[Spam] Re: [IMPROVEDX] Researchers want a better system for fixing bad science | The Verge

Peggy Zuckerman peggyzuckerman at GMAIL.COM
Fri Feb 12 17:57:00 UTC 2016


I spoke to a head nurse in a Seattle hospital who was so frustrated about
her team being on the hunt for necessary materials, from linens to
band-aid, that she tracked the number of lost hours per shift.  Only when
the administration was shown that over 3 hours per 8 hour shift were lost
in the searches, did they institute a series of changes which had those
supplies refilled automatically in multiple locations by non-nurses.

The administration was clearly concerned, but had no idea of the magnitude
of the problem.  But providing the metrics in terms of the loss of
time/money made the difference.  Certainly the same approach will be
effective when those observations can be linked with the analysis of costs
to the institutions and patients.

Peggy

Peggy Zuckerman
www.peggyRCC.com

On Fri, Feb 12, 2016 at 3:05 AM, DR WILLIAM CORCORAN <
williamcorcoran at sbcglobal.net> wrote:

> One of my mentors loved to repeat:
>
> A short pencil is better than a long memory.
>
> Take care,
>
> Bill Corcoran
>
>
> William  R. Corcoran, Ph.D., P.E.
> 21 Broadleaf Circle
> Windsor, CT 06095-1634
> 860-285-8779
> William.R.Corcoran at 1959.USNA.com
> http://www.linkedin.com/in/williamcorcoranphdpe
> https://www.box.com/shared/kfxg1lt9dh
>
>
>
> On Thursday, February 11, 2016 10:27 PM, Bob Latino <
> blatino at RELIABILITY.COM> wrote:
>
>
>
> Hi Peter
>
> I thought you might like this concept.
>
> *Care Journals* by The Josie King Foundation
>
> http://www.josieking.org/carejournals
>
> I have always liked this idea of providing patients Care Journals to keep
> records during loved one's stay in a hospital.  I think all involved 'win'
> when everyone actively participates in the quality delivery of care.
>
> Just an FYI.
>
>
> *Robert J. Latino, CEO*
> Reliability Center, Inc.
> 1.800.457.0645
> blatino at reliability.com
> www.reliability.com
>
> *From:* Elias Peter [mailto:pheski69 at GMAIL.COM]
> *Sent:* Wednesday, February 10, 2016 4:45 PM
> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> *Subject:* Re: [IMPROVEDX] Researchers want a better system for fixing
> bad science | The Verge
>
> " I kept daily lists of the errors and worked with the Risk Managers to
> resolve.”
>
> If I had a magic wand, I would require that all hospitals create a group
> of 'safety observers’ that would include patients, provide some training in
> systems and medical care, and then pay them to sit and observe and take
> notes and report regularly (monthly at least) to administration/risk
> management and involved departments to identify, prioritize, and address
> safety issues.
>
> I think there is a simple logic to this: direct observation of process by
> independent individuals with different perspectives will see and find
> things that no fancy internal risk management system will see.
>
> Peter Elias, MD
>
>
> On 2016.02.09, at 7:50 AM, Bob Latino <blatino at RELIABILITY.COM> wrote:
>
> The U.S. spends ~17% of its GDP on Healthcare or about $3 Trillion/yr (or
> ($9,323/person).  It is hard to believe we do not throw enough money at
> it.  It is how we use the monies so inefficiently and ineffectively that is
> the problem.  For all of the money thrown at HC, our mortality rates as
> compared to the rest of the world do not demonstrate ours was money well
> spent.  Why not?
>
> To put this into perspective France and Switzerland spend 11% of their GDP
> on healthcare.  The Middle East spends much less (see below).
>
> <image003.png>
>
> *Source: *
> https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf
> *Source: *
> https://www.cia.gov/library/publications/the-world-factbook/rankorder/2066rank.html
> *Definition:* The *crude death rate* is the number of *deaths* occurring
> among the population of a given geographical area during a given year, per
> 1,000 mid-year total population of the given geographical area during the
> same year.
>
> Because the manner in which death rates are collected, deaths due to
> 'medical' error are not uniformly collected or collected at all in many
> countries.  So the only uniform measure of death is called the 'crude death
> rate' around the world (see definition above).  Deaths due solely to
> medical error are included however, the split (%) is not discernible.
> Regardless, when you look at the investment in HC as opposed to GDP, and
> overall crude death rate/1000 total population, the numbers are varied and
> quite startling.  Why do these countries with the lowest investment in HC
> as a % of their GDP, also have the lowest crude death rates in the world?
>
> I know there are many researchers on this forum who will chew this up and
> explain to us the reasons; but as a layman, I am interested in learning why.
>
> Irrespective of what the studies in the link Rob provided conclude, just
> sitting in any hospital for a day and observing, one can make a list of
> errors for themselves.  To me, it is hard to imagine a hospital stay
> without an error occurring the course of the delivery of care.  Both of my
> parents passed in the last 9 years and both were in ICU's for 2 - 4 weeks.
> We stayed with them 24/7 during those stays.  I kept daily lists of the
> errors and worked with the Risk Managers to resolve.  I know what I am
> looking for, just think of those who do not and just 'trust' their care
> givers and their delivery of care systems. Are they told of these errors?
>
> I believe Rob's point is not that the errors are not occurring, but what
> is the scope and magnitude of them?  How do we accurately identify,
> quantify and prioritize them so we can focus on solving them in a logical
> manner?  How do we do this in a fashion where actions replace words and
> change can be observable in the near term (instead of during our
> lifetime)?  Certainly there are more complex issues that will take longer
> to resolve but I believe the 80/20 applies here as well.  I suspect that
> 20% or less of the error types (Failure Modes we call them in my business)
> account for 80% or more of the total occurrences.  Certainly we can act on
> this 'low hanging fruit' in the 20% range (or what we call the Significant
> Few).
>
> Bob Latino
>
>
> Robert J. Latino, CEO
> Reliability Center, Inc.
> 1.800.457.0645
> blatino at reliability.com
> www.reliability.com
>
>
> -----Original Message-----
> From: Robert Bell [
> mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG
> <0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>]
> Sent: Monday, February 08, 2016 10:09 PM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: [IMPROVEDX] Researchers want a better system for fixing bad
> science | The Verge
>
>
> http://www.theverge.com/2016/2/3/10897938/science-correction-process-problems-report-university-alabama
>
> This supoports the concept that the diagnostic infrastructure is overall
> in a bad state. Is money the big problem - too much or too little?
>
> Rob Bell
> Sent from my iPad
>
>
>
> http://LIST.IMPROVEDIAGNOSIS.ORG/ <http://list.improvediagnosis.org/>
> (with your password)
>
>
> Moderator: David Meyers, Board Member, Society to Improve Diagnosis in
> Medicine
>
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> </p>
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> Medicine
>
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>
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>
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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