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Every hospital, nursing home, physician office must make quality improvement their top priority

By Senator Richard T. Moore

October 10, 2007...It is a fundamental principle for health care providers: primum non nocere — first, do no harm. It is our duty, our responsibility. Patients ask and assume that the health care that intends to help them should, at the very least, not injure them.

Despite the extraordinary hard work and best intentions of caregivers, thousands of patients are harmed in US hospitals every day. Hospital-acquired infections, adverse drug events, surgical errors, pressure sores, and other complications are commonplace.

Based on data collected over several years from multiple partner institutions, the Institute of Healthcare improvement, a Boston-based international non-profit leader in health care quality, estimates that nearly 15 million instances of medical harm occur in the US each year — a rate of over 40,000 per day. This is a burden larger than most patients and professionals, and even some health care researchers, realize.

It is time to declare this annual toll unacceptable; time to end it.

We need to ask our every hospital and health care provider in Massachusetts to adopt the twelve proven steps in quality and safety recommended by the Institute for Healthcare Improvement’s Five Million Lives Campaign to provide care that save lives and reduce patient injuries:

The six interventions proven to work from IHI’s 100,000 Lives Campaign

  • Deploy Rapid Response Teams.. .at the first sign of patient decline.
  • Deliver Reliable, Evidence-Based Care for Acute Myocardial Infarction... .to prevent deaths from heart attack.
  • Prevent Adverse Drug Events (ADEs). . .by implementing medication reconciliation
  • Prevent Central Line Infections.. .by implementing a series of interdependent, scientifically grounded steps
  • Prevent Surgical Site Infections...by reliably delivering the correct perioperative antibiotics at the proper time
  • Prevent Ventilator-Associated Pneumonia.. .by implementing a series of interdependent, scientifically grounded steps.

New interventions targeted to reduce harm to patients:

  • Prevent Harm from High-Alert Medications... starting with a focus on anticoagulants, sedatives, narcotics, and insulin
  • Reduce Surgical Complications… by reliably implementing all of the changes in care recommended by SCIP, the Surgical Care Improvement Project (www.niedgic.org/scip)
  • Prevent Pressure Ulcers... by reliably using science-based guidelines for their prevention
  • Reduce Methicillin-ResistantStaphy/ococcus aureus (MRSA) infection...by reliably implementing scientifically proven infection control practices
  • Deliver Reliable, Evidence-Based Care for Congestive Heart Failure... to avoid readmissions
  • Get Boards on Board ... by defining and spreading the best-known leveraged processes for hospital Boards of Trustees, so that they can become far more effective in accelerating organizational progress toward safe care

As America observes National Health Care Quality Week from October 21 through 27, hospitals, health center, physician practices, nursing homes and other health care providers should use this opportunity to demonstrate what they are doing to promote health care quality improvement. Health care providers generally oppose more government regulation. However, if health care providers are unwilling to regulate themselves, and follow steps to improve quality, they will have only themselves to blame when government is forced to take action to require quality improvement steps such as those outlined by the Institute for Healthcare Improvement.

Senator Richard T. Moore is a Democratic State Senator from Uxbridge who is the Senate Chairman of the Massachusetts Legislature’s Committee on Health Care Financing.

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