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Improvements in patient safety, regional health disparities, and a podcast series on ‘bad medicine’

December 22, 2016

In order to bring you more of the news you want to read, Right Care Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, Right Care Weekly presents articles related to moving our healthcare system toward the right care for all patients.

Join the conversation: Post your comments in our new section at the bottom of this page.

Here’s some good news in time for the holidays: The number of harmful hospital-acquired conditions (HACs) in U.S. hospitals decreased by 21% between 2010 to 2015, according to a new report from the Agency of Healthcare Research and Quality. The AHRQ estimates that this drop in HACs saved more than 120,000 lives and $28.2 billion over the five-year period. Reductions in adverse drug events, pressure ulcers, and catheter-associated urinary tract infections comprised about 80% of the overall decrease in HACs. Some HACs, such as venous thromboembolisms and central-line associated bloodstream infections, declined by more than 75% in the five-year period. The decrease in HACs is likely the result of system-wide changes to health care, including financial penalties for hospitals that don’t focus on improving patient safety, increased transparency through public reporting of hospitals’ rates of HACs, and programs that give hospitals technical assistance to reduce HACs. These results show that change can happen quickly and at scale. They also reflect the results of focused efforts in a few key areas, such as reducing central line infections. Now hospitals need to maintain these good results and move to other sources of harm.

In Mingo County, WV, the rate of mortality due to mental and substance abuse disorders was nearly four times higher than the national rate in 2014. The rate of deaths from transport injuries in Breathitt County, KY, increased by 43.6% from 1980 to 2014, while the state rate decreased by 22.8%. And in Stuben County, NY, the rate of deaths caused by nutritional deficiencies in 2014 was nearly seven times higher than in neighboring Allegany County. These data come from a recent study in JAMA that examines patterns in mortality over time on a county level. The authors analyzed more than 80 million death records, using a new method to assign more specific causes of death where records were previously vague. That new method allowed them to create a detailed map of regional disparities for 21 leading causes of death over 34 years. The paper allows us to see how local environmental factors such as infrastructure, availability of healthy food, and access to mental health services can have a profound effect on health, causing huge variations in problems like opioid addiction on a local level.

For the last few weeks, the Freakonomics podcast has been releasing a new series on Bad Medicine. The series (Part 1, Part 2, Part 3) includes interviews with Vinay Prasad, MD MPH and Martin Makary, MD MPH, and covers a wide range of topics crucial to understanding right care, including the prevalence of harm from medical errors, the way conflicts of interest can corrupt medical trials, and the rise of evidence-based medicine. The series is compelling and accessible for general audiences, so it’s a great way to start a conversation with family and friends over the holidays about what they want from their health care.

Announcements

  • In order for our staff to spend time with family and friends during this holiday season, RightCare Weekly will be taking a short hiatus, returning next year. On behalf the Lown Institute staff, we wish you a happy and healthy holiday season.
  • We’ve extended our deadline for submitting research abstracts to the 2017 Lown Institute Conference. The new deadline is 11:59 pm PST on Sunday, January 8.  Learn more and submit your abstract here.
  • In collaboration with JAMA Internal Medicine, the Lown Institute announces the third national Right Care Vignette Competition. We are seeking clinical vignettes written by trainees, describing harm or near-harm caused by medical overuse. We want to hear your stories! See the full description of the competition here and apply here.

Headlines

Overuse

Access

Aging

Caregiving

Clinician health

Cost of care

Ethics

Evidence

Inequalities and disparities

Med ed

Mental health

Palliative care

Pharma

Politics

Public health

Shared decision-making

Social determinants

Transparency

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation.

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