Opioid Safety, Patient Safety, Patient Stories

Are Patients Receiving Opioids Safer Today Than 6 Years Ago?

Six years ago on July 27, 2011, I posted the first article on a free WordPress blog for the Physician-Patient Alliance for Health & Safety. It was titled “Is it possible to survive 96-minutes without a heart beat?”. Howard Snitzer, a man who suffered a heart attack survived after two volunteer paramedics responded and began a 96-minute CPR marathon. The ordeal involved 20 others, who took turns pumping his chest. This life-saving feat was only possible with the use of capnography readings, which told the volunteer paramedics that Howard was still alive and that they needed to continue their efforts.

Little would I know that that article would lead to an invitation by the University of Notre Dame and the beginnings of a 6-year friendship with the parents of Amanda Abbiehl. Amanda was admitted to hospital for “severe strep throat.” Read More

Patient Safety

An Interview With The Creator Of PatientAider: Navigating the World of Hospitals and Healthcare

By Michael Wong, JD (founder and executive director, the Physician-Patient Alliance for Health & Safety)

Often times, as a patient, the hospital and its staff can be a bewildering and seemingly unfriendly environment; processes, procedures, and even the language spoken can truly be confusing. In a recent NY Times article, “In the Hospital, a Degrading Shift From Person to Patient”, Benedict Carey writes:

Entering the medical system, whether a hospital, a nursing home or a clinic, is often degrading… at many others the small courtesies that help lubricate and dignify civil society are neglected precisely when they are needed most, when people are feeling acutely cut off from others and betrayed by their own bodies.

To help navigate this world of hospitals and healthcare, I recently spoke with Mari Miceli. Mari has worked over 15 years as a registered nurse after graduating from the University of Massachusetts, Lowell with a BS in Nursing and the University of Illinois with a BFA. in Industrial Design. She is also a Regional Network Chair, a volunteer position at the Patient Safety Movement Foundation. Read More

Hospital Acquired Conditions, Patient Safety

Reducing Obstetric Malpractice Claims Starts With Training, Communication, and Culture

Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety).

Can “perfect care” exist in the clinical setting? This is one of the questions that was asked at a recent conference that I spoke at with Bruce Pastner, MD, JD (Vice-Chair, Patient Safety & Quality, Inova Fairfax Women’s Hospital).

It’s a utopic vision for patient safety that we all strive for. But the unfortunate reality of healthcare today is that bad outcomes can happen; this is sadly true in practices regarded as higher-risk, such as obstetrics. Not all terrible events leading to death or major injury are predictable, preventable, or even treatable. What clinicians can do, however, is to focus on identifying the most preventable incidents and prepare for them. Read More

Opioid Safety, Position Statement, Respiratory Compromise

Patients Receiving Opioids Must Be Monitored With Continuous Electronic Monitoring

The following is a position statement published by PPAHS. If you would prefer to view our statement as a PDF, please click here.

Much of the public attention has been focused on the harm caused by prescription use and abuse of opioids. However, there is another facet that must be focused on: opioid-induced respiratory depression in clinical settings. This includes patients undergoing moderate and conscious sedation, or recovering from procedures and managing pain using a patient-controlled analgesia (PCA) pump, particularly those during the postoperative period. Read More

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

Opioid Safety, Patient Safety, Respiratory Compromise

Organizations Need to Collaborate To Improve Patient Safety

In an article published on March 13, the National Patient Safety Foundation (NPSF) announced the first day of Patient Safety Awareness Week, as well as their merger with the Institute for Healthcare Improvement (IHI). Most importantly, the now-joint organizations restated a potent call to action: that preventable health care harm is a public health crisis and requires a coordinated public health response.

The Physician-Patient Alliance for Health & Safety (PPAHS) echoes the call of NPSF and IHI for healthcare leaders to treat every week as patient safety week by initiating a coordinated public health response to improve patient safety and drive the collective work. Doing so would help ensure that patients, and those who care for them, are free from preventable harm.

Directly targeting preventable harm at the clinical level is a deeply interconnected – and nuanced – problem. It will take the concerted efforts of many stakeholders:

  • Clinicians, key to the development and implementation of patient safety initiatives and sharing their successes and failures.
  • Hospital administrators, capable of empower doctors, nurses, and other specialists by providing them with the resources to continuously improve quality of care.
  • The academic community, who can ensure that patient safety interventions are high-quality through peer review.
  • Patient safety organizations like the IHI and PPAHS, who can examine the big picture, spot trends, and call attention to highlights and lowlights.
  • Public health agencies at the state and federal levels, who can transform the efforts by stakeholders described above into policy.

Most importantly, it will also involve actively engaging patients, who can play an active role in ensuring the safety of their own care by knowing their medical history, understanding which questions to ask, speaking up when something does not seem right, and following the instructions of their doctors and nurses.

Integrating stakeholders from across all of these groups is essential for the success of any coordinated public health response. This is a key reason why the PPAHS Board of Advisors consists of representatives from each of these stakeholder groups. It is also why we choose to work in tandem with other organizations on priority areas such as respiratory compromise: initiatives need to involve multiple stakeholders who bring with them diverse perspectives and skill sets.

The Respiratory Compromise Institute (RCI) embodies this level of coordination. Consisting of members such as the Society of Hospital Medicine, American Association for Respiratory Care, and CHEST/American College of Chest Physicians, RCI is a collaborative effort to improve opioid safety.

A recently-released report by RCI exemplifies the outcome of coordination and collaboration. The report identifies eight distinct subsets of respiratory compromise that pose a high risk of patient harm – and, most importantly, could be prevented with early detection and intervention. The manuscript is the result of a workshop organized by the National Association for the Medical Direction of Respiratory Care to address the unmet needs of respiratory compromise across the clinical spectrum. The writing committee was comprised of a diverse set of clinicians focusing on respiratory ailments – a collaborative group consisting of doctors, nurses, and respiratory therapists. Read the report here.

These kinds of reports are just one step in improving patient safety and help set direction for coordinated responses. It is up to us as a public health community – clinicians, administrators, patient safety organizations, public health agencies, as well as patients – to use this knowledge and take action to transform the standard of care in hospitals across the nation.

Hospital Acquired Conditions, Opioid Safety, Patient Safety, Respiratory Compromise

Nine Minutes to Improving Opioid Safety: PPAHS Releases Patient Safety Video

The Physician-Patient Alliance for Health & Safety (PPAHS) has released a YouTube video which discusses in nine minutes how to improve opioid safety. The video features highlights from over 10 hours of in-depth interviews released by PPAHS in 2016; altogether, the podcast series has generated over 130,000 cumulative views on YouTube. The podcast series brings together physicians, nurses, and respiratory therapists discussing how they have improved opioid safety in their hospitals.

According to Michael Wong, JD, Founder and Executive Director of PPAHS:

“In just nine minutes, the video summarizes experiences of clinicians in improving opioid safety in their hospital or healthcare facility, and reminds us of the tragic consequences of adverse events and deaths that may ensue if clinicians and healthcare executives are not proactive in promoting safety. We hope that the video will energize quality improvement and patient safety teams to strive to reduce adverse events and deaths related to opioid use.”

The opioid epidemic was one of the most heavily-covered, and hotly-debated, topic in patient safety covered in 2016. This dialogue has been mostly centered around the effects of ‘street’ use and abuse of prescription painkillers. In contrast, the PPAHS podcast series aims to highlight the preventable harm of opioid-induced respiratory depression during hospital procedures. Read More

Patient Safety, Position Statement, Practices & Tips

Patient Ambulation a Key Metric to Improved Health

The following is a first in a series of position statements. If you would prefer to view our position on patient ambulation as a PDF, please click here.

Movement is a critical factor to improving patient health. Patient ambulation, the ability to walk from place to place independently with or without an assistive device, is necessary to improve joint and muscle strength, as well as prevent pressure ulcers during extended bed rest. It is a critical factor in improving patient well-being while in hospital, as well as reducing total length of stay (LOS). Read More

Must Reads, Patient Safety

Top 10 Patient Safety Must Reads – November 2016

We’re saying “hello” to December, and looking back at some of PPAHS’ top posts and tweets in November.

Top Posts

This month, as part of our new campaign targeting VTE in orthopedic patients, PPAHS was invited to become a partner of World Thrombosis Day!  We also provided bittersweet coverage regarding opioid safety, including celebrating St. Joseph’s/Candler Health System’s (SJ/C) 12-years event-free and opioid safety’s place – once again – on ECRI’s Top 10 Health Technology Hazards. Read More