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News Article
U.S. News & World Report's best children's hospitals 2023-24 honor roll
Patient Safety Learning posted a news article in News
U.S. News & World Report's Best Children's Hospital list for 2023-2024, released 21 June, said 11 children's hospitals are at the top of their game when it comes to 10 pediatric specialties. This year, 11 children's hospitals are included on this list due to a tie in the diabetes and endocrinology category. U.S. News gathered subjective data from more than 15,000 pediatric specialists and clinical data from close to 200 children's hospitals to develop its Best Children's Hospitals 2023-2024 listings. For the first time, Cincinnati Children's Hospital Medical Center took the top spot on the list. The hospital has the only level 4 neonatal intensive care unit, which offers care to infants at all level 3 NICUs in the area. The hospital discovered a "super antibody" it believes will inform new vaccines and offered a specialized approach to reduce stays in the NICU for opioid-exposed newborns. Steve Davis, MD, president and CEO: "This distinction only confirms what we have always known — that we have outstanding, talented team members who are unmatched in their dedication to ensuring that all children have access to exceptional care." Read full story Source: Becker's Hospital Review, 23 June 2023 -
Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Dan talks to us about how his experiences as a paediatrician and military doctor have influenced his view of patient safety. He also describes the increasing complexity in healthcare systems and highlights the need for the Government to commit policy and resources to building and sustaining the NHS workforce. -
Content ArticleThe Armstrong Institute for Patient Safety and Quality provides an infrastructure that oversees, coordinates and supports patient safety and quality efforts across Johns Hopkins' integrated healthcare system. Their mission is to eliminate patient harm, achieve best patient outcomes at the lowest possible cost and share that knowledge through research and training The Armstrong Institute for Patient Safety and Quality leads regional, national and international projects that reduce preventable harm, improve patient and clinical outcomes, and decrease health care costs. They apply a scientific approach to improvement, employing robust measures and rigorous data-collection methods that can be broadly disseminated and sustained.
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News Article
How chatbots are helping doctors be more human and empathetic
Patient Safety Learning posted a news article in News
Despite the drawbacks of turning to artificial intelligence in medicine, some US physicians find that ChatGPT improves their ability to communicate with patients. Last year, Microsoft and OpenAI released the first free version of ChatGPT. Within 72 hours, doctors were using the artificial intelligence-powered chatbot. Experts expected that ChatGPT and other A.I.-driven large language models could take over mundane tasks that eat up hours of doctors’ time and contribute to burnout, like writing appeals to health insurers or summarising patient notes. However, they found that doctors were asking ChatGPT to help them communicate with patients in a more compassionate way. Dr Michael Pignone, the chairman of the department of internal medicine at the University of Texas at Austin, has no qualms about the help he and other doctors on his staff got from ChatGPT to communicate regularly with patients. However, skeptics like Dr Dev Dash, who is part of the data science team at Stanford Health Care, are so far underwhelmed about the prospect of large language models like ChatGPT helping doctors. In tests performed by Dr Dash and his colleagues, they received replies that occasionally were wrong but, he said, more often were not useful or were inconsistent. If a doctor is using a chatbot to help communicate with a patient, errors could make a difficult situation worse. Read full story (paywalled) Source: New York Times, 12 June 2023 -
Content ArticleThe U.S. Preventive Services Task Force (USPSTF) recently changed its recommendations for all women to get screened for breast cancer every other year starting at age 40 instead of 50. Wanda Nicholson, USPSTF Vice Chair and professor at George Washington University said the updated recommendations “will save more lives among all women.” However, time and time again, the evidence shows that screening healthy women using mammograms in fact, does not save lives. Dr Maryanne Demasi discusses the evidence.
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Content ArticleECRI is an independent non-profit that produces an annual list of Top 10 Patient Safety Concerns, and its list for 2023 includes a new emphasis on system safety. In this interview for the Betsy Lehman Center, two leaders at ECRI talk about the list and the current state of patient safety. Shannon Davila, ECRI’s Director of Total Systems Safety and Marcus Schabacker, President and CEO, discuss the need to address gaps in performance with a "total systems approach," the ongoing issue of health inequity and the patient safety risks associated with recent changes in state laws and guidance around obstetrics and maternity.
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News ArticleGrail, a company that developed blood tests to detect cancer, mistakenly sent approximately 400 customers letters saying they might be positive for the disease, The New York Times has reported. Grail's Galleri test uses blood to detect cancer signals shared by 50 types of cancers and is available only by prescription, according to the report. Grail said in a statement that one of its vendors sent hundreds of letters with incorrect test results due to a "software configuration issue." "No patient health information has been disclosed or breached due to this issue, and no patient harm or adverse events have been reported," Grail's statement said. The issue was not caused by incorrect test results, according to the company. More than half of people who received the erroneous letter had not yet had their blood drawn for the test. PWNHealth said in a statement that the system it uses to send template messages to people had a "misconfiguration." Read full story Source: Becker's Hospital Review, 4 June 2023
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News ArticleTwo new healthcare workforce surveys outline widespread reports of discrimination, racism and workplace violence in the USA perpetuated by patients and coworkers alike. Among the findings were acknowledgments from respondents that incidents of discrimination are rarely reported to management or law enforcement. Additionally, more than half of the respondents to one survey said that they believed that incidents of workplace violence have increased over the course of their tenure, while nearly half of the nurses who responded to the other survey said they believe “a culture of racism/discrimination” was present as early as in nursing school. “If we are to truly provide just and equitable care to our patients, we as nurses must hold ourselves accountable for our own behavior and work to change the systems that perpetuate racism and other forms of discrimination,” said Beth Toner, RN, director of program communications at the Robert Wood Johnson Foundation (RWJF). Read full story Source: Fierce Healthcare, 2 June 2023
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Content ArticleProbiotics are used for both generally healthy consumers and in clinical settings, but there have been adverse events as a result of their consumption. Concise and actionable recommendations on how to use probiotics safely and effectively are therefore needed, especially as increasing numbers of new strains and products come to market, and probiotic use increases in vulnerable populations. The International Scientific Association for Probiotics and Prebiotics convened a meeting to discuss and produce evidence-based recommendations on potential acute and long-term risks, risks to vulnerable populations, the importance for probiotic product quality to match the needs of vulnerable populations and the need for adverse event reporting related to probiotic use. This paper presents these recommendations to guide the scientific and medical community on judging probiotic safety.
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News ArticleA US organisation that supports people with eating disorders has suspended use of a chatbot after reports it shared harmful advice. The National Eating Disorder Association (Neda) recently closed its live helpline and directed people seeking help to other resources, including the chatbot. The AI bot, named "Tessa," has been taken down, the association said. It will be investigating reports about the bot's behaviour. In recent weeks, some social media users posted screenshots of their experience with the chatbot online. They said the bot continued to recommend behaviours like calorie restriction and dieting, even after it was told the user had an eating disorder. For patients already struggling with stigma around their weight, further encouragement to shed pounds can lead to disordered eating behaviours like bingeing, restricting or purging, according to the American Academy of Family Physicians. Read full story Source: BBC News, 2 June 2023
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News Article
Florida doctors can soon deny patient care based on personal, religious beliefs
Patient Safety Learning posted a news article in News
A controversial new Florida bill will allow physicians to opt out of performing certain services because of "sincerely held" religious, moral, or ethical beliefs. The bill, part of a "medical freedom" legislative package signed last week, permits healthcare providers to make conscience-based objections to providing medical care and protects them from getting sued or losing their licenses. Critics say the new law could exacerbate health disparities and lead to discrimination against certain groups of patients, including LGBTQ+ individuals and women seeking reproductive healthcare. Psychologists could refuse to treat someone for gender dysphoria, for example. Doctors could refuse to prescribe birth control, administer childhood vaccines, or accept patients with state insurance. Kenneth W. Goodman, professor and director of the University of Miami's Institute for Bioethics and Health Policy, told Medscape Medical News the legislation could upset a longstanding precedent. "To deny care based on unspecified and unarticulated 'moral, ethical, or religious reasons' opens the door to neglect, abandonment, and suspicion," Goodman said. "It undermines two millennia of a cornerstone of medical ethics: take care of your patients — no matter who they are." Read full story Source: Medscape, 18 May 2023 -
News Article
FDA proposes revamping medication guides that come with prescriptions
Patient Safety Learning posted a news article in News
The US Food and Drug Administration has proposed to add to what you get with your prescription drugs. The proposed rule would require the prescriptions you get to come with a new kind of single-page medication guide with an easy-to-use set of directions and easy-to-understand safety information, a goal the FDA has been working toward for years. One study found that nearly 75% of Americans have had trouble taking their medicine as directed. A lot of that is due to cost – people might not be able to afford their medicine, so they don’t take it – but some is due to confusion. They might get more than one kind of written information with their prescription, or the information they receive can be conflicting, incomplete or repetitive, the FDA said. When people are confused or misinformed about their prescription, there is a good chance they will not take it or will stop taking it, and that can directly hurt their health. “Research suggests that medication nonadherence can contribute to nearly 25% of hospital admissions, 50% of treatment failures, and approximately 125,000 deaths in our country each year,” the FDA says. The agency said the new proposal is also meant to help fight the “nation’s crisis with health care misinformation and disinformation.” Read full story Source: CNN, 30 May 2023 -
News ArticlePeople concerned about the safety of patients often compare health care to aviation. Why, they ask, can’t hospitals learn from medical errors the way airlines learn from plane crashes? That’s the rationale behind calls to create a 'National Patient Safety Board,' an independent federal agency that would be loosely modelled after the US National Transportation Safety Board (NTSB), which is credited with increasing the safety of skies, railways, and highways by investigating why accidents occur and recommending steps to avoid future mishaps. But as worker shortages strain the US healthcare system, heightening concerns about unsafe care, one proposal to create such a board has some patient safety advocates fearing that it wouldn’t provide the transparency and accountability they believe is necessary to drive improvement. One major reason: the power of the hospital industry. The board would need permission from health care organisations to probe safety events and could not identify any healthcare provider or setting in its reports. That differs from the NTSB, which can subpoena both witnesses and evidence, and publish detailed accident reports that list locations and companies. A related measure under review by a presidential advisory council would create such a board by executive order. Its details have not been made public. Learning about safety concerns at specific facilities remains difficult. While transportation crashes are public spectacles that make news, creating demand for public accountability, medical errors often remain confidential, sometimes even ordered into silence by court settlements. Meaningful and timely information for consumers can be challenging to find. However, patient advocates said, unsafe providers should not be shielded from reputational consequences. Read full story Source: CNN, 30 May 2023 Related reading on the hub: Blog - It is time for a National Patient Safety Board: Pittsburgh Regional Health Initiative
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Content ArticleThis study in the Journal of Patient Safety outlines the development of the Leapfrog composite patient safety score. The researchers aimed to develop a composite patient safety score that provides patients, healthcare providers and healthcare purchasers with a standardised method to evaluate patient safety in general acute care hospitals in the United States. The study concluded that the composite score reflects the best available evidence regarding a hospital’s efforts and outcomes in patient safety.
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Content ArticleWhat a subway killing reveals about New York City’s revolving-door approach to mental illness and homelessness.
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News Article
USA: Drug shortages near an all-time high, leading to rationing
Patient Safety Learning posted a news article in News
Thousands of patients are facing delays in getting treatments for cancer and other life-threatening diseases, with drug shortages in the United States approaching record levels. Hundreds of drugs are on the list of medications in short supply in the United States, as officials grapple with an opaque and sometimes interrupted supply chain, quality and financial issues that are leading to manufacturing shutdowns. The shortages are so acute that they are commanding the attention of the White House and Congress. The Biden administration has assembled a team to find long-term solutions for shoring up the pharmaceutical supply chain, at a time when the United States remains heavily reliant on medicines and drug ingredients from India and China. And in recent weeks, generic drug makers, supply-chain experts and patient advocates have appeared before lawmakers to discuss the problems. The scarcity of generic forms of chemotherapy to treat lung, breast, bladder and ovarian cancers has only heightened concerns. “This is, in my opinion, a public health emergency,” said Dr. Amanda Fader, a professor at the Johns Hopkins School of Medicine and a president-elect of the Society of Gynecologic Oncology, “because of the breadth of the individuals it affects and the number of chemotherapy agents that are in shortage right now.” Read full story (paywalled) Source: New York Times, 17 May 2023 -
News ArticleHealthcare providers caring for pregnant patients in the months after the US Supreme Court’s decision to strike down Roe v Wade have been unable to provide standard medical care in states where abortion is effectively outlawed, leading to delays and worsening and dangerous health outcomes for patients, according to an expansive new report. In the wake of the Supreme Court’s ruling last year, individual reports from patients and providers have shed some light on the wide range of harm facing pregnant women in states where access to abortion care is restricted or outright banned. But a first-of-its-kind report from the University of California San Francisco captures examples from across the country, documenting 50 cases in more than a dozen states that enacted abortion bans within the last 10 months, painting a “stark picture of how the fall of Roe is impacting healthcare in states that restrict abortion,” according to the report’s author Dr Daniel Grossman. “Banning abortion and tying providers’ hands impacts every aspect of care and will do so for years to come,” he said in a statement accompanying the report. “Pregnant people deserve better than regressive policies that put their health and lives at risk.” Read full story Source: The Independent, 16 May 2023
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Content ArticleA new report presents the preliminary findings of the Care Post-Roe Study, and shows how US healthcare providers have been unable to provide the standard of care in states with abortion bans since the Supreme Court struck down Roe v. Wade ten months ago, leading to harm and negative health outcomes for patients. The report shows that healthcare providers have seen increased morbidity, exacerbated pregnancy complications, an inability to provide time-sensitive care, and increased delays in obtaining care for patients in states with abortion bans. This has impacted both patients and providers and has deepened the existing inequities in the health care system for people of colour.
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Content ArticleThis article looks at the experience of Tammy Dobbs, who has cerebral palsy and requires extensive support from home carers to carry out daily tasks. In 2016, Tammy's care needs were reassessed by the state of Arkansas where she lives, and the hours of support she was eligible to receive were cut in half. The change in eligibility was due to a new state-approved algorithm that had calculated her support needs in a new way, in spite of the fact that there was no change to her level of need. The situation caused Tammy much distress and resulted in drastic life changes. The article highlights the issues associated with the use of algorithms to determine need and allocate resources in health and social care. It also raises questions about what transparency means in an automated age and highlights concerns about people’s ability to contest decisions made by machines.
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Content ArticleThe implementation and continuous improvement of patient safety learning systems (PSLS) is a principal strategy for mitigating preventable harm to patients. Although substantial efforts have sought to improve these systems, there is a need to more comprehensively understand critical success factors. This study aims to summarise the barriers and facilitators perceived by hospital staff and physicians to influence the reporting, analysis, learning and feedback within PSLS in hospitals.
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Content ArticleEconomist Dana Peterson estimates that the economic toll of racism against Black Americans was $16 trillion over the past two decades. Discriminatory lending, wage disparities and inequities in access to higher education, among other factors, have limited the Black community’s ability to generate personal wealth and economic growth. Other minority communities have had similar experiences, and the impact goes far beyond the economy; each of these factors also takes an enormous toll on the health and wellbeing of people of colour. This is the recording of a panel discussion hosted by Harvard T.H. Chan School of Public Health, in which economic, scientific and policy experts discuss how we can build a more equitable and healthier future for everyone.
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News Article
US recommends women start screening for breast cancer at 40
Patient Safety Learning posted a news article in News
A leading health panel in the USA has recommended the age at which women are regularly screened for breast cancer should be cut from 50 to 40. The US Preventive Services Task Force (USPSTF) said an extra 20 million women in their forties would benefit from a mammogram every two years. The change would save 20% more lives, according to the USPSTF, which has drafted the proposal in response to rising rates among middle-aged women. Currently, all women in the USA aged 50 to 74 are advised to get checked via a mammogram every two years. The number of new breast cancer cases is rising roughly two percent every year, John Wong, an internist and professor of medicine at Tufts University School of Medicine, who is on the task force, told the Washington Post. Dr Wong said: "It is now clear that screening every other year starting at age 40 has the potential to save about 20 percent more lives among all women, and there is even greater potential benefit for black women, who are much more likely to die from breast cancer." Read full story Source: Mail Online, 9 May 2023 -
News Article
FDA panel backs first over-the-counter birth control pill in US
Patient Safety Learning posted a news article in News
The first non-prescription birth control pill in the US is on the way to approval, after a thumbs-up from an advisory committee of drug regulators. The Food and Drug Administration (FDA) panel's unanimous vote is not binding, but means the agency is likely to formally approve the drug this summer. Opill has been available, but only by prescription, for the past 50 years. The push for over-the-counter access in the US comes amid Republican-led efforts to restrict access to abortion and contraception at the national and state level. Advisors on the panel said they were mostly confident women of all ages would use the drug as appropriate without first consulting a healthcare provider. "In the balance between benefit and risk, we'd have a hard time justifying not taking this action," said chairwoman Maria Coyle, an Ohio State University pharmacist. "The drug is incredibly effective, and I think it will be effective in the over-the-counter realm just as it is in the prescription realm." Read full story Source: BBC News, 10 May 2023 -
Content ArticleThis case study published by The Beryl Institute looks at an initiative to collect real-time feedback on patient experiences at the Stanford Health Care emergency department in California. Previously, the department had sent a survey to patients well after their visit, but the team realised that capturing this information sooner was critical. Matthew Lim, Patient Experience Manager at Stanford Health Care describes the practical and replicable steps the organisation took in implementing a QR code-based feedback system. He describes the results, lessons learned and potential future developments.
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News Article
USA: Amid hospital 'chaos,' stick to standards to improve quality
Patient Safety Learning posted a news article in News
Every time a mistake is made in a healthcare setting, there can be serious repercussions. Patients may suffer lifetime injuries or even pay the ultimate price for someone else's mistake. Hospitals may wind up paying the price literally — financially and legally — and suffer costly public reputation troubles in the aftermath. Increased patient loads combined with the workforce shortage and often decreasing financial resources have created "chaos" in hospitals, said Doug Salvador MD, chief quality officer at Baystate Health in Springfield, Mass. Safety watchdog organizations, including The Joint Commission and The Leapfrog Group, have reported the result of that chaos: soaring cases of preventable medical errors. The solution, he and several other sources who spoke with Becker's said, is to create standard operating procedures in every department, at every step of the patient journey. These SOPs are more than lists of guidelines; they require strict adherence and limited room for error thanks to built-in cross-check points. And, when instituted properly, they highlight system flaws in real time by creating what Dr. Salvador called "situational awareness." Situational awareness, he added, keeps front-line healthcare professionals on top of their safety game. Read full story Source: Becker's Healthcare, 9 May 2023
