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Entries in Department of Health & Human Service (3)

Saturday
Jan072012

80 Percent of Hospital Errors Go Unreported

Getty(WASHINGTON) -- Martine Ehrenclou felt sidelined when her mother was admitted to the hospital for acute pancreatitis.

"I didn't know what I was supposed to do and what my role was in her care," said Ehrenclou, 51, of Los Angeles. "I just thought I needed to comfort my mother and just talk to the doctors."

But what was explained to Ehrenclou as a common procedure for the condition turned fatal. While in the hospital, Ehrenclou's mother, who was 71, acquired a host of complications including pneumonia and a staph infection.

Within five months, Ehrenclou's mother died.  

Hospital staff members could have made some mistakes with her mother's care, but Ehrenclou would never know.

A new report released Friday by the inspector general of the U.S. Department of Health and Human Services found that more than 80 percent of hospital errors go unreported by hospital employees.

The report, which looked at data from hospitalized Medicare patients, also found that most hospitals where errors were reported rarely changed their policies and practices to prevent repeat errors, saying the event did not reveal any "systemic quality problems."

The errors included overused or wrong medications, severe bedsores, hospital-based infections and even patient death.

In order to be paid by Medicare, hospitals are required to track and analyze medical errors. But organizations that inspect hospitals loosely regulate hospital tracking records, the study said.

Also, many hospital employees may not recognize "what constitutes patient harm," or they may not realize that particular events harmed patients and should be reported, according to the report.

The national report looked at nearly 300 adverse patient events acquired from medical records and traced the records back to its respective hospitals to see whether the hospitals had identified medical error. The report found very few hospitals did.

Sixty-one percent of unreported cases were not perceived as errors by hospital staff. The remaining 25 percent of unreported cases were situations that were typically reported by the staff, but happened not to be reported.

"We're always going to make mistakes," said Dr. Peter Pronovost, medical director at the Center for Innovation in Quality Patient Care at Johns Hopkins University Medical School of Medicine. "What we need to do is reduce harm."

The more serious events, like hospital-acquired infections and patient deaths, were no more likely to be reported than the smaller cases, like allergic reactions to medications.

Pronovost created a standard patient safety checklist for commonly performed procedures that are implemented in hospitals nationwide.  

The Center for Medicare Services also plans to develop and distribute a list of adverse events that should be reported, said Ruth Ann Dorrill, deputy regional inspector general for the Department of Health and Human Services.

Staff members may have feared retribution or may have not wanted to report their own colleagues said Dorrill.

The study is one of many finding similar results. In April 2011, a study released in the journal Health Affairs found that one third of hospital visits will lead to hospital related injuries, and as many as 90 percent of hospital errors are missed by current surveillance systems.

Forty-four percent of the errors identified were preventable, Dorrill said.

But beyond staff education, family members and patients themselves should be educated too, said Ehrenclou, who authored the book, "Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive."

Ehrenclou promised herself she would never again feel uncertain about her role at the hospital as she felt about her mother. Three years later, when her godmother was admitted to a different hospital for complications because of her diabetes, Ehrenclou felt better prepared.

The hospital staff informed her that her godmother received twice the dose of the sedative benzodiazepine, and her body wasn't capable of clearing the medication.

Her godmother also endured bed sores during her seven-month stay. Although her godmother also passed away, Ehrenclou said she became more involved in her godmother's hospital care by asking questions to understand her condition.

"I would've done so many things differently with my mother. I would've gotten a second opinion from a specialist. I would've done research on her disease," said Ehrenclou. "I would've been on top of all of her medications. I would've communicated all of that to her doctors."

Copyright 2012 ABC News Radio

Thursday
Feb032011

Campaign Encourages Women to Recognize Heart Attack, Dial 911

Photo Courtesy - Getty Images(WASHINGTON) -- Heart disease is the number one killer of women.  An American woman suffers a heart attack every minute.  Yet after years of public education programs, the message hasn't penetrated and many women can't detect the signs.

The "Make the Call, Don't Miss a Beat" campaign, unveiled Tuesday by the Department of Health and Human Services and its Office on Women's Health, wants women to learn to recognize signs of a heart attack, especially the signs they're likely to dismiss.

The campaign also emphasizes the importance of dialing 911 if women experience one or more of those signs with an intensity and persistence they've never felt before, delivering its message through print and broadcast public service advertisements, billboards and public transit ads, and with testimonials of heart attack survivors.

The underpinning of the campaign is clear: getting appropriate medical attention within an hour of a heart attack halves the risk of dying.

In 2006, an American Heart Association survey conducted every three years found that 79 percent of women reported that the first thing they would do if they thought they were having a heart attack was to call 911.  But in the 2009 survey, "we were shocked that only 53 percent of women said they would call 911 first," said Suzanne Haynes, senior science adviser for the Office on Women's Health and director of the campaign.

Women easily overlook or excuse subtle symptoms that can end in a heart attack, as well as many acute symptoms during a heart attack, said Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital and one of the campaign's developers.

The seven major signs you are having a heart attack are:

1. Unusual or unexplained fatigue unrelated to exercise.

2. Unfamiliar dizziness or lightheadedness.

3. Unexplained nausea, vomiting.

4. Sharp pain in the upper body, including the neck, back and jaw.

5. Severe shortness of breath.

6. Heavy pressure on the chest, which may feel like indigestion, heartburn, fullness or squeezing, lasts more than a few minutes and may abate before returning.

7. Cold sweats that do not resemble the hot flashes associated with menopause.´╗┐

Copyright 2011 ABC News Radio

Friday
Jan072011

New Fluoride Recommendations Buck Decades-Old Dental Health Practices

Photo Courtesy - Getty Images(AUSTIN, Texas) -- After decades of touting the importance of fluoride, federal officials now say that many Americans may be getting too much of a good thing.

For years, parents have heeded their dentists' warnings and had their children take fluoride supplements or use fluoride toothpaste, in addition to whatever amount of the mineral they received from their tap water.

But Friday the U.S. Department of Health and Human Services and the U.S. Environmental Protection Agency announced that too much fluoride can cause fluorisis, a hypermineralization of tooth enamel that can result in the staining or pitting of teeth.

"In the vast majority of those affected, it's barely noticeable, even by dentists and oral health professionals," said Dr. Howard Koh, assistant secretary for health at HHS, "and that's why we believe making this adjustment now will promote health, improve oral health and reduce rates of fluorosis going forward."

HHS has proposed that the current recommendation be set at 0.7 milligrams of fluoride per liter of water, lowered from the previously recommended range of 0.7 to 1.2 milligrams.

Fluoride, when taken in moderate amounts, can help prevent cavities. The mineral has been added to toothpaste and to water to improve dental health. But some parts of the country, where the water is already rich in fluoride, have reported cases of fluorosis.

Dr. Griffin Cole, a dentist in Austin, Texas, said he has seen several cases of mild to severe fluorosis in his practice.

While he applauded the feds' proposal, he'd like to see the recommendations go even lower.

"I still don't think it's enough, honestly," he said. "I don't think there should be fluoride in the water at all.

"I think it's a nice move in the right direction," he said.

Cole said he began his dentistry career in the early 1990s, working for a dentist who was openminded about fluoride use and believed that his patients were getting too much.

Cole said he had never once prescribed fluoride supplements to his patients.

He cited studies from the past decade that have linked excess fluoride to not only fluorosis but to higher instances of bone cancer in the test subjects. He also said osteoporosis was an additional concern, since ingested fluoride is known to sit in a person's bones.

"Ingesting fluoride in any form does nothing for your teeth," he said. In cases of "rampant" tooth decay, applying a topical fluoride can improve dental health, but only minimally.

Fluoride, Cole said, molds to the tooth's enamel. So while it will aid in preventing decay, it can also make teeth brittle.

"When you see a case of somebody coming in with bad fluorosis, to restore those teeth you either have to crown them completely or at least do a veneer," he said. "So it's a very costly thing to fix."

Depending on the dentist and the region of the country, restoration could cost between $900 and $1,600 a tooth.

Koh said that in recognition of the multiple sources of fluoride available, HHS and the EPA also recommend that municipalities lower the levels of fluoride in their drinking water.

"The main issue of the very mild dental fluorosis in children is what we're addressing right now," he said, "and what we anticipate is that with this adjustment, we're going to lower that."

Copyright 2011 ABC News Radio´╗┐







ABC News Radio