Medical Association's Physician Consortium for Performance Improvement and The Joint Commission have come up with ways to reduce five commonly overused treatments use of antibiotics for viral infections like colds, over-transfusion of red blood cells, placing tubes in ears for middle ear infusion, early elective delivery, and elective percutaneous coronary intervention (PCI).
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No one expects everyone to read through the 1,000-plus pages of the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) proposals for 2014. But there are parts of the proposal that impact quality departments, and they demand some study.
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Wrong-site surgery: 20 times a week. Wrong surgery on a patient: 20 times a week. Object left in a patient: nearly 40 times a week. Surgical "never events": more than 4,000 times a year. Those statistics were reported in a study published in April in the journal Surgery.1 With such statistics, there will never be a single solution that makes surgery safer.
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Every parent of a toddler knows that a time-out isn't so much a punishment for the child as a moment to breathe for the parent. It's this moment of calm that is the basis for the use of time-outs in a variety of fields, including surgical medicine. It's a chance to stop and make sure the path you are on is correct. And it's a tool that anyone can use, says Vicki Hess, RN, MS, principle at Catalyst Consulting, based in Baltimore, MD.
