Thursday, May 31, 2012

Wake Up Your Zombie Workforce To Patient Safety Risks

Fierce Healthcare has;
Ms Karen Cheung's Editor's Corner:
Wake Up Your Zombie Workforce To Patient Safety Risks

Is your hospital a hotspot for the walking dead?
study in published in the Archives of Surgery uncovered more evidence that sleepy surgeons are a threat to patient safety--and the news is making its way through the mainstream media (and reaching your patients).

On average, a surgical resident gets 5.3 hours of sleep a day, according to a study of orthopedic surgical residents at Boston's Massachusetts General Hospital and Brigham and Women's Hospital, with some residents only getting 2.8 hours a night.

What's even more alarming is that during a quarter of their waking hours, surgical residents' fatigue is akin to being legally drunk, meaning that they are functioning at 70% mental effectiveness (correlating with a blood alcohol level of 0.08%).

Although we've heard sobering statistics such as these before, the study did call out the pervasiveness of fatigue and how it affects patient care. Fatigued residents have a 22 percent greater risk of causing a medical error than alert, well-rested doctors, according to the study.

The Accreditation Council for Graduate Medical Education 
(ACGME) took great steps to limit resident work hours when it finalized duty hour rules in 2011, years after the ACGME adopted the groundbreaking 80-hour limit in 2003 and the landmark Institute of Medicine report in 2008.

The problem is so significant that that the largest accrediting body declared it a sentinel event in December 2011, when The Joint Commission warned hospitals about the potential dangers of extended hours and excessive workloads, not just for residents but for all healthcare workers.

"Imagine an intoxicated person working in a hospital setting, and you'll have a better understanding of the dangers of being fatigued,"  Frederick Southwick, professor at the University of Florida and manager of New Quality and Safety Initiatives for the University of Florida and Shands Health Care System, wrote in yesterday's Hospital Impact blog post.

We wouldn't let a drunk physician into the operating room. Why would we tolerate a sleepy surgeon?
Part of the sleep problem stems from the glutton-for-punishment mentality so persuasive in medical and nursing school for years. But the call to patient safety requires a severe change in culture.

"In this era of ever-increasing medical complexity, the most important realization is that no one can do it all," Southwick said. "Teamwork is vital for efficient care; each professional caregiver possesses unique and equally important expertise that should be shared."

Southwick noted it's not just individual variables such as fatigue that factor into the problem of adverse events. There's emotional stress on providers, as well as the pressure to multitask. Southwick pointed out there also are systemwide problems, such as nursing ratios (or what Southwick referred to as "skeleton crews" at night and on weekends).

The fatigue factor, however, is one area in which the healthcare industry can start to take control.
The Joint Commission in its 
Sentinel Event Alert suggested organizations assess their fatigue-related risks, including limiting off-shift hours and consecutive shift work; examining the hand-off process; inviting staff to offer input in their own work schedules; implementing a fatigue management plan; and educating staff about the effects of fatigue on patient safety.

It's unlikely that the problem of resident fatigue is going to go away altogether, but the immediate threat that fatigue poses on patient safety requires immediate action--hospitals must consider their staffing rations and redesigning shifts now.  - Karen (@FierceHealth)

Thank You Fierce Healthcare and Ms Cheung

"We wouldn't let a drunk physician into the operating room"
No, We wouldn't Want Drunken Surgeons in an Operating Room, ....... BUT:
Study: 15% Of Surgeons Abuse Alcohol
 "Teamwork is vital for efficient care; each professional caregiver possesses unique and equally important expertise that should be shared." 
Hospital Workers Don't Report 86% Of Patient Harm Events  
And it continues because the Control mechanism in situ to put the brakes on it is an openly Protectionist farce.
Medical Boards Lack Resources To Punish Dangerous Docs 
State Med Boards Not Punishing Dangerous Docs 
National Database Riddled With Holes: Records Missing On Disciplined Healthcare Workers

In fact, Medicine has systemically gotten So lax that not only has the Operating Room become a post 19th Hole good old boys club, but the surgical instruments themselves are becoming an ever more septic hazard. 
Dirty Surgical Tools, A Dangerous, Growing Problem
Here's part of that last link, because it's so easy to "Diagnose" All of these 'Behaviors' as 'Incurable Mental Illnesses' requiring a Junk Medical Incarceration and Destruction of the perpetrator's Unalienable Rights, ...... by political philosophers/drug peddlers pretending to be Physicians: who are all an integral part of today's obscenely expensive, dangerous, incompetent, and deadly, Good Old Boys club. 

"But then What can you expect, when Hospital Staff need Hall Monitors to herd them back into the washroom to wash their hands after Using the rest rooms, and between patients? 

SF General Hospital is a Major Trauma Center: 2nd & 3rd degree burns etc. All of the Physicians there are UCSF (State University) Faculty. (Pg 34) They are not students. They are not graduates. They are Faculty. The Best & the Brightest in medicine today.
58% of them needed a Hall Monitor (pg 6) to herd them back to the wash basin after they used the bathroom, or moved between patients. Even With the hand hygiene Hall Monitors, they Still couldn’t housebreak 18% of the slobs.
Not Students. Not Graduates. State University Faculty. The best there is. Just ask the taxpayers.
Here's an idea. How about we hire a whole lot More Psychiatrists and Psychologists to condemn these septic 'Caregivers' as Incurably Mentally Ill, show them the door, and State/Federal paperwork them as a Danger to Others? Their 'Behaviors' are actually Killing people, aren't they?
And CMS under Dr Seuss can authorize Itself (Why not? Congress has done some incredibly stupid things in the past, but it's difficult to imagine even Congress openly authorizing Medicare/Medicaid Reimbursement for Buddhist mindfulness meditative techniques and Hegelian Dialectical bait and switch Political BS which includes propping up Che Guevara as an exemplar of Wisdom and Compassion, as Healthcare) to BUY those new Psychs, excuse us, Self Identified Illuminati, (with your Parents and Grandparents Medicare/Medicaid co-pays) every movie every made so they can sit at home (or at the Esalen Institute) Watching them as Psy-entific Justification for all of the Paperwork they're generating.
Illuminati Psychiatric Bio-Science

And when the Corrective/Protectionist State Agencies/Jokes do correct Healthcare Workers,

California Diversion Programs

US Constitution  Amendment 14
Section. 1. All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws
We looked up the delusional crackpots comprising Psychiatry's 'Diagnosing' knowledge base for a reason. And this tiny list barely scratches the surface of the collectivist idiocy infusing the 'Mental Health' field's all out war on the last, best hope for Western Civilization: The US Constitution.

We Will be exposing More of these fruitcakes. 

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