The Last Person You'd Expect to Die in Childbirth

Bob Latino blatino at RELIABILITY.COM
Fri May 12 14:44:26 UTC 2017


The Last Person You’d Expect to Die in Childbirth
The U.S. has the worst rate of maternal deaths in the developed world, and 60 percent are preventable. The death of Lauren Bloomstein, a neonatal nurse, in the hospital where she worked illustrates a profound disparity: the health care system focuses on babies but often ignores their mothers.
Interesting article that Kathy Wire posted on LI, that I thought was fitting for this forum.

"Preeclampsia, or pregnancy-related hypertension, is a little-understood condition that affects 3 percent to 5 percent<mailto:https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/Pages/risk.aspx> of expectant or new mothers in the U.S., up to 200,000 women a year."

Why wouldn't an OB/GYM naturally consider this potential condition under these circumstances?

https://www.propublica.org/article/die-in-childbirth-maternal-death-rate-health-care-system

Bob

Robert J. Latino, CEO
Reliability Center, Inc.
1.800.457.0645
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From: Peggy Zuckerman [mailto:peggyzuckerman at GMAIL.COM]
Sent: Friday, May 12, 2017 8:43 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Doctor lectures Valley health professionals on dangers of errors | Local News | dailyitem.com

​Other than saying, "Liar, liar, pants on fire", I would ask him to cite his sources.

The problem is indeed bi​g, but to describe the situation as he has done is to bring ridicule on the situation, and really doesn't take a step toward solving it.  This is the same hype that the headline writers use.

Peggy Zuckerman

Peggy Zuckerman
www.peggyRCC.com<http://www.peggyRCC.com>

On Fri, May 12, 2017 at 5:27 AM, HM Epstein <hmepstein at gmail.com<mailto:hmepstein at gmail.com>> wrote:
While we want people in the medical field to talk about preventing diagnostic and medical errors, how do we handle it when the speaker is using inaccurate and inflated statistics? For example, Dr. David Nash is quoted in this article as telling a room full of doctors, “I know you won’t believe this,” he said, “but every American in 2016, had a misdiagnosis or late diagnosis when they visited a doctor in an office. Every American.”

Best,
Helene

http://www.dailyitem.com/content/tncms/live/
Doctor lectures Valley health professionals on dangers of errors
Rick Dandes<https://www.dailyitem.com/users/profile/Rick%20Dandes>6 hrs ago

LEWISBURG — The idea that medical errors are the third leading cause of death in the United States might have surprised many of the health care workers in attendance at the eighth annual Charles P. Fasano Memorial Lecture, Thursday night at Trout Auditorium on the Bucknell University campus.

But that was the controversial nature of Dr. David Nash’s one hour talk to approximately 175 area medical doctors and administrators. “And many of those errors are preventable,” he said. “They should be. As doctors, as people in the medical field, we should do no harm.”

Nash was introduced by Maria Fasano Bhandgia, who introduced Nash as “someone internationally recognized for his work in public accountability for outcomes and quality of care improvement.”

Nash, dean of the Jefferson College of Population Health, in Philadelphia, presented the idea that safety practices in hospitals are not taught and present dangers to patients, even more so than the actual medical procedure, although that can be a problem too.

“It’s long been a well-kept secret in the medical field,” he said “that health care is dangerous. For years, those in the field would say, ‘stuff happens because what we do is complicated and people get hurt.”

No more is that the case, Nash said. Now there is a public conversation about quality and safety in the medical field. “To do no harm is an enduring notion. But it is more important today than ever before because the tools at our disposal, the technology, the drugs are so incredible. And they all carry risks.”

What Nash talked about are preventable medical mistakes. “Certain things carry risk that we describe to patients. Cancer chemotherapy, we know, has bad side effects. That is not what we are talking about.”

Nash refers to how, “in this country, four times a week, somebody is operating on the wrong side of the body, the wrong kidney, the wrong side of the brain. That’s a preventable medical mistake.”

He also asked, and answered the question, where are there more errors, in a hospital or a doctor’s office?

“Four times as many in a doctor’s office,” Nash said. “And the reasons are interesting. The office is a totally failed system because there has never really been any compelling need to really study systems in the office setting. The good news is most of those errors hardly reach the patient. And when they do reach the patient they are not as deadly.”

Some errors, he said are: putting the wrong chart on the door. Wrong prescription is a typical office based error. “I know you won’t believe this,” he said, “but every American in 2016, had a misdiagnosis or late diagnosis when they visited a doctor in an office. Every American.”

Nash is all about bringing attention to system failure, and he is optimistic that given the Millennial generation’s demands for transparency, hospitals will respond to the need of patients to have more information about their own treatment. And hospitals will have to pay a lot of attention to their systems, make them safe, collaborate as a team … doctors, nurses, other staff.”

“But we have a long way to go on all of that,” said Nash.

Email comments to rdandes at dailyitem.com<mailto:rdandes at dailyitem.com>. Follow Dandes on Twitter @rdandes.

Sent from my iPhone

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