Tag Archives: patient care

#AHCJ17 panel explored humanizing medicine in a high-tech world

The demands that technology places on care providers often are at odds with the human connection necessary for them to do their jobs properly. How to strike a balance?

That was the question panelists discussed at the compelling panel, “Humanizing Medicine in a High Tech World,” during AHCJ’s Health Journalism 2017 in Orlando.

Analia Castiglioni, M.D., explained how medical schools could serve as a model in this area. Castiglioni is director of clinical skills and simulation center and associate professor at the University of Central Florida’s College of Medicine. Continue reading

Exploring ‘preventable harm’ and making it accessible to readers

Sarah Kliff

Sarah Kliff

Vox’s Sarah Kliff, who has an AHCJ Reporting Fellowship on Health Care Performance, is writing a series about fatal, preventable medical errors.

Not the inevitable tragic things that can happen to a patient – but the ones that we know how to avoid, the lives that should not be at risk.  Kliff spent several months on one story – actually a story and accompanying video and graphics – that combined insights about how hospitals think central line infections and a gripping narrative about the death of a 3-year-old girl.  You can find the story here.

Kliff wrote a “How I did It” essay for AHCJ that addresses a lot of the nuts and bolts of a vast project like this. She outlines how she reached out to patients/families, how she organized the voluminous – initially not searchable – medical records, how she found researchers who could elucidate things she did not fully understand in those records.

And she talks about the power of a good analogy to both organize a 5000-word narrative and give readers an accessible entry point to her work. Read about how she did it.

CMS-ordered report, withheld by hospital, reveals hundreds of deficiencies

When Ryan McNeill of The Dallas Morning News recently wrote for AHCJ about that paper’s investigation into patient care and safety at Parkland Memorial Hospital, he noted that the institution narrowly avoided being shut down by the federal government by agreeing to a rare form of oversight.

That oversight included a requirement that the hospital undergo outside monitoring that was carried out by the Alvarez & Marsal Healthcare Industry Group and paid for with about $7 million in taxpayer money.

When Parkland received the federally mandated report, dated Feb. 2, its governing board refused to release it to the public, “citing a fear that it could be used against the embattled public facility in court.”

Now we know why it was loathe for people to see its contents.

The Dallas Morning News has independently obtained a copy of the report and posted it online. It details hundreds of problems throughout the hospital.

Among the findings: Patient rooms were found to contain overflowing trash bins, excrement and blood. Hundreds of medications were improperly administered to patients. Dozens of beds remained empty despite crushes of patients seeking emergency care. Senior leaders kept critical information from the hospital’s board of managers. One patient died, apparently after receiving a drug without doctors’ orders.

Even after the hospital came under scrutiny, patients continued to be harmed, according to the 315-page report: “Considering that Parkland knows it has been under intense scrutiny by the State, CMS and the ICE for the past few months, the number of negative patient events that have occurred just since November 8, 2011 is surprising.”

Perhaps the most disturbing thing about the report is the conclusion that hospital employees do not share a sense of urgency and that  “Large parts of the organization still operate in a business-as-usual mode.”

A CMS representative described the report as a “chilling account.” Monitors said Parkland’s “culture has failed in accountability, from top to bottom.” A Morning News editorial says the report is “scathing in its indictment of a once-respected safety-net hospital.”

Navigators work to keep patients from falling through cracks

Patient navigators – “like the air traffic controllers in health care” – captured the attention of Pamela Fayerman of the Vancouver Sun.

Fayerman explains that patient navigators are specially trained health care providers who help patients get access to care and services they need, serve as liaisons between patients and doctors and generally ensure patients don’t fall through the cracks of a complex health care system.

Fayerman’s five-day, multiplatform series on patient navigators was published last week and is a comprehensive look at this relatively new practice being applied to Canadian patients. She explores the roots of patient navigation in Harlem and goes on to document the evolution in Canada over the past decade.

In a story about one patient, Fayerman shows how the role of a navigator in getting efficient treatment, follow up and having a point of contact got the patient into the hospital for triple bypass surgery before she had a heart attack and sustained damage to her heart.

Other stories look at how navigators bring a culturally sensitive approach to treating members of the aboriginal community, as well as the unwillingness of Canadians to pay out of pocket for navigators, but:

In the U.S., where people are used to paying for health care, navigators are becoming more and more common – in both insured and non-insured settings and at for-profit and non-profit hospitals.

Fayerman, who used a $20,000 grant from the Canadian Institutes of Health Research, visited five provinces and 12 cities over eight months, interviewing nurse and other navigators, their patients and health system leaders. She explains why the series is important and how patients can be their own navigators.

Some Mass. hospital quality measures online

Elizabeth Cooney, writing on White Coat Notes, alerts us to a change in data provided by the Massachusetts Hospital Association and the Massachusetts Organization of Nurse Executives.

PatientCareLink, the new site, adds examples of hospitals improving their performance and, for patients, gives advice on choosing a doctor or hospital, according to Cooney.

The site allows you to view hospital staffing plans and performance measures, such as prevalence of bedsores, patient falls, heart attack care, pneumonia care and surgical care.

Some of the data comes from Hospital Compare (also participating hospitals. And there’s no apparent way to download the data for analysis, as you can from the Hospital Compare site (and AHCJ).

Of course, ratings of Massachusett’s hospitals also are available from the Massachusetts Health Care Quality and Cost Council.