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National
Data Standards Seen Critical To Improving Patient Safety Continuity
Of Care Record Plan May Go Online By Next Year Quality
Initiative Endorsed By U.S. Chamber of Commerce USP:
More Hospitals Reporting Errors JCAHO
Raises Expectations On Infection Control Standards Improved
Quality Care For Minorities Linked To Cultural Sensitivity New
Report Finds Physicians Leaning Toward Online Options Large
Tumors In Breast Cancer Cases Increased During 1990s National
Data Standards Seen Critical To Improving Patient Safety A study released
Nov. 20 by the Institute of Medicine (IOM) calls for adopting information
technology systems to develop a national infrastructure of patient care
information accessible to all health care organizations. The study specifically
recommended creating electronic health records (EHR) based on a uniform
set of data standards. The study
also suggested that all health care organizations should promote a “culture
of safety” through comprehensive patient safety programs that would
identify failures in each health care system, analyze the causes of such
failures, and then make improvements to prevent future errors. Recognizing
that moving to EHR systems would require sizable capital investments,
the committee called upon the federal government to pay some of the costs
of building a national infrastructure of patient records, especially in
areas less likely to attract private sector investments. The committee
said the migration to EHRs is a critical step in improving patient safety
and should be the highest priority for all health care stakeholders and
would pose a higher return on the investment in the long run. Dr. Paul
C. Tang, committee chairman and Chief Medical Officer of the Palo Alto
Medical Foundation, said 5%-15% of health systems across the country have
moved to electronic systems. Without a national standard for collecting
data, he said, there is no mechanism for health providers to share information. “Patients
with chronic diseases interact with many providers,” Tang said.
“If we want the patients’ data to follow them in all settings
of care, we must establish common data standards that allow electronic
record systems to share information.” IOM formed
the Committee on Data Standards for Patient Safety to produce a detailed
plan to facilitate the development of data standards applicable to the
collection, coding, and classification of patient safety information.
The study looked at errors of commission as well as errors of omission,
arguing that the latter may have a larger effect on health. In
the report, the Committee outlined seven recommendations, including: For
more info, www.nap.edu. Continuity
Of Care Record Plan May Go Online By Next Year A new
plan to increase the capability for sharing patient records between health
practitioners and cut down on medical errors has garnered support from
influential medical groups. The
Wall Street Journal reported that American Academy of Family Physicians,
the Massachusetts Medical Society and the Health care Information and
Management Systems Society have agreed on a final design for the Continuity
of Care Record (CCR) system. Dr.
Thomas Sullivan, president of the Massachusetts Medical Society and the
chief architect of the CCR plan, said an electronic form of CCR is scheduled
to be available sometime next year, which would allow doctors to download
the CCR and create a record for each patient. The
CCR system is based on an XML document, will be compatible with any standards,
and the records can be incorporated into a more complete electronic medical
record. For
more info, www.aafp.org. Quality
Initiative Endorsed By U.S. Chamber of Commerce The
U.S. Chamber of Commerce, which represents more than 3 million businesses
nationwide, has endorsed the hospital-led voluntary public reporting and
quality initiative. “Employers
spend more than $400 billion annually on workplace health care benefits
and therefore have a vested interest in ensuring the highest quality and
most cost effective care possible for their employees, retirees and their
dependents,” the Chamber’s board of directors wrote in a Nov.
12 resolution. The
resolution urges state and local chambers of commerce to formally support
the initiative and encourage their hospital members to participate, citing
the growing need for information to help employers and consumers make
appropriate decisions about their care, the program’s voluntary
nature, and the validity of its 10 quality measures. For
more info, www.aha.org. USP:
More Hospitals Reporting Errors A study
by U.S. Pharmacopeia shows an 82% increase in the number of reported medication
errors from last year, which the group attributed to better internal reporting
and a change in culture that encourages reporting of medical errors. The
data, the 4th annual release of the database run came from 482 hospitals
and health care facilities, a 31% increase in the number of hospitals
that volunteered to participate. The
vast majority of errors are caught before patients receive medication
and most mistakes have no serious impacts on patients. The number of cases
requiring lifesaving intervention declined from 2.4% to 1.7% from last
year. Twenty deaths were linked to medical errors. However,
the study indicates that the seniors are the most vulnerable population
to medical errors, with more than one-third of errors affecting the older
segment of health care patients. For
more info, www.usp.org. JCAHO
Raises Expectations On Infection Control Standards The
Joint Commission on Accreditation of Health care Organizations (JCAHO)
has approved revised standards that sharpen and raise expectations of
organization leadership in reducing hospital-acquired infections. The
requirements, which apply to ambulatory care, behavioral health care,
home care, hospital, laboratory and long term care organizations, will
take effect in January 2005. The revised standards are designed to raise
awareness that health care associated infections are a national concern
that can be acquired within any care, treatment or service setting, and
transferred between settings, or brought in from the community. JCAHO
has also included infection control as a special focus area during its
random, unannounced surveys for hospitals in 2003. The Joint Commission
also made the CDC’s recently updated handwashing guidelines a 2004
National Patient Safety Goal for all accredited organizations—to
bring further attention to infection control issues. Furthermore,
the Joint Commission has advised accredited organizations that health
care-associated infections resulting in death or serious injury should
also be voluntarily reported to its Sentinel Event database. The
2004 National Patient Safety Goals require organizations to manage as
sentinel events all health care-associated infections that result in death
or major permanent loss of function. For
more info, www.jcaho.org. Improved
Quality Care For Minorities Linked To Cultural Sensitivity A study
funded by the Agency for Health care Research and Quality shows training
physicians to have greater cultural sensitivity may improve the quality
of health care to lower-income and minority segments of the population. Led
by Dr. Carolyn M. Tucker of the University of Florida, the study, Effects
of patient and physician practice socioeconomic status on the health care
of privately insured managed care patients, looked at cultural competence
from the standpoint of low-income whites, Latinos, and blacks. Based on
20 focus groups of 135 patients, researchers looked at four indicators:
physician people skills, individualized treatment, effective communication
and technical competence. The
study, published in the journal Medical Care, found that for
Latinos, sharing a common language influenced levels of trust and comfort. For
more info, www.ahrq.gov. The Centers
for Disease Control and Prevention is urging Americans to get their flu
shots as soon as possible, citing early indications the country may be
in the midst of a more severe flu season than in several years. The agency
recommends the flu shot for people 50 and older; adults and children aged
six months and older who have chronic diseases or weakened immune systems;
children and teenagers who are on long-term aspirin therapy; and women
who will be more than three months pregnant during the flu season. The agency
also recommends the shot for household members of people at high risk
of complications from the flu and for health. For more
info, www.cdc.gov. New
Report Finds Physicians Leaning Toward Online Options A report
prepared for the California Health care Foundation (CHCF) by First Consulting
Group said many physicians are overcoming resistance to electronic communication,
but encountering complex choices when it comes to selecting the right
tool for their practice. The report,
Online Patient-Provider Communication Tools: An Overview, provides
a detailed review of electronic communication tools available to physician
practices of all sizes; case study summaries on how single, multi-site,
and integrated delivery systems use these tools; and vendor lists offering
various online communication solutions. For more
info, www.chcf.org. URAC has
launched a Web-based tool to collect and analyze information on prevention
strategies in medical management and preferred provider organizations
(PPO). URAC will
primarily collect information for the study via the Web-based tool, and
is specifically interested in how organizations directly address or work
with payors to communicate with beneficiaries in the following categories:
communicating coverage; promoting services to consumers; promoting provider
compliance; automated systems; training staff; and measuring/reporting.
In addition,
URAC conducted a focus group of industry leaders in conjunction with the
4th Annual Quality Summit in October to identify promising approaches
to prevention. Interested
organizations should fill out the Web-based tool at www.urac.org
by Dec. 8. For more info, Liza Greenberg, vice president of Research and
Quality Initiatives, 202-216-9010; lgreenberg@urac.org. Large
Tumors In Breast Cancer Cases Increased During 1990s An analysis
by the American Cancer Society shows an increase during the 1990s in the
proportion of women with newly diagnosed breast cancer who have unusually
large tumors. The analysis
found that the incidence of large tumors increased by slightly more than
2% a year between 1992-2000, but only in white women. Large tumors
are about twice as common in black women. The cancer society attributes
this to less access to high-quality screening, particularly for poor women.
In 2000, there were 12 cases of large tumors for every 100,000 black women,
a figure that changed little throughout the 1990s. The analysis
is based on the National Cancer Institute’s Surveillance, Epidemiology
and End Results program, a database of cancer incidence and survival data
that covers about 14% of the U.S. population. It was published in the
latest issue of the cancer society’s journal CA. For more
info, www.cancer.org.  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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