Increasing the Speed of Medical Patient Safety Advances in the USA

Wed Nov 12 13:29:19 UTC 2014

At the regulatory level, one could make professional license renewal contingent on passing an on-line open book test. That way, every health professional would at least be familiar with specific safety safety advances.
Brian Goldman, MD, MCFP(EM), FACEP
Mount Sinai Hospital, Room 206
600 University Avenue
Toronto, ON M5G 1X5
416-822-5044 phone
416-586-4719 fax

On Wednesday, November 12, 2014 12:26 AM, robert bell <rmsbell at ESEDONA.NET> wrote:

Increasing the Speed of Medical Safety Advances in the USA

Medical advances are sometimes quick and sometimes painfully
slow. There is an estimate now that 440,000 patients are dying of error (including diagnostic) every
year in the USA with more being injured. This figure if true has risen from
the IOM estimate 15 years ago of an upper limit of 99,000 deaths. And
presumably with the Affordable Care Act and more people coming into the system
there will be even more deaths occurring.
About 167 years ago Ignaz Semmelweis suggested we wash our
hands before seeing patients – it has been said that only 2/3rds of physicians
do this today when going from patient to patient in hospitals. The importance
of Helicobacter pylori in peptic ulcers and its treatment with antibiotics discovered
by Nobel Prize winners Barry Marshall and Robin Warren of Australia took some
15 years to be fully accepted in the US. Also, the length of time it takes to
get a new pharmaceutical drug on the market (about 10 - 15 years).  Are such times acceptable when patients are dying?
Here on this list we talk about ways to handle a particular
problem. Some will be excellent and life saving advances, but whether they are
introduced into hospitals will depend on the enthusiasm of a few and the
culture in the hospital in question. And then with normal good idea spread one could
expect that idea to take 20 – 30 years to be adopted in all 5,723 hospitals in
the US.
So if we want to prevent more deaths we need to introduce
ideas that are effective far, far more quickly.
How to do this well is the challenge? The quickest way would seem
to be through legislation, but in our gridlocked Washington DC environment, is
this possible? 
It would seem that numbers are more powerful and that
greater co-operation and coalition formation between the Medical Safety Societies
would be worth exploring further to see if such an approach would move things
along much faster.
It also seems that all or most communications to the list
should more often focus on solutions and how to achieve widespread use of
something that works. This so that posts are more action oriented.
Further, I would suggest that contributors copy others to
help move things along. Ideas can be like seeds in the desert waiting for the right conditions to germinate. Perhaps even establish a good idea website by category.
I do not know what the whole solution is in this complicated field but it seems
that we need to be experimenting more, communicating more, and doing more, if
we want to significantly impact the death and injury toll.
I would also propose that a National Symposium be held to
discuss, How to Increase the Speed of
Medical Patient Safety Advances.
Would welcome comments.
Robert M. Bell, M.D.


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