Healthcare Epidemiology is the Paradigm for Patient Safety

2002 ◽  
Vol 23 (1) ◽  
pp. 47-51 ◽  
Author(s):  
William E. Scheckler
Keyword(s):  
Patient Safety ◽  
The United States ◽  
Lessons Learned ◽  
Institute Of Medicine ◽  
Hospital Epidemiology ◽  
Making A Difference ◽  
Control And Prevention ◽  
Quality Of Medical Care ◽  
Healthcare Epidemiology

I was honored to receive the 2001 Lectureship Award from the Society for Healthcare Epidemiology of America (SHEA). It was my intent during the talk to review our field and implications that some of the new initiatives called “patient safety” have for our expertise. This article is based on the SHEA Lectureship that was given April 1, 2001, at the SHEA Annual Meeting in Toronto, Ontario, Canada.This article consists of four sections. First, I review lessons learned from colleagues during the 33 years that I have been associated with the field of hospital epidemiology and infection control, since my first days at the Centers for Disease Control and Prevention (CDC). Second, I explore issues raised by the Institute of Medicine (IOM) report on patient safety, adverse events, and medical errors, evaluating research that went into the extrapolation of the numbers of preventable deaths that this report highlighted. Those deaths gained everyone's attention. Third, I review the field of healthcare epidemiology, highlighting the three decades of success in our field in enhancing the safety of patients, improving their outcomes, and making a difference in the quality of medical care received in the United States. Finally, I discuss the challenges that hospital epidemiology currently faces and the opportunities that come with the expertise we have developed during more than 30 years.

Lessons Learned From Hospital Ebola Preparation

2015 ◽  
Vol 36 (6) ◽  
pp. 627-631 ◽  
Author(s):  
Daniel J. Morgan ◽  
Barbara Braun ◽  
Aaron M. Milstone ◽  
Deverick Anderson ◽  
Ebbing Lautenbach ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Ebola Virus ◽  
Virus Disease ◽  
The United States ◽  
Routine Care ◽  
Lessons Learned ◽  
Convenience Sample ◽  
Control And Prevention ◽  
Prevention Activities ◽  
Healthcare Epidemiology

BACKGROUNDHospital Ebola preparation is underway in the United States and other countries; however, the best approach and resources involved are unknown.OBJECTIVETo examine costs and challenges associated with hospital Ebola preparation by means of a survey of Society for Healthcare Epidemiology of America (SHEA) members.DESIGNElectronic survey of infection prevention experts.RESULTSA total of 257 members completed the survey (221 US, 36 international) representing institutions in 41 US states, the District of Columbia, and 18 countries. The 221 US respondents represented 158 (43.1%) of 367 major medical centers that have SHEA members and included 21 (60%) of 35 institutions recently defined by the US Centers for Disease Control and Prevention as Ebola virus disease treatment centers. From October 13 through October 19, 2014, Ebola consumed 80% of hospital epidemiology time and only 30% of routine infection prevention activities were completed. Routine care was delayed in 27% of hospitals evaluating patients for Ebola.LIMITATIONSConvenience sample of SHEA members with a moderate response rate.CONCLUSIONSHospital Ebola preparations required extraordinary resources, which were diverted from routine infection prevention activities. Patients being evaluated for Ebola faced delays and potential limitations in management of other diseases that are more common in travelers returning from West Africa.Infect Control Hosp Epidemiol 2015;00(0): 1–5

scholarly journals Lessons Learned From an Intensive Writing Training Course for Applied Epidemiologists

2020 ◽  
Vol 135 (4) ◽  
pp. 428-434
Author(s):  
Jessica Arrazola ◽  
Malorie Polster ◽  
Paul Etkind ◽  
John S. Moran ◽  
Richard L. Vogt
Keyword(s):  
Public Health ◽  
Lessons Learned ◽  
Publishing Process ◽  
Writing Courses ◽  
Training Course ◽  
Public Health Professionals ◽  
Control And Prevention ◽  
Council Of State

Although writing is a valued public health competency, authors face a multitude of barriers (eg, lack of time, lack of mentorship, lack of appropriate instruction) to publication. Few writing courses for applied public health professionals have been documented. In 2017 and 2018, the Council of State and Territorial Epidemiologists and the Centers for Disease Control and Prevention partnered to implement a Morbidity and Mortality Weekly Report Intensive Writing Training course to improve the quality of submissions from applied epidemiologists working at health departments. The course included 3 webinars, expert mentorship from experienced authors, and a 2-day in-person session. As of April 2020, 39 epidemiologists had participated in the course. Twenty-four (62%) of the 39 epidemiologists had submitted manuscripts, 17 (71%) of which were published. The program’s evaluation demonstrates the value of mentorship and peer feedback during the publishing process, the importance of case study exercises, and the need to address structural challenges (eg, competing work responsibilities or supervisor support) in the work environment.

scholarly journals Leveraging massive open online courses to expand quality of healthcare education to health practitioners in Rwanda

2019 ◽  
Vol 8 (4) ◽  
pp. e000532 ◽  
Author(s):  
Kirstin Woody Scott ◽  
Theophile Dushime ◽  
Vincent Rusanganwa ◽  
Liana Woskie ◽  
Clint Attebery ◽  
...  
Keyword(s):  
Patient Safety ◽  
Global Health ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Lessons Learned ◽  
Online Course ◽  
Massive Open Online ◽  
District Hospitals

Improving the quality of healthcare delivery is increasingly a global health priority. However, quality improvement training opportunities that provide theoretical foundations and basic skills for patient safety and other quality initiatives have been limited or historically out of reach, especially in low-and-middle income countries (LMICs). To address this gap, the Harvard Initiative on Global Health Quality (HIGHQ) created and launched a massive open online course (MOOC) in 2014 focused on patient safety and quality of care using the edX platform. More than 30 000 students from across 195 countries registered for the online course. This paper summarises an innovative educational partnership between the course team and one of these countries, Rwanda, to develop a blended-learning model to bolster participation in this new course among Rwandan healthcare professionals. Although a small country, Rwanda was among the top performing countries for attracting course registrants and was the leading country for the proportion of enrollees who ultimately completed the course. Further, half (21 of 42) of Rwanda’s district hospitals opted to appoint a PH555x course facilitator at their site to help lead regular meetings and discussions about the course content at their facility. The majority of Rwandan enrollees were health professionals (63%) and 81% reported that PH555x was their first experience taking an online course. Among those participating in the ‘flipped’ component at hospital sites, 94% reported that the course helped them to think of specific ways to improve healthcare quality at their facility. In this paper, we describe this innovative public–private educational model, challenges to implementation and lessons learned that may be helpful for future MOOC developers who wish to augment learning opportunities among healthcare professionals in LMICs.

scholarly journals Leveraging IT to Improve Patient Safety

2003 ◽  
Vol 12 (01) ◽  
pp. 153-158
Author(s):  
D.E. Garets ◽  
T.J. Handler ◽  
M.J. Ball
Keyword(s):  
Patient Safety ◽  
Medical Errors ◽  
Improve Patient Safety ◽  
Quality Care ◽  
Quality Of Healthcare ◽  
The United States ◽  
Institute Of Medicine ◽  
The Media ◽  
The Military ◽  
Improve Patient

Abstract:Medical errors and issues of patient safety are hardly new phenomena. Even during the dawn of medicine, Hippocrates counselled new physicians “to above all else do no harm.” In the United States, efforts to improve the quality of healthcare can be seen in almost every decade of the last century. In the early 1900s, Dr. Ernest Codman failed in his efforts to get fellow surgeons to look at the outcomes of their cases. In the 1970s, there was an outcry that the military allowed an almost blind surgeon to continue to practice and even transferred him to the prestigious Walter Reed Hospital. More recently, two reports by the Institute of Medicine caught the attention of the media, the American public, and the healthcare industry. To Err Is Human highlights the need to reduce medical errors and improve patient safety, and Crossing The Quality Chasm calls for a new health system to provide quality care for the 21st century.

Proposed Agenda for the Measurement of Quality-of-Care Outcomes in Oncology Practice

1999 ◽  
Vol 17 (8) ◽  
pp. 2614-2614 ◽  
Author(s):  
Jeanne S. Mandelblatt ◽  
Patricia A. Ganz ◽  
Katherine L. Kahn
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
Outcome Measures ◽  
Cancer Care ◽  
The United States ◽  
Leadership Role ◽  
Institute Of Medicine ◽  
Oncology Practice ◽  
The Impact

ABSTRACT: Cancer is an important disease, and health care services have the potential to improve the quality and quantity of life for cancer patients. The delivery of these services also has recently been well codified. Given this framework, cancer care presents a unique opportunity for clinicians to develop and test outcome measures across diverse practice settings. Recently, the Institute of Medicine released a report reviewing the quality of cancer care in the United States and called for further development and monitoring of quality indicators. Thus, as we move into the 21st century, professional and regulatory agencies will be seeking to expand process measures and develop and validate outcomes-oriented measures for cancer and other diseases. For such measures to be clinically relevant and feasible, it is key that the oncology community take an active leadership role in this process. To set the stage for such activities, this article first reviews broad methodologic concerns involved in selecting measures of the quality of care, using breast cancer to exemplify key issues. We then use the case of breast cancer to review the different phases of cancer care and provide examples of phase-specific measures that, after careful operationalization, testing, and validation, could be used as the basis of an agenda for measuring the quality of breast cancer care in oncology practice. The diffusion of process and outcome measures into practice; the practicality, reliability, and validity of these measures; and the impact that these indicators have on practice patterns and the health of populations will be key to evaluating the success of such quality-of-care paradigms. Ultimately, improved quality of care should translate into morbidity and mortality reductions.

scholarly journals Neurosurgical credentials: a history and critique

1998 ◽  
Vol 5 (2) ◽  
pp. E3 ◽  
Author(s):  
Sidney Tolchin
Keyword(s):  
The United States ◽  
Quality Of Education ◽  
Peer Evaluation ◽  
New Paradigm ◽  
Medical Practices ◽  
Outcomes Evaluation ◽  
Practice Of Medicine ◽  
Quality Of Medical Care ◽  
And Training

The author presents a review of the process of peer evaluation in this century, as well as how certification and techniques of evaluation in the practice of medicine and neurosurgery have evolved. The effect of licensure on the workforce, the influence of trade laws on quality of education and training, and the new paradigm of competition and managed medical practices have made a remarkable impact on the nature of the care of patients in the United States. The author also discusses the effect of risk management and litigation on the quality of medical care, the nature of outcomes evaluation and economic credentials in the absence of appropriate instruments for such evaluation, and alternatives for the future of the credentials process.

Assessment of the Quality of Medical Care Among Patients with Early Stage Prostate Cancer Undergoing Expectant Management in the United States

2012 ◽  
Vol 188 (3) ◽  
pp. 769-774 ◽  
Author(s):  
Jamie Ritchey ◽  
E. Greer Gay ◽  
Benjamin A. Spencer ◽  
David C. Miller ◽  
Lauren P. Wallner ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Medical Care ◽  
Early Stage ◽  
Expectant Management ◽  
The United States ◽  
Quality Of Medical Care

scholarly journals Forecasting the COVID-19 Pandemic: Lessons learned and future directions

2021 ◽  
Author(s):  
Saketh Sundar ◽  
Patrick Schwab ◽  
Jade Z.H. Tan ◽  
Santiago Romero-Brufau ◽  
Leo Anthony Celi ◽  
...  
Keyword(s):  
Healthcare Resource ◽  
Public Awareness ◽  
The United States ◽  
Lessons Learned ◽  
Health Policies ◽  
Mechanistic Models ◽  
Future Directions ◽  
Public Health Policies ◽  
Time Period ◽  
Control And Prevention

The Coronavirus Disease 2019 (COVID-19) has demonstrated that accurate forecasts of infection and mortality rates are essential for informing healthcare resource allocation, designing countermeasures, implementing public health policies, and increasing public awareness. However, there exists a multitude of modeling methodologies, and their relative performances in accurately forecasting pandemic dynamics are not currently comprehensively understood. In this paper, we introduce the non-mechanistic MIT-LCP forecasting model, and assess and compare its performance to various mechanistic and non-mechanistic models that have been proposed for forecasting COVID-19 dynamics. We performed a comprehensive experimental evaluation which covered the time period of November 2020 to April 2021, in order to determine the relative performances of MIT-LCP and seven other forecasting models from the United States Centers for Disease Control and Prevention (CDC) Forecast Hub. Our results show that there exist forecasting scenarios well-suited to both mechanistic and non-mechanistic models, with mechanistic models being particularly performant for forecasts that are further in the future when recent data may not be as informative, and non-mechanistic models being more effective with shorter prediction horizons when recent representative data is available. Improving our understanding of which forecasting approaches are more reliable, and in which forecasting scenarios, can assist effective pandemic preparation and management.

scholarly journals �A Phenomenal Person and Doctor�: Thank You Letters to Medical Care Providers (Preprint)

2016 ◽  
Author(s):  
Talya Miron-Shatz ◽  
Stefan Becker ◽  
Franklin Zaromb ◽  
Alexander Mertens ◽  
Avi Tsafrir
Keyword(s):  
Medical Care ◽  
The United States ◽  
Care Providers ◽  
Good Care ◽  
Patient Centered ◽  
Medical Facilities ◽  
Centered Care ◽  
Quality Of Medical Care ◽  
The Web

BACKGROUND Thank you letters to physicians and medical facilities are an untapped resource, providing an invaluable glimpse into what patients notice and appreciate in their care. OBJECTIVE The aim of this study was to analyze such thank you letters as posted on the Web by medical institutions to find what patients and families consider to be good care. In an age of patient-centered care, it is pivotal to see what metrics patients and families apply when assessing their care and whether they grasp specific versus general qualities in their care. METHODS Our exploratory inquiry covered 100 thank you letters posted on the Web by 26 medical facilities in the United States and the United Kingdom. We systematically coded and descriptively presented the aspects of care that patients and their families thanked doctors and medical facilities for. We relied on previous work outlining patient priorities and satisfaction (Anderson et al, 2007), to which we added a distinction between global and specific evaluations for each of the already existing categories with two additional categories: general praise and other, and several subcategories, such as treatment outcome, to the category of medical care. RESULTS In 73% of the letters (73/100), physicians were primarily thanked for their medical treatment. In 71% (71/100) of the letters, they were thanked for their personality and demeanor. In 52% cases (52/100), these two aspects were mentioned together, suggesting that from the perspective of patient as well as the family member, both are deemed necessary in positive evaluation of medical care. Only 8% (8/100) of the letters lacked reference to medical care, personality or demeanor, or communication. No statistically significant differences were observed in the number of letters that expressed gratitude for the personality or demeanor of medical care providers versus the quality of medical care (χ21, N=200=0.1, not statistically significant). Letters tended to express more specific praise for personality or demeanor, such as being supportive, understanding, humane and caring (48/71, 68%) but more general praise for medical care (χ21, N=424=63.9, P<.01). The most often mentioned specific quality of medical care were treatment outcomes (30/73, 41%), followed by technical competence (15/73, 21%) and treatment approach (14/73, 19%). A limitation of this inquiry is that we analyzed the letters that medical centers chose to post on the Web. These are not necessarily a representative sample of all thank you letters as are sent to health care institutions but are still indicative of what centers choose to showcase on the Web. CONCLUSIONS Physician demeanor and quality of interaction with patients are pivotal in how laymen perceive good care, no less so than medical care per se. This inquiry can inform care providers and medical curricula, leading to an improvement in the perceived quality of care.

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