FW: [IMPROVEDX] Increasing the Speed of Medical Patient Safety Advances in the USA

Michael Grossman Michael.Grossman at MIHS.ORG
Wed Nov 12 17:20:48 UTC 2014


I do agree that deeper discussion regarding enhancing safe practices is in order.
I would caution against  too rapid acceptance of new medications ( FDA approval) and some safety issues as well. Post marketing surveillance of medications at times lead to discovery of serious consequences of pharmaceuticals that cannot be discovered by the routine clinical trials necessary for FDA approval. Drugs are “black boxed “as well as removed from the market frequently-after causing major damage to patients. New genomic markers and testing may assist in more rapid and more accurate approval of new agents.
License renewal can be used to enforce education in given areas ( California does that frequently). What I am not sure of is if that actually changes behaviors.
Hand washing is a perfect example , everyone is aware of it as a necessary element in preventing cross contamination-but…we know the reality
Michel Grossman, MD MACP
VP Academic Affairs

From: BRIAN GOLDMAN [mailto:drhbg at ROGERS.COM]
Sent: Wednesday, November 12, 2014 6:29 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Increasing the Speed of Medical Patient Safety Advances in the USA

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<mailto: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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