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the medical community make can result in serious
harm or even death, if they are wrong. Realizing
that, it's amazing that anyone who is human and
doesn't have a crystal ball would want to become
a doctor or nurse. Only doctors' strict adherence to
evidence-based practice and empathetic medical
ethics can result in a climate that truly serves patient
safety in our hospitals--especially in a fast-paced,
ever changing environment full of pressure!
In the area of patient safety, most of the
focus has been on front line staff--doctors, nurses,
pharmacists and so forth that provide direct
medical care. We believe that to effect permanent,
long-term progress in preventing medical errors, all
of the following need to be included in the scope of
change: 1) Management; 2) Technology; 3) Medical
Care Team; 4) Patient; 5) Caregiver. Yes, everyone
involved in patient care--including the patient
and caregiver--should be part of the solution. In
this article, we will focus on the Management and
Patient/Caregiver components of patient safety.
m
anagement
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When corporate economic concerns are coupled
with incorrect assumptions, a monster of another
sort is created. Professional responsibility and
effective management should carefully review the
impact of decisions relative to short- and long-term
patient care. An article from 2011 in the New York
Times brought up an interesting topic...Should
Hospitals Be Run by Doctors? (by Tara Parker-Pope).
"Among the nearly 6,500 hospitals in the United
States, only 235 are run by physician administrators,
according to a 2009 study in the journal Academic
Medicine. But new research suggests that having a
doctor in charge at the top is connected to overall
better patient care and a better hospital." Don't
shoot the messenger, but this may be a significant
point where patient safety is concerned.
Let's take, for example, the decision of
management to hire pharmacy technicians to
compound intravenous chemotherapy in major
hospitals across the U.S. There is probably little
doubt what facilitated that decision...the hourly
cost of hiring a pharmacy technician is much lower
than that of a pharmacist. This decision cost Emily
Jerry (2-year-old daughter of Chris Jerry, founder
of the Emily Jerry Foundation) her life in 2006, and
countless others since then. Management probably
assumed that the pharmacy technicians would
be properly trained before taking over the duties
of critical medications. There are still no federal
government regulations for training pharmacy
technicians at major hospitals--although some
states have enacted certification requirements. Go
to the National Pharmacy Technician Regulation
Scorecards to find out how poorly trained pharmacy
technicians might be putting patients at risk in
hospitals, cancer centers, and retail pharmacies in
your state. (March 12th-18th is National
Patient Safety Awareness Week.)
In my husband Gordon's case, I am
convinced that upper management
in the cancer center where he was
treated made the decision to cut down
on patient referrals to other treatment
facilities that might be more qualified to
treat rarer cancers. The first five months
of Gordon's treatment for his aggressive
cancer in a rare location (his central
nervous system) ended with his cancer
being three times worse than when he
was first diagnosed! In addition to two hundred
tumors eating his bones from the inside out,
Gordon's kidneys (a problem with myeloma patients
that had never been tested at the other facility) were
in trouble. Consequently, the oncologists could
never get far enough of his cancer to save Gordon's
life. (March is Myeloma Awareness Month.)