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News ArticleThe Biden administration announced Wednesday that it is reviving a programme to mail free rapid coronavirus tests to Americans. Starting 25 September, people can request four free tests per household through covidtests.gov. Officials say the tests are able to detect the latest variants and are intended to be used through the end of the year. The return of the free testing program comes after Americans navigated the latest uptick in covid cases with free testing no longer widely available. The largest insurance companies stopped reimbursing the costs of retail at-home testing once the requirement to do so ended with the public health emergency in May. The Biden administration stopped mailing free tests in June. The Department of Health and Human Services also announced Wednesday that it was awarding $600 million to a dozen coronavirus test manufacturers. Agency officials said the funding would improve domestic manufacturing capacity and provide the federal government with 200 million over-the-counter tests to use in the future. “These critical investments will strengthen our nation’s production levels of domestic at-home COVID-19 rapid tests and help mitigate the spread of the virus,” HHS Secretary Xavier Becerra said in a statement. Experts say free coronavirus testing proved to be an effective public health tool, allowing people to check their status before attending large gatherings or spending time with older or medically vulnerable people at risk of severe disease even after being vaccinated. It also enables people to start antiviral treatments in the early days of infection to prevent severe disease. Read full story (paywalled) Source: Washington Post, 20 September 2023
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News Article
USA: Walgreens and CVS warned about selling illegal eye products
Patient Safety Learning posted a news article in News
The US Food and Drug Administration (FDA) has sent warning letters to pharmacy chains Walgreens and CVS accusing them of illegally marketing eye care products. The FDA’s warning letters said the products in question, which were falsely labelled as potential treatments for conditions like glaucoma, cataracts, and pink eye, should be modified if the companies and manufacturers that make and distribute them want to avoid legal action. “The FDA is committed to ensuring the medicines Americans take are safe, effective and of high quality,” Jill Furman, Director of the Office of Compliance at the FDA’s Center for Drug Evaluation and Research, said in a statement. “When we identify illegally marketed, unapproved drugs and lapses in drug quality that pose potential risks, the FDA works to notify the companies involved of the violations.” Ms Furman wrote in the letter sent to Walgreens: “Your ‘Walgreens Allergy Eye Drops,’ ‘Walgreens Stye Eye Drops,’ and ‘Walgreens Pink Eye Drops’ products are especially concerning from a public health perspective. Ophthalmic drug products, which are intended for administration into the eyes … pose a greater risk of harm to users because the route of administration for these products bypasses some of the body’s natural defences.” Read full story Source: The Independent, 21 September 2023 -
Content ArticleWorld Patients Alliance is the umbrella organisation of patients and patients’ organisations around the globe. They seek to ensure that all patients have access to safe, high quality, and affordable healthcare everywhere in the world. These videos produced by World Patients Alliance provide information for patients on the following topics: How do you talk to your healthcare provider? An introduction to medication safety How many medications are too many?
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Content ArticleIn this interview, Derek Feeley, IHI President Emeritus and Senior Fellow shares the work of the Health Improvement Alliance Europe (HIAE) workgroup related to curiosity. He outlines five simple rules linked to complexity theory, which states that if you are trying to make sense of a complex situation, you should create simple, order-generating rules. The five simple rules are: Ask rather than tell. Listen to understand rather than to respond. Hear every voice rather than only those easiest to hear. Prioritise problem framing rather than problem solving. Treat vulnerability as a strength rather than a weakness.
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Content ArticleGetting the president of the United States to consider enacting your policy proposals is a major achievement. Having him actually implement them is an accomplishment that can change lives. The patient safety movement reached that first milestone with a recent report by the President’s Council of Advisors on Science and Technology entitled, A Transformational Effort on Patient Safety. Whether advocates achieve the second, crucial goal remains very much an open question. The PCAST casts a wide net, examining everything from nanotechnology to the public health workforce. It appears until now to have addressed patient safety only tangentially, when in 2014 it was a small part of a larger report on accelerating health system improvement through systems engineering. The good news for patient safety advocates is that President Joe Biden has shown a genuine understanding of the issue. Leah Binder, president of the Leapfrog Group, hailed the report in a statement that singled out two of the recommendations. The first one was to publicly report Never Events (medical errors that never should have happened) by individual facility. The second was a recommendation to establish a National Patient Safety Team. A major barrier standing between recommendation and implementation is the patient safety movement’s paltry political power. At present, patient safety has little public awareness and no grassroots constituency. Hospitals, on the other hand, are an integral part of almost every Congressional district, have a largely positive public image and are facing tough financial pressures. The White House will think long and hard about taking any actions hospitals see as unreasonable.
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Content ArticleDoctors are dying by suicide at higher rates than the general population—somewhere between 300 to 400 physicians a year in the US take their own lives. This article in The Guardian looks at why so many surgeons are dying to suicide and what can be done to stop the trend. It examines how the culture of working long hours and the expectation to be 'superhuman' leads surgeons to suppress their symptoms and avoid seeking help for mental health issues. The article also tells the story of US surgeon and President of the Association of Academic Surgery Carrie Cunningham, who has lived with depression, anxiety and a substance abuse disorder for many years.
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Content ArticleThis article published by the Betsy Lehman Center looks at the benefits of real-time monitoring of electronic health records (EHRs). Early adopter hospitals have demonstrated dramatic gains in safety by monitoring patients' EHR's in real time for signals of potential safety events, allowing providers to more quickly and effectively address safety gaps and improve outcomes. This monitoring is carried out by automated safety surveillance software that continuously runs in the background of EHR systems and can detect hundreds of categories of adverse events as they occur. Expert analysis then quickly helps organisations gain insight from the data, which can be used to proactively reduce safety risks and reliably measure incidence of harm over time.
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Content ArticleInvestigative journalist and medical researcher Maryanne Demasi interviews Phillip Buckhaults, a cancer genomics expert and professor at the University of South Carolina. Professor Buckhaults describes how he decided to test for DNA contamination in vials of Pfizer and Moderna’s bivalent booster shots, hoping to debunk myths about contamination. However, his research revealed that billions of tiny DNA fragments are present in Pfizer’s mRNA vaccine. He highlights the need for further research to find out whether this poses any risk to people who have been given the vaccine, particularly around whether these fragments of DNA could trigger people developing cancer or autoimmune conditions.
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News ArticleThe U.S. Department of Health and Human Services (HHS), through the Agency for Healthcare Research and Quality (AHRQ), announced nine grant awards of $1 million each for up to 5 years to support existing multidisciplinary Long COVID clinics across the country to expand access to comprehensive, coordinated, and person-centered care for people with Long COVID, particularly underserved, rural, vulnerable, and minority populations that are disproportionately impacted by the effects of Long COVID. The grants are a first of their kind. They are designed to expand access and care, develop, and implement new or improved care delivery models, foster best practices for Long COVID management, and support the primary care community in Long COVID education. This initiative is part of the Biden-Harris Administration's whole-government effort to accelerate scientific progress and provide individuals with Long COVID the support and services they need. “The Biden-Harris Administration is supporting patients, doctors and caregivers by providing science-based best practices for treating long COVID, maintaining access to insurance coverage, and protecting the rights of workers as they return to jobs while coping with the uncertainties of their illness,” said Secretary Xavier Becerra. “Treatment of Long COVID is a major focus for HHS, and AHRQ is helping lead the way through grants to investigate best practices and get useful guidance to doctors, hospitals, and patients.” Read full story Source: AHRQ, 20 September 2023
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Content ArticleWhen it comes to your health, it's easy to fall into the mindset that unless you are having signs or symptoms of an illness, you can put off going to see your doctor and skip yearly exams or tests. But preventative care—such as blood tests, cancer screening, mental health check-ins, vaccinations and tests for genetic conditions—can help keep you from developing a serious illness or having to receive care at the hospital. Speak Up™ To Prevent Serious Illness is a patient safety campaign from The Joint Commission designed to educate patients on how to find preventative care services, get past barriers and try to avoid reaching a crisis point with their health. The Joint Commission has produced a video, infographic and distribution guide as part of the campaign.
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Content ArticleThis blog from the Institute for Healthcare Improvement (IHI) looks at the importance of embedding quality control (QC) measures into everyday work. QC methods sustain improvements for the long-run and promote stable systems to produce reliable outcomes. When effectively used, they can internally monitor performance, assess progress towards goals and allow systems to direct improvement resources to where they are needed most.
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News ArticleA not-for-profit health system in Maine has threatened legal action against a 15-year-old boy for shedding light on alleged patient safety issues in the paediatric ward of one of its hospitals. Samson Cournane, a student at the University of Maine, started a petition (Patient Safety in Maine Matters) advocating for an investigation into Northern Light Eastern Maine Medical Center last year, claiming conditions at the hospital were unsafe. Mr Cournane’s mother, Dr Anne Yered, had previously been fired from the hospital after reportedly voicing safety concerns to the hospital’s CEO and president in 2020. In the petition, Mr Cournane said his mother was threatened by hospital staff after raising concerns, with one hospital manager going so far as to show up in her backyard to confront her. Dr Yered subsequently claimed she was wrongfully terminated. Mr Cournane then began pushing for an investigation into the hospital, outlining problems in the petition, which was addressed to US Representative Jared Golden. He alleged that the medical director of the paediatric intensive care unit (ICU) — a former colleague of his mother’s — finished just one year of a three-year critical care fellowship, and implied other hospital employees may be scared to come forward with safety concerns. Read full story Source: The Independent, 4 September 2023
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Content ArticleThe Aviation Safety Reporting System (ASRS) is an important part of the continuing effort by the US government, industry and individuals to maintain and improve aviation safety. The ASRS collects voluntarily submitted aviation safety incident/situation reports from pilots, controllers and others. it analyses and responds to these incident reports to reduce the likelihood of aviation accidents. ASRS data are used to: identify deficiencies and discrepancies in the National Aviation System (NAS) so that these can be remedied by appropriate authorities. support policy formulation, planning for and improvements to the NAS. strengthen the foundation of aviation human factors safety research. This is particularly important since it is generally recognised that over two-thirds of all aviation accidents and incidents have their roots in human performance errors. The ASRS website outlines the purpose and aims of the system, provides details on how to submit reports and lists related research studies and resources.
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Content ArticleThe nurse-to-patient ratio represents the number of patients a registered nurse cares for during a shift. Most hospitals have guidelines to ensure safe staffing ratios, but staffing shortages have led to heavier nursing workloads. This article outlines which US states have laws and regulations in place for safe staffing ratios.
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Content ArticleMost US healthcare organisations use staffing guidelines to decide a nurse's patient load on a given shift, but current staffing shortages are pushing nurse-to-patient ratios to the limit. In this article for Nurse Journal, registered nurse Alexa Davidson asks whether laws and regulations could prevent nursing workloads from getting out of control. She argues that mandated staffing ratios are a proven way to ensure patient safety. She describes the situation in Massachusetts and California, the two US states where laws have been passed mandating nurse-to-patient ratios, and outlines the implications of introducing ratios for nurses and patients.
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Content ArticleThe Patient Safety Network (PSNet) produces primers which provide guidance on key topics in patient safety through context, epidemiology and relevant PSNet content. This primer focuses on nurse-related medication administration errors and highlights that despite error reduction efforts through implementing new technologies and streamlining processes, medication administration errors remain prevalent. It covers the background to the issue, low-tech and high-tech prevention strategies and the current context.
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Content ArticleIn rare cases, healthcare providers who have contributed to accidental patient harm may be criminally prosecuted to obtain justice for the patient and family or to set an example, which theoretically prevents other providers from making similar mistakes due to fear of punishment. This strategy was chosen in the recent case of RaDonda Vaught, who was convicted of criminally negligent homicide and impaired adult abuse after a medication error killed a patient in 2017. This article in the journal Human Factors in Healthcare discusses the case and its ramifications for healthcare staff and systems. The authors provide recommendations for actions that healthcare organisations should take to foster a safer and more resilient healthcare system, including: placing an emphasis on just culture. ensuring timely, systems-level investigations of all incidents. refining and bolstering participation in national reporting systems. incorporating Human Factors professionals at multiple levels of organisations. establishing a national safety board for medicine in the US.
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News Article
The BMJ Investigates U.S. defunding virus detection programme
Patient Safety Learning posted a news article in News
Two years after launching what officials hailed as a five-year flagship project for hunting viruses among wildlife to prevent human pandemics, the US Agency for International Development is shutting down the enterprise. Hear the update from the Editor-in-Chief of The BMJ, Kamran Abbasi. Source: BMJ, 7 September 2023 -
Content ArticleThe USA President’s Council of Advisors on Science and Technology have released their report to the US President, Joe Biden, on patient safety. The report contains recommendations aimed at dramatically improving patient safety in Amercia.
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News ArticleSharri Shaw walked out of the CVS on Vermont Avenue in South Los Angeles in 2019 believing she had a prescription for the pain reliever acetaminophen. Instead the bottle held a medicine to treat high blood pressure, a problem she did not have. Shaw began taking the pills, not learning of the mistake until six days later when a CVS employee arrived at her home, according to a lawsuit she filed last year. The employee told her not to take the tablets, the lawsuit said, before leaving the correct prescription at her door. The mistake, she said, left her stunned. Shaw’s experience is far from an isolated event. California pharmacies make an estimated 5 million errors every year, according to the state’s Board of Pharmacy. Officials at the regulatory board say they can only estimate the number of errors because pharmacies are not required to report them. Most of the mistakes that California officials have discovered, according to citations issued by the board and reviewed by The Times, occurred at chain pharmacies such as CVS and Walgreens, where a pharmacist may fill hundreds of prescriptions during a shift, while juggling other tasks such as giving vaccinations, calling doctors’ offices to confirm prescriptions and working the drive-through. Christopher Adkins, a pharmacist who worked at CVS, and then at Vons pharmacies until March, said that management policies at the big chains have resulted in understaffed stores and overworked staff. “At this point it’s completely unsafe,” he said. Read full story Source: Los Angeles Times, 5 September 2023
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Content ArticleA new issue brief from the Agency for Healthcare Research and Quality (AHRQ) examines the unique challenges of studying and improving diagnostic safety for children in respect to their overall health, access to care and unique aspects of diagnostic testing limitations for multiple paediatric conditions. The issue brief features approaches to address these challenges cross the care-delivery spectrum, including in primary care offices, emergency departments, inpatient wards and intensive care units. It also provides recommendations for building capacity to advance paediatric diagnostic safety.
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News ArticleTonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child. But, just five weeks after confirming her pregnancy she seemed unable to stop urinating. She didn’t realize her amniotic fluid was leaking. Then came the excruciating pain. “I ended up going to the emergency room,” said Hill, now 35. “That’s where I had the most traumatic, horrible experience ever.” An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN’s office rushed her back to the hospital. But she lost her baby. Black women are less likely than women from other racial groups to carry a pregnancy to term — and in Harris County, where Houston is located, when they do, their infants are about twice as likely to die before their 1st birthday as those from other racial groups. Black fetal and infant deaths are part of a continuum of systemic failures that contribute to disproportionately high Black maternal mortality rates. “This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.” Read full story Source: KFF Health News, 24 August 2023
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Content ArticleThe number of cyberattacks and information system breaches in healthcare has grown steadily, escalating from isolated incidents to widespread targeted and malicious attacks. In 2022, 707 data breeches occurred in the US, exposing more than 51.9 million patient records, according to data from the Department of Health and Human Services (DHHS). To help healthcare organisations address this growing patient safety concern, The Joint Commission has issued this Sentinel Event Alert that focuses on risks associated with cyberattacks and provides recommendations on how healthcare organizations can prepare to deliver safe patient care in the event of a cyberattack.
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Content ArticleThis toolkit provides information about how the US Department of Health and Human Services Office of the Director General conducted recent medical record reviews to identify patient harm. It outlines the decision criteria for adverse events and describes the methods used in the report, 'Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm' in October 2018, building upon a broader series of reports about adverse events in hospitals and other health care settings.
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News Article
USA: Why are so many kids losing Medicaid coverage?
Patient Safety Learning posted a news article in News
At the end of the COVID pandemic, more than half (54%) of US children were covered by Medicaid or CHIP; the vast majority by Medicaid. So, the lifting of the pandemic-related Medicaid continuous enrolment protection this spring is a really big deal, putting low-income children at risk of losing access to health care and/or exposing their families to medical debt. In fact, researchers at federal Office of the Assistant Secretary for Planning and Evaluation (ASPE) projected that just shy of three-quarters of children losing Medicaid would be disenrolled despite remaining eligible. Children are most at risk of losing coverage during the unwinding despite being eligible and the likelihood that the child uninsured rate will go up if states do not take care in the process. Over half a million children have lost Medicaid already in 21 states where there is data. And that large number doesn’t include Texas, a state that disenrolled more than 500,000 people on June 1st, and where state agency employees recently blew the whistle on systems errors that caused inappropriate terminations. The Biden Administration must take swift and definitive action to pause all terminations in states with systemic problems. Governors who see large numbers of children losing coverage must pause the process. Coverage must be reinstated for those who lose coverage inappropriately. The time for action to protect children is now. Read full story Source: McCourt School of Public Policy at Georgetown University, 23 August 2023
