Kia Franklin

Sometimes these things just happen…

But sometimes they can be prevented. Today's article in the New York Times reminds us that some of the deaths and serious injuries that result from medical errors can easily be prevented, with a little extra care and some effective incentives:

Since 2005, central-line bloodstream infections, which stem from bacteria invading a catheter leading to the heart and can often be fatal, have fallen 55 percent in adult intensive care units at the city’s 11 public hospitals, according to statistics released last week. Ventilator-associated pneumonia, caused by bacteria in breathing tubes and which also can be fatal, declined by 78 percent.

Before the hospital system began cracking down on them in late 2005, preventable infections were considered part of the collateral damage of advanced lifesaving techniques, such a routine occurrence that few people questioned their prevalence, or the deaths that resulted from them.

Speaking of incentives, the article points out the perverse incentives against taking on patient safety:

In fact, there had been a perverse financial upside to hospital-based infections, since they filled beds that might otherwise be empty. But changes in government reimbursements have driven New York’s public hospitals, which serve the city’s poorest patients, to tackle the problem.

As part of a pay-for-performance plan, the federal government and many private insurers are planning to stop reimbursing hospitals for harm caused to patients by certain preventable errors.

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Posted at 1:28 PM, May 19, 2008 in Medical Errors
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Kia: Hopkins developed a checklist to reduce infections in these lines. The Hopkins IRB exempted it because it was just paperwork. Hospitals using the checklist reduced their infections by 90% or more. The DOJ stopped this "human experimentation" to protect its human subjects.

If you cannot use a checklist to prevent a blood infection, thank the lawyer.

Posted by: Supremacy Claus | May 19, 2008 3:13 PM

First, remember it is all about selling newspapers and The Times is having problems. Sensationalism sell. Lets look at catheter infections and why they are decreasing. First, is a catheter infection a medical error? No, if you put a piece of plastic through the skin it will eventually get infected. What has decreased the infections is the use of new technology, the PIC line instead of the central line. These became widely available for use in 2005. What decreases ventilator associated pneumonia? Getting them off the ventilator or more importantly performing tracheotomy sooner. They still get the same number of infections but now it is called aspiration. The problem of the infections is not tackled, it is just renamed. With technology we are decreasing certian things but other things remain the same. That is running loose with the facts helps sell newspapers and keeps government officials in their jobs.

Posted by: throckmorton | May 19, 2008 9:26 PM