Hospital Acquired Conditions, Opioid Safety, Respiratory Compromise

Anesthesiology Standards Shouldn’t be Different in Hospital and Outpatient Settings

Written by Lynn Razzano RN, MSN, ONC-C (Clinical Nurse Consultant, Physician-Patient Alliance for Health & Safety).

When preventable medical errors occur, one of the very first questions asked by patients, families, the legal system, the press, and the public is: “were appropriate care standards met?”. As a professional Registered Nurse, I look at this question from a quality and patient safety perspective to ask what could have been done differently? What are the best practice medical standards, and why are they not applied across the US health care systems? How applicable should the medical standard of care be? And how do we, as clinicians and patient advocates, define the best practice standard of care?

The reality is that the definition of best practice and standard of care differs between acute care hospital settings and outpatient surgery centers. And, even then, the standard of care being applied by the ambulatory surgical center, anesthesiologist and the gastroenterologist may not be the same. Read More

Must Reads

Patient Safety Weekly Must Reads (January 14, 2017)

This week in #patientsafety, we’re back in the swing of things. We bring you highlights from Joan Rivers’ death and subsequent lawsuit. We also released findings from our Orthopedic Safety Survey. From around the web, an orthopedic surgeon shares thoughts on how pain scores led to the opioid epidemic, a study looks at the impact of opioid policies, and ECRI Institute releases the 2017 Top 10 Hospital C-suite Watch List.

From PPAHS:

Highlights From Joan Rivers’ Death and Lawsuit. Based on discussions at a recent meeting of the American Society for Healthcare Risk Management (ASHRM) New Jersey chapter.

Orthopedic VTE Safety Report Now Available. We released findings from a survey on practical solutions to prevent venous thromboembolism (VTE) in patients undergoing hip and knee replacement.

From Around the Web:

Making pain a vital sign caused the opioid crisis. Here’s how. This orthopedic surgeon makes the case that, despite good intentions, making pain a vital sign was a disastrous mistake.

Measuring the Impact of Opioid Policies. Federal agencies have issued policies to curb the opioid epidemic. MedPage Today looks at whether these policies are making an impact.

2017 Top 10 Hospital C-suite Watch List. Number 2 on ECRI’s latest list is opioid addiction. The report posits what role technology can have in predicting the risk of addiction and relapse, as well as provides five action points for better opioid safety.

Patient Safety

5 Lessons Learned from the Joan Rivers Death Settlement

By Frank Overdyk, MSEE, MD (Staff Anesthesiologist, Roper St. Francis), Kenneth P. Rothfield, MD, MBA, CPE, CPPS (System Vice President, Chief Medical Officer, Saint Vincent’s Healthcare, Ascension Health), Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety), Lynn Razzano RN, MSN, ONC-C (Clinical Nurse Consultant, PPAHS)

The lawsuit against Yorkville Endoscopy, where Joan Rivers stopped breathing and tragically died, has been settled. In the statement by her daughter, Melissa Rivers said that she is now “able to put the legal aspects of my mother’s death behind me and ensure that those culpable for her death have accepted responsibility for their actions quickly and without equivocation.”

To read the complete article in Outpatient Surgery, please click here.

Opioid Safety, Patient Safety, Respiratory Compromise

What do Joan Rivers and Katherine O’Donnell Have in Common?

Joan Rivers and Katherine O’Donnell underwent medical procedures. They and their loved ones expected these procedures to be routine – and, yet, they tragically died during their medical procedures prompting their families to commence lawsuits.

As reported by CNN, Joan Rivers died during throat surgery: Read More

Opioid Safety, Respiratory Compromise

Death of Joan Rivers a Wake Up Call for Surgical Centers and Patients

At this year’s OR Excellence conference, Kenneth P. Rothfield, M.D., M.B.A. (System Vice President and Chief Medical Officer, St. Vincent’s Healthcare, Jacksonville, FL) will discuss why the death of Joan Rivers is a wake up call for surgical centers and patients.

“The death of Joan Rivers has drawn attention to the safety of outpatient surgery facilities,” said Dr. Rothfield. “Hopefully, the positive from this scrutiny will be a re-evaluation of policies and practices, and safety culture at surgical centers that result in improvements to patient safety.” Read More

Must Reads

Weekly Must Reads in Patient Safety and Health Care (September 11, 2015)

Weekly Must Reads in Patient Safety and Health Care (September 11, 2015)

What has changed a year after Joan Rivers’ death?

According to USA Today – the answer is “nothing much of consequence”:

On the first anniversary of the death of Joan Rivers following what was supposed to be an ordinary outpatient procedure, nothing much of consequence — except for bad publicity — has happened to the clinic where she was treated and to the doctors who were treating her.

Read More

Opioid Safety, Respiratory Compromise

Case Studies in Improving Patient Safety and Health Outcomes Through Capnography

Dr. Melissa Langhan (Emergency Medicine, Yale School of Medicine) discusses case studies to improve patient safety through capnography.

Recent deaths – comedian Joan Rivers and 17-year-old Sydney Galleger – are a reminder of the need to ensure patient safety during common medical procedures.

“When medical tragedies occur, one of the very first questions asked by patients, families, the legal system, the press, and the public is: ‘were appropriate care standards met?’,” said Michael Wong, JD (Executive Director of the Physician-Patient Alliance for Health & Safety). Read More