In the news: Patient safety

You may have clipped out a recent Wall Street Journal article, "How to keep the hospital from making you sicker." If you did not see this article, I suggest that you request a copy from your library. The article points out what most competent surgeons have known for years--between 40% and 60% of surgical infections are preventable if health care providers take the necessary precautions.

The article contains a "surgical checklist" that medical staff leaders should share with colleagues, specifically the infection control committee and members of surgical departments.

All medical staffs should analyze the standards included on the surgical checklist and determine how they affect the hospital's patient-oriented policies and procedures. You can be sure that patients and plaintiff attorneys will soon begin to use these standards to pursue malpractice and negligence cases against hospitals.

In response to the article, consider taking the following steps:

1. Compare your current practices to the standards listed in the article.

2. If you do not already track infection rates by procedure type, request that the hospital quickly adopt this practice. Implement an innovative way to post the results. For example, focus on the number of days between infections.

3. Discuss the results at the performance improvement committee or medical executive committee (MEC) meeting.

If you discover that your staff's current practices conform to the suggestions in the article, you should applaud your staff's excellent work. On the other hand, if you find that many of your hospital's surgeons do not adhere to these practices, take this opportunity to begin the education process--perhaps an article in the medical staff newsletter or a discussion at all surgical department meetings.

4.The MEC must determine whether it will permit physicians to ignore these guidelines when scheduling and performing surgery.

The information in the article is very clear and parallels similar data published in peer-reviewed medical and surgical journals. Many surgery-related infections are indeed preventable if providers follow a few specific steps. In the past, each surgeon was permitted to follow his or her own beliefs regarding pre- and post-operative antibiotic use. Those days may be fading rapidly as evidence-based medicine garners a bigger following, and as third-party payers and plaintiff attorneys begin to punish physicians who believe that the practices they learned years ago in medical or osteopathic school are the most effective in today's environment.

That's all for this week.

All the best,

Hugh Greeley