Better Living Through Well Being
The recent inaugural Patient, Safety, Science and Technology Summit challenged all those who work in hospitals, medtech companies, as well as individual doctors, executives and engineers to commit to achieving zero preventable patient deaths by the year 2020. This primary goal is reflective of the awful fact that every year there are over 200,000 preventable patient deaths in U. S. hospitals. To put this into perspective, the event’s founder explained that after 3,000 people were lost in the 9/11 tragedy, the federal office of Homeland Security was formed. There are more than 3,000 people a week being lost in U.S. hospitals, yet no “Patient Safety Security” department has been formed to declare war on these preventable deaths.
The Patient Safety Summit tore down walls between the colleagues present, identified challenges that are causing preventable deaths and provided recipes to address the challenges. Former President Clinton also joined the challenge, encouraging all present to make a commitment to zero preventable patient deaths by 2020, one hospital department at a time, one medical product at a time, one act of kindness and love at a time.
A few of the actionable commitments made by the clinical community participants to reduce preventable patient harm and deaths within our hospitals include: Preventing respiratory depression deaths from post-operative opioids, preventing infections in hospitalized patients, creating a proactive culture of patient safety, and preventing blood transfusion overuse.
The commitments made at the Patient Safety Summit signify an unprecedented success. In the words of one attendee, “For over a decade since I lost my daughter due to a failure to rescue event in a prestigious hospital, I have watched different organizations create patient safety meetings. While great minds were assembled, I could not feel that something tangible was going to come out of it. The Patient Safety Summit from the onset was totally different. With the first few words stated, the Summit took a group of people who were not sure they could work together, let alone trust each other, to realize it’s time to break down the walls between the entire healthcare industry to work together. By the first break, hospital representatives and corporate CEOs were lining up to make their commitments to achieve the goal of zero preventable deaths by 2020. It was unlike anything I’ve ever experienced. I was not alone, which is what everyone I spoke to said about the meeting. I can tell you that this is the first time people can see the light at the end of this tragic tunnel. It is the first time in 10 years I feel like I want to get up in the morning.”
A way to stop the revolving door of hospital readmission for legions of frail Medicare recipients has recently been found in another effective solution to an important healthcare problem.
The newly formed Medicare Healthcare Corps utilizes ex-military medics, skilled in war zone medical care and trained as multi-taskers during stressful conditions, to use their skills helping to design and implement strategies that help these Medicare recipients manage their healthcare lives, and at the same time help these ex-military medics to find a valuable place in the civilian workforce.
This Medicare Healthcare Corps uses a three-pronged strategy: First, focus on “preventable readmission” of the frail elderly after being discharged from a hospital by monitoring their vital signs and helping them obtain and manage medications; second, work with these patients to help them get services needed to maximize their independence and keep them out of nursing homes, and thirdly, by serving as personal healthcare advocates Medicare Healthcare Corps professionals can answer questions to help Medicare patients navigate the hospital process and their future needs.
Early statistics show that the readmission rate for Medicare patients in states where their new program has been implemented has been reduced from 20.7% to 1.62%.
Other articles of interest in this Spring 2013 TMIS eNewsletter:
* A new survey from The Atlantic shows that Americans rate themselves and their communities as healthy, despite research showing the opposite.
* A new survey from Cancer and Careers shows the majority of cancer patients and survivors want to continue working during and after treatment.
* Recent research findings into the key role that white blood cells play in immune response could lead to novel therapies for diseases or conditions in which the red blood cell production is thrown out of balance.
* Research in Clinical Chemistry shows that decreased levels of vitamin D may predispose smokers to developing tobacco-related cancer.
* A study in the Journal of the National Cancer Institute shows that patients who consume high-fat dairy products following breast cancer diagnosis increase their chances of dying from the disease years later.
* A report from the U.S. Centers for Disease Control (CDC) shares insight into how hundreds of heart attacks across the U.S. could be prevented with a change in consumer thinking.
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From the Front Page of TMIS News
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Patient Safety, Science and Technology Summit Inspires Healthcare Industry Stakeholders to Action in Pursuit of 0 Preventable Patient Deaths by 2020
Each year there are over 200,000 preventable patient deaths in U.S. hospitals alone, more than 3,800 every week. That is equivalent to two jumbo jet passenger airplanes crashing and killing all passengers, on a daily basis.
Hundreds of prominent doctors, nurses, hospital administrators, medical technology executives and engineers, as well as patient advocates from across the world attended the recent inaugural Patient Safety, Science & Technology Summit. The goal was to create actionable solutions to today's most pressing patient safety problems. By the end of the second day, the Patient Safety Summit had inspired a groundswell of hospital commitments to establish recipes to eliminate preventable deaths and medical technology company commitments of patient data accessibility in hopes to eliminate preventable patient deaths by the year 2020.
"When we lost 3,000 people in the 9/11 tragedy, we created Homeland Security, the TSA, spent four trillion dollars on two wars and put our soldiers and innocent civilians in Iraq and Afghanistan in harm's way. Yet we lose more than 3,000 people a week in U.S. hospitals alone, and no Patient Safety Security department has been created and the government has not declared war on these preventable deaths," stated Joe Kiani , founder and Chairman of the Masimo Foundation for Ethics, Innovation & Competition in Healthcare, founder of the Patient Safety, Science & Technology Summit, and CEO of medical technology company, Masimo.
"With the Patient Safety Summit, we felt it was time to try something unique. We tore down the walls between the hospital, medtech companies, executives, doctors and engineers. We brought in the voice of the patient with powerful stories from patient advocates. We identified challenges that are causing preventable deaths and provided recipes to address the challenges. The recipes were clear, concise and left nothing out, for the sake of patient safety. We asked medtech companies to sign a pledge to make the data their products are purchased for, the patient's data. We also announced that to return to the next Summit, each attendee had to make a commitment toward achieving the goal of zero preventable deaths. Former President Clinton also joined the challenge and from the reaction of the participants, the formula worked. We got nine medtech companies to make the pledge. We got more than 20 hospitals and hospital groups to make commitments to implement one to all of the recipes to get to zero preventable deaths," Kiani continued.
Former Military Medics' Services Engaged in Caring for Our Frail Elderly
Military medics have been saving lives on the front lines all over the world where the United States military is engaged. Medics have performed emergency services that often meant the difference between life and death for our soldiers. Their medical skills have been honed under stressful, wartime conditions.
These men and women are among the army of heroes who walk among us every day. However, when they return to the U.S., their certifications and credentials often don't match civilian workforce requirements. Sadly, our nation's health care system is not equipped to assist in transforming their skills, experience, and work ethic into appropriate non-military jobs.
Nathan Anspach , CEO of Phoenix-based John C. Lincoln Health Network's Accountable Care Organization (ACO), saw these heroes as a new force, a Medicare health care corps. While gaining their medical credentials in the U.S., Anspach recognized that former military medics can be instrumental in helping design and implement strategies to aid the legions of frail Medicare recipients to manage their health care lives. Anspach's vision is to employ this health care corps to stop the revolving door of hospital readmission for Medicare patients. To accomplish this, he created a three-pronged strategy:
Americans Rate Themselves and Their Communities as Healthy, Despite Research Showing the Opposite
A new survey from The Atlantic shows those who most want community health resources have the least access to them, and for those Americans who use online resources, 40 percent self-diagnose. One-third of young Americans who use online resources act without consulting a medical professional. Despite an optimistic view of health in their communities, significant portions of the U.S. population are not convinced that communities provide sufficient access to key resources for good health, and 60 percent of Americans say online information is important to their health.
The national survey, conducted by Penn, Schoen & Berland, found a strong majority of Americans place a premium on health care providers and environment as being primary drivers of their community's health. The phone survey of 1,004 individuals found that American lower-income individuals, defined as those making less than $50,000 in household income in particular (55 percent), view doctors and hospitals as primarily responsible for ensuring good health in a community.
The Atlantic has partnered on a national initiative to examine the barriers and identify opportunities to build healthier communities in the U.S. The program, "A Conversation on Community Health" consisted of a series of events in U.S. cities to explore what it means, and what it takes, to be a healthy community. This poll builds on the learnings from those events by focusing on citizens' perspectives.
Newly Released Survey Reveals the Majority of Cancer Patients and Survivors Want To Continue Working
New York, New York
Nearly 80 percent of cancer patients and survivors say continuing work after diagnosis aids recovery, according to a new survey from Cancer and Careers and Harris Interactive. Still, just as many respondents struggle to find support navigating the work/life balance of employment with cancer, which is where Cancer and Careers offers assistance.
As the only organization in the U.S. dedicated solely to serving people who work during and after cancer treatment, Cancer and Careers designed the survey with Harris Interactive to better understand and empower employed persons with cancer. Results indicate that several factors motivate cancer survivors to continue working, including feeling well, wanting to maintain a routine and wanting to be productive. At the same time, 67 percent of surveyed cancer patients and survivors said work/life balance was critical to having a career.
"As a breast cancer survivor, I know there are so many unknowns and questions you have when you receive a cancer diagnosis. That's why it's so important for people going through the cancer journey to feel supported in every aspect of their lives, particularly when it comes to work," said Sonia Kashuk , creator, Sonia Kashuk Beauty, and Cancer and Careers board member. "Cancer and Careers is incredibly instrumental as a resource to help people navigate the practical challenges of balancing work and cancer."
White Blood Cells Found to Play Key Role in Controlling Red Blood Cell Levels
Bronx, New York
Researchers at Albert Einstein College of Medicine of Yeshiva University and the Icahn School of Medicine at Mount Sinai have found that macrophages, white blood cells that play a key role in the immune response, also help to both produce and eliminate the body's red blood cells (RBCs). The findings could lead to novel therapies for diseases or conditions in which the red blood cell production is thrown out of balance. The study, conducted in mice, is published in the online edition of the journal Nature Medicine.
"Our findings offer intriguing new insights into how the body maintains a healthy balance of red blood cells," said study leader Paul Frenette, M.D., professor of medicine and of cell biology and director of the Ruth L. and David S. Gottesman Institute for Stem Cell and Regenerative Medicine Research at Einstein. "We've shown that macrophages in the bone marrow and the spleen nurture the production of new red blood cells at the same time that they clear aging red blood cells from the circulation. This understanding may ultimately help us to devise new therapies for conditions that lead to abnormal RBC counts, such as hemolytic anemia, polycythemia vera, and acute blood loss, plus aid recovery from chemotherapy and bone marrow transplantation." Einstein has filed a joint patent application with Mount Sinai related to this research, which is currently available for licensing and further commercialization.
Previous studies, all done in the laboratory, had suggested that macrophages in the bone marrow act as nurse cells for erythroblasts, which are RBC precursors. But just how these "erythroblastic islands" (macrophages surrounded by erythroblasts) function in living animals was unclear.
For Smokers, Low Levels of Vitamin D May Lead to Cancer
New research appearing online in Clinical Chemistry, the journal of AACC, shows that decreased levels of vitamin D may predispose smokers to developing tobacco-related cancer. This study illustrates that simple vitamin D blood tests and supplements have the potential to improve smokers' health.
In the U.S. alone, cigarette smoking accounts for more deaths annually than HIV, illegal drugs, alcohol, motor vehicle injuries, suicides, and murders combined. It is the primary causal factor for at least 30% of all cancer deaths, and can lead to multiple kinds of cancer, including bladder, cervical, esophageal, head and neck, kidney, liver, lung, pancreatic, and stomach, as well as myeloid leukemia. According to the Centers for Disease Control and Prevention, the healthcare expenditures and productivity losses due to smoking cost the economy approximately $193 billion per year.
In this paper, Afzal et al. measured plasma vitamin D levels in blood samples collected in 1981-1983 from 10,000 Danes from the general population. Researchers then followed the study participants for up to 28 years through the Danish Cancer Registry. Of the participants, 1,081 eventually developed a tobacco-related cancer. The authors determined that the median vitamin D concentration among these participants was only 14.8 ng/mL, versus the higher 16.4 ng/mL median concentration found for all participants together.
These results show for the first time that the risk of tobacco-related cancers as a group is associated with lower concentrations of vitamin D. The data also indicate that tobacco smoke chemicals may influence vitamin D metabolism and function, while vitamin D may conversely modify the carcinogenicity of tobacco smoke chemicals. If further research confirms this, it would be consistent with previous studies demonstrating the anti-tumorigenic effects of vitamin D derivatives, as well as the correlation of vitamin D deficiency with favorable cancer-forming conditions and increased susceptibility to tobacco smoke carcinogens. Interestingly, though, low vitamin D levels were not connected with risk of other cancer types.
High-Fat Dairy Products Linked to Poorer Breast Cancer Survival
Patients who consume high-fat dairy products following breast cancer diagnosis increase their chances of dying from the disease years later, according to a study by Kaiser Permanente researchers.
The study, published in the Journal of the National Cancer Institute, is the first to examine the relationship between high-fat and low-fat dairy consumption following a diagnosis of breast cancer and long-term breast cancer survival.
Previous studies have shown that higher lifetime exposure to estrogen is a causal pathway to breast cancer. Estrogen levels are believed to be elevated in dairy products consumed in the Western world, because most of its milk comes from pregnant cows. Estrogenic hormones reside primarily in fat, so levels are higher in high-fat than in low-fat dairy products.
The researchers studied a cohort of women who were diagnosed with early-stage, invasive breast cancer between 1997 and 2000, primarily from Kaiser Permanente's Northern California region (83 percent) and the Utah Cancer Registry (12 percent).
Those consuming larger amounts of high-fat dairy (one serving or more per day) had "higher breast cancer mortality as well as higher all-cause mortality and higher non-breast cancer mortality," wrote lead author Candyce H. Kroenke , ScD, MPH, staff scientist with the Kaiser Permanente Division of Research, and co-authors.
"Specifically, women consuming one or more servings per day of high-fat dairy had a 64 percent higher risk of dying from any cause and a 49 percent increased risk of dying from their breast cancer during the follow-up period," said Kroenke. The category of high-fat dairy products researchers tracked included cream, whole milk, condensed or evaporated milk, pudding, ice cream, custard, flan and also cheeses and yogurts that were not low-fat or non-fat.
A Silent Killer: How to Prevent Your Heart Attack
A heart attack strikes an American at an average of once every 30 seconds throughout the year.
Chronic conditions are a leading cause of heart attacks. Family members worry about long distance relatives who are at-risk for a sudden medical emergency.
The U.S. Centers for Disease Control (CDC) reports more than 98 million Americans currently suffer from at least one of the three following chronic conditions:
68 million Americans have high blood pressure
25 million Americans have diabetes
5 million Americans have heart failure
"The best way to prevent a heart attack is to make lifestyle changes through healthier eating, better fitness, and vital sign monitoring," says Ross McCabe , M.D., an Emergency Room physician.
In over 30 years of practicing medicine, he has seen thousands of people struggle to make the changes recommended by their doctor.
"I'm convinced that you can form healthy habits with some guidance. But, you need a proven road map to make a lasting change," continues Dr. McCabe.
Dr. McCabe has launched an education program called, "How to Take Control of Your Health." Each week, he publishes a new video lesson for use by doctors, nurses, and their patients. Anyone can view the video lessons, at no cost, on the web site, www.every30seconds.com.
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