When Alicia Cole went to a hospital in Burbank, California, in August 2006 to have two small fibroids removed, she never imagined that what was supposed to be a two-day stay would end up being two months.
The cause? Hospital-acquired infections, including MRSA and flesh-eating disease. “Eight years later, and I am still in recovery from the infections I got in the hospital,” Cole says. “I was christened by fire” into patient advocacy, she continues.
“I’ve been fighting since August 2006 — for my life, my bandages and my aftercare, because unfortunately when there is hospital-acquired harm, often hospitals don’t want to help you out because doing so is an admission of liability,” she says.
“When my parents [and I] would ask questions like, ‘Has this happened before?’ we were met with silence and side-stepping. I was told that these things happen, and that it was the luck of the draw, and I’d pulled a bad card.”
This scenario unsettled Cole, so after she was released from the hospital, she started probing. “I started a MySpace group for survivors [of hospital infections] because I was trying to reach out to other people who had been harmed by infections and were looking for help,” she says.
Zero Preventable Deaths
That was the beginning of a journey that led Cole from feeling hopeless in a hospital bed to being empowered on the front lines of a nationwide struggle against avoidable infections that lead to thousands of preventable deaths every year. Between 44,000 and 98,000 Americans died from preventable deaths in 1999, according to an Institute of Medicine Report that alarmed experts throughout the nation. And yet, that number has since doubled. Those sobering statistics led Joe Kiani, a medical device entrepreneur who specializes in noninvasive pulse oximeters, to start a nonprofit called the Patient Safety Movement Foundation. Its mission is to reach a goal of zero preventable deaths by the year 2020.
The foundation holds an annual summit to showcase data, findings and best practices for reaching its goal. Kiani explains his thinking behind the summit: “Let me try to put a meeting together where I have access to the greatest minds, and we can figure out what is causing all these deaths and come up with apps that people could actually go and implement.”
The meeting gathers hospital CEOs, medical technology companies and, most importantly, patients like Cole who sit on every panel. “I was so pleased when I got there because patient advocates were involved in every aspect. That’s when real communication happens, and real change can take place,” Cole says.
But most of the work goes on behind the scenes throughout the rest of the year, she adds. And hospitals throughout the nation have made concrete changes following the meeting, which have led to improved patient outcomes, Kiani says. One example is MedStar Health, a hospital group in Maryland and the District of Columbia that includes 10 hospitals. Dave Mayer, MedStar Health vice president of quality and safety, says that last year, six of their hospitals reported no catheter-associated infections, which has traditionally been one of the biggest threats to patient safety. Mayer says good staff communication, including checklists, accounts for some of the success.
Patients and Caregivers: Speak Up!
Patient and caregiver engagement is also very important, he adds. MedStar Health developed a program called “We Want to Know,” for patients to communicate with a patient navigator about perceived breakdowns in care and for hospitals to monitor readmission rates. The five-year program, which is sponsored by the Agency for Healthcare Research and Quality, is now in its second year at two hospitals.
“The average patient or family member is still concerned about speaking up and questioning the nurse or doctor for fear of complaining. If you are seen as complaining, the perception is people won’t want to go into your room,” Mayer adds.
Instead, he says, “We want you to be proactive. We want you to ask us, ‘What is that medication?’ and ‘Can you tell me the dose?’ So, we are trying to break down those walls.”
Kiani says family members need to “ask questions in a pleasant way,” but also “demand in an assertive way about the care given to their loved ones.”
“Patients have to be active and assertive when they engage with their health care,” Cole says, adding that at this year’s summit, which takes place next month in Irvine, California, there will be a panel on assertive patients that explores how patients and caregivers should speak up when they sense medical errors.
“The most important thing is for people to speak up and ask questions,” says Cole, who will be on the panel. “I still have times when I’m uncomfortable speaking up because we’re just taught to not question doctors. It’s a cultural courtesy thing that we’re taught that they know better than we do, and so we feel bad speaking up and asking questions.”
Treating Hospitals Like Airplanes
For Michael Ramsay, chairman of the department of anesthesiology and pain management at Baylor University Medical Center, pilots and hospital staff have similar roles. “Just like pilots do as they take off in a plane, they make checks in the room,” Ramsay says. “We’re still very subject to the human element. We’re all humans and make errors.”
To make sure those checks are adequate, Ramsay says it’s “a combination of ongoing education, hand-washing and every hospital [bringing] in rigid protocols. If one person doesn’t do it, you’ve got a problem.”
Ramsay is on the Patient Safety Movement Foundation of directors and says the beauty of the summit is that it brings together the multiple actors that need to be involved in patient safety: “patients, patients’ families, hospital administrators, the joint commission and the industry who can make devices when our human insight fails.”
“We’ve got all the pieces to make hospitals safer places,” he says. “It’s a matter of getting people’s attention and getting the word out to every person employed in the hospital.”
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Zero Preventable Hospital Deaths: How One Nonprofit Is Making Safety Its Mission originally appeared on usnews.com
