scholarly journals In-Hospital Patient Safety Events, Healthcare Costs and Utilization: An Analysis from the Incident Reporting System in an Academic Medical Center

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 388
Author(s):  
Yao-Wen Kuo ◽  
Jih-Shuin Jerng ◽  
Chia-Kuei Lin ◽  
Hsiao-Fang Huang ◽  
Li-Chin Chen ◽  
...  
Keyword(s):  
Patient Safety ◽  
Claims Data ◽  
Reporting System ◽  
Medical Center ◽  
Academic Medical Center ◽  
Near Miss ◽  
Study Approach ◽  
Academic Medical ◽  
Matched Comparison ◽  
And Control

The possible association of patient safety events (PSEs) with the costs and utilization remains a concern. In this retrospective analysis, we investigated adult hospitalizations at a medical center between 2010 and 2015 with or without reported PSEs. Administrative and claims data were analyzed to compare the costs and length of stay (LOS) between cases with and without PSEs of the three most common categories during the first 14 days of hospitalization. Two models, including linear regression and propensity score-matched comparison, were performed for each reference day group of hospitalizations. Of 14,181 PSEs from 424,635 hospitalizations, 69.8% were near miss or no-harm events. Costs and LOS were similar between fall cases and controls in all of the 14 reference days. In contrast, for cases of tube and line events and controls, there were consistent differences in costs and LOS in the majority of the reference days (86% and 57%, respectively). Consistent differences were less frequently seen for medication events and control events (36% and 43%, respectively). Our study approach of comparing cases with PSEs and those without any PSE showed significant differences in costs and LOS for tube and line events, and medication events. No difference in cost or LOS was found regarding fall events. Further studies exploring adjustments for event risks and harm-oriented analysis are warranted.

scholarly journals Descriptive Epidemiology of Safety Events at an Academic Medical Center

2020 ◽  
Vol 17 (1) ◽  
pp. 353
Author(s):  
Alexandre R. Marra ◽  
Abdullah Algwizani ◽  
Mohammed Alzunitan ◽  
Theresa M. H. Brennan ◽  
Michael B. Edmond
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Surveillance System ◽  
Medical Center ◽  
Academic Medical Center ◽  
Incident Reporting ◽  
Near Miss ◽  
Descriptive Epidemiology ◽  
Near Misses ◽  
Academic Medical

Background: Adverse safety events in healthcare are of great concern, and despite an increasing focus on the prevention of error and harm mitigation, the epidemiology of safety events remains incomplete. Methods: We performed an analysis of all reported safety events in an academic medical center using a voluntary incident reporting surveillance system for patient safety. Safety events were classified as: serious (reached the patient and resulted in moderate to severe harm or death); precursor (reached the patient and resulted in minimal or no detectable harm); and near miss (did not reach the patient). Results: During a three-year period, there were 31,817 events reported. Most of the safety events were precursor safety events (reached the patient and resulted in minimal harm or no detectable harm), corresponding to 77.3%. Near misses accounted for 10.8%, and unsafe conditions for 11.8%. The number of reported serious safety events was low, accounting for only 0.1% of all safety events. Conclusions: The reports analysis of these events should lead to a better understanding of risks in patient care and ways to mitigate it.

Patient Safety Trilogy: Perspectives from Clinical Engineering

2013 ◽  
Vol 47 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Izabella Gieras ◽  
Paul Sherman ◽  
Dennis Minsent
Keyword(s):  
Patient Safety ◽  
Medical Center ◽  
Academic Medical Center ◽  
Clinical Engineering ◽  
Veterans Health ◽  
Health Administration ◽  
Healthcare Technology ◽  
Academic Medical ◽  
Clinical Engineers

This article examines the role a clinical engineering or healthcare technology management (HTM) department can play in promoting patient safety from three different perspectives: a community hospital, a national government health system, and an academic medical center. After a general overview, Izabella Gieras from Huntington Hospital in Pasadena, CA, leads off by examining the growing role of human factors in healthcare technology, and describing how her facility uses clinical simulations in medical equipment evaluations. A section by Paul Sherman follows, examining patient safety initiatives from the perspective of the Veterans Health Administration with a focus on hazard alerts and recalls. Dennis Minsent from Oregon Health & Science University writes about patient safety from an academic healthcare perspective, and details how clinical engineers can engage in multidisciplinary safety opportunities.

A multicentered academic medical center experience of a simulated root cause analysis (RCA) for hematology/oncology fellows.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 188-188
Author(s):  
Danielle Wallace ◽  
Denise Cochran ◽  
Jennifer Michelle Duff ◽  
Julia Lee Close ◽  
Martina Cathryn Murphy ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Medical Center ◽  
Academic Medical Center ◽  
Near Miss ◽  
Safety Skills ◽  
Clinical Patient ◽  
Root Cause ◽  
Event Flow ◽  
Flow Map

188 Background: Quality improvement and patient safety education is an Accreditation Council for Graduate Medical Education (ACGME) common program requirement for hematology/oncology fellowships. Specifically, the ACGME requires trainee participation in interprofessional clinical patient safety activities, such as root cause analyses. These can be challenging to incorporate into busy schedules and are intimidating to some trainees, but simulated RCAs are a novel way to assure trainees gain important patient safety skills. We report on a multicentered experience utilizing a simulated RCA educational module in an attempt to provide fellows with the tools needed to participate in a live RCA and to increase awareness of the need to analyze patient safety events. Methods: The two-hour module included a didactic session explaining the basics of an RCA including common terminology, effective chart review, and personal interviews. The fellows assessed a patient safety event of a missed coagulopathy and created an event flow map and fishbone analysis. They then formed root cause/contributing factor statements and proposed a solution. Seventeen fellows from two institutions completed pre- and post-session surveys regarding the experience. Results: There was a 47% increase in both the percentage of fellows who felt comfortable participating in live RCAs in the future, and in the number of fellows who felt comfortable with using the tools typically utilized in an RCA. 70.59% of respondents felt that as a result of the mock RCA, they were more likely to report a near miss or adverse event. Conclusions: Mock RCAs are a feasible method of incorporating ACGME-required patient safety activities into hematology/oncology fellow education and are effective in increasing their comfort and understanding of important quality improvement skills

Resident and RN perceptions of the impact of a medical emergency team on education and patient safety in an academic medical center*

2009 ◽  
Vol 37 (12) ◽  
pp. 3091-3096 ◽  
Author(s):  
Babak Sarani ◽  
Seema Sonnad ◽  
Meredith R. Bergey ◽  
Joanne Phillips ◽  
Mary Kate Fitzpatrick ◽  
...  
Keyword(s):  
Patient Safety ◽  
Medical Center ◽  
Academic Medical Center ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Emergency Team ◽  
Academic Medical ◽  
The Impact

scholarly journals A Single Virtual Consult Reduces Severe Hyperglycemia in Patients Admitted with COVID19 Infection

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A335-A335
Author(s):  
Diana Athonvarangkul ◽  
Felona Gunawan ◽  
Kathryn Nagel ◽  
Leigh Bak ◽  
Kevan C Herold ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Control Group ◽  
Post Intervention ◽  
Academic Medical ◽  
Treatment Plans ◽  
The Mean ◽  
Glucose Management ◽  
And Control ◽  
Glycemic Management

Abstract Diabetes and hyperglycemia are risk factors for morbidity and mortality in hospitalized patients with COVID19. Subspecialty consultative resources to help front-line clinicians treat these conditions is often limited. We implemented a “Virtual Hyperglycemia Surveillance Service (VHSS)” to guide glucose management in COVID19 patients admitted to our 1541-bed academic medical center. From April 22 to June 9, 2020, hospitalized adult patients with COVID19 and 2 or more blood glucose (BG) values greater than 250 mg/dl over 24-h were identified using a daily BG report. The VHSS reviewed BGs and treatment plans, then made recommendations for future glycemic management via a one-time note, visible to all providers. Some patients with re-admission or persistently elevated BG after 1 week received a second VHSS note. We compared BGs from 24-h pre- and 72-h post-intervention starting at 6AM on the day following VHSS review. We also evaluated for hypoglycemia, insulin infusion use and use of formal diabetes consults. A subgroup analysis was performed on patients in the intensive care unit (ICU). At the end of the intervention, we identified a retrospective control cohort admitted to the same hospital from March 21 to April 21, 2020 who met the inclusion criteria for a VHSS assessment. The VHSS group consisted of 100 patients with 126 individual VHSS encounters, and the control group comprised 50 patients. Baseline characteristics in the VHSS and control groups, respectively, were: mean age 62.5 vs 62.1 years, % male 58 vs 56, mean weight 91.4 vs 93.4 kg, BMI 31.8 vs 33.0 kg/m2, and HbA1c 9.1 vs 8.8 %. There were fewer patients in the ICU in the VHSS than control group (44% vs 66%). In the VHSS group, mean BG pre- vs. post-intervention was 260.3 ±21.7 and 227.4 ±25.3 mg/dl (p<0.001). In the control group, mean BG pre-and post- the day they met assessment criteria was 264.8 ± 6.5 mg/dl and 250.6 ± 8.6 mg/dl (p=0.18). There was no difference in the use of insulin infusions or diabetes consults between the two groups. More hypoglycemia (BG<70 mg/dl) occurred in the VHSS than control group (8.3% vs 0%, p=0.04). Within the VHSS group, the average change in BG was significantly greater in ICU than non-ICU patients (-51.8 ±8.7 vs -19.6 ±5.0 mg/dl, p<0.01) and the reduction in the % of BG over 250 mg/dl was also significantly greater in the ICU (-32.2% vs -16.8%, p=0.02). Implementation of a single virtual consult for severely hyperglycemic hospitalized COVID19 patients was associated with rapidly reduced BG concentrations, especially in the ICU. The mean reduction in BG with VHSS intervention was more than 2-fold greater than that observed in our control group. Glucose control remained suboptimal, however, suggesting the need for subsequent input from this specialty service.

Agency for Healthcare Research and Quality Patient Safety Indicators and Mortality in Surgical Patients

2014 ◽  
Vol 80 (8) ◽  
pp. 801-804 ◽  
Author(s):  
Rajesh Ramanathan ◽  
Patricia Leavell ◽  
Luke G. Wolfe ◽  
Therese M. Duane
Keyword(s):  
Patient Safety ◽  
Length Of Stay ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Length ◽  
Healthcare Research ◽  
Hospital Length Of Stay ◽  
Surgical Patients ◽  
Patient Safety Indicators ◽  
Academic Medical

Patient safety indicators (PSI), developed by the Agency for Healthcare Research and Quality, use administrative billing data to measure and compare patient safety events at medical centers. We retrospectively examined whether PSIs accurately reflect patients’ risk of mortality, hospital length of stay, and intensive care unit (ICU) requirements at an academic medical center. Surgical patient records with PSIs were reviewed between October 2011 and September 2012 at our urban academic medical center. Primary outcomes studied included mortality, hospital length of stay, and ICU requirements. Subset analysis was performed for each PSI and its association with the outcome measures. PSIs were more common among surgical patients who died as compared with those alive at discharge (35.3 vs 2.7 PSIs/100 patients, P < 0.01). Although patients who died with PSIs had shorter hospital courses, they had a significantly greater ICU requirement than those without a PSI (96.0 vs 61.1%, P < 0.01) and patients who were alive at discharge (96.0 vs 48.0%, P < 0.01). The most frequently associated PSIs with mortality were postoperative metabolic derangements (41.7%), postoperative sepsis (38.5%), and pressure ulcers (33.3%). PSIs occur at a higher frequency in surgical patients who die and are associated with increased ICU requirements.

Comparing successful insertions, dwell time, reinsertions and the costs of supplies between integrated and simple short peripheral catheters

2021 ◽  
pp. 112972982110548
Author(s):  
Jonathan D Cura
Keyword(s):  
Patient Safety ◽  
Dwell Time ◽  
Clinical Performance ◽  
Medical Center ◽  
Academic Medical Center ◽  
Insertion Site ◽  
The Philippines ◽  
Adult Patients ◽  
Academic Medical ◽  
Quasi Experimental

Background: Along with the challenges to strengthen patient safety in the use of short peripheral catheters (SPCs), various studies have been conducted in the past to explore differences between two main types of SPCs—integrated SPC (ISPC) and simple SPC (SSPC) in terms of clinical performance. The accumulated evidence from the literature lean toward the benefits of ISPC use in preventing complications leading to longer dwell time and more economical savings than SSPC use. The study aimed to compare ISPC and SSPC in terms of first-attempt successful insertions, number of attempts before successful insertion, perceived ease of insertion, dwell time, reinsertion rate, reasons for removal, and costs of supplies used for the insertions. Furthermore, it aimed to verify whether the previous results of referenced work in the use of ISPC were similar, and its use provided more foreseeable benefit for patient safety and cost-efficiency. Methods: This quasi-experimental study was conducted in a 650-bed tertiary academic medical center in the Philippines. Eligible participants were adult patients who were required SPC for at least 72 h by the physician. Using inferential statistics, comparisons were done among adult patients with integrated ( n = 350) and simple ( n = 350) SPC. Comparisons were also made according to insertion site and gauge of SPC. Results: The successful first-attempt insertions did not vary significantly at around 80% in both groups ( p = 0.428). No significant differences were found in terms of attempts before successful insertion ( p = 0.677), dwell time ( p = 0.144), reinsertions ( p = 0.934), and reasons for removal ( p = 0.424). Meanwhile, comparable differences were noted in terms of perceived ease of insertion ( p < 0.001) and cost of supplies used during the insertions ( p < 0.001). Conclusion: ISPCs can yield the same results with that of SSPCs while being easier to use and less costly.

scholarly journals Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center

2020 ◽  
Vol 10 (4) ◽  
pp. 154
Author(s):  
Amy L. Pasternak ◽  
Kristen M. Ward ◽  
Mohammad B. Ateya ◽  
Hae Mi Choe ◽  
Amy N. Thompson ◽  
...  
Keyword(s):  
Patient Safety ◽  
Laboratory Tests ◽  
Medical Center ◽  
Academic Medical Center ◽  
Clinical Implementation ◽  
Academic Health ◽  
Implementation Processes ◽  
Academic Medical ◽  
Multiple Groups ◽  
Test Ordering

Multiple groups have described strategies for clinical implementation of pharmacogenetics (PGx) that often include internal laboratory tests that are specifically developed for their implementation needs. However, many institutions are not able to follow this practice and instead must utilize external laboratories to obtain PGx testing results. As each external laboratory might have different ordering and reporting workflows, consistent reporting and storing of PGx results within the medical record can be a challenge. This might result in patient safety concerns as important PGx information might not be easily identifiable at the point of current or future prescribing. Herein, we describe initial PGx clinical implementation efforts at a large academic medical center, focusing on optimizing three different test ordering workflows and two distinct result reporting strategies. From this, we identified common issues such as variable reporting location and structure of PGx results, as well as duplicate PGx testing. We identified several opportunities to optimize our current processes, including—(1) PGx laboratory stewardship, (2) increasing visibility of PGx tests, and (3) clinician and patient education. Key to the success was the importance of engaging clinician, informatics, and pathology stakeholders, as we developed interventions to improve our PGX implementation processes.

Sign in / Sign up

Export Citation Format

Share Document