In 1996, following the death of our mother from a hospital-caused pressure ulcer, my brother Gary and I founded the National Decubitus Foundation. Gary died in September from a rare form of cancer. Our hope, and even expectation, when we undertook this effort to eradicate the hospital-caused pressure ulcer, was that one or more wealthy individuals whose families had suffered from bedsores would make large donations that would put the NDF on a firm financial footing. But that has not happened. In all likelihood this effort will end with our deaths.
But there are some encouraging signs, as reported in the Fall 2015 issue of the NDF newsletter just published today:
1. One of the largest hospitals in Hong Kong has, in effect, adopted the NDF Prevention Protocol by purchasing 300 pressure-relieving support surfaces and providing them to all at-risk patients. Ulcer formation dropped by over 70%, and further improvement is expected.
2. Many hospitals are following the lead of Kaiser-Permanente and forming their own insurance companies, either on their own or as part of an Accountable Care Organization (ACO). This completely changes the incentives for bedsore prevention, because hospitals that have already been paid by the patient's annual insurance premium profit greatly by avoiding the expense of treating pressure ulcers, whereas those being paid for each procedure by the outside insurer gain cash flow by having to treat pressure ulcers.
Tuesday, November 10, 2015
Tuesday, August 11, 2015
Time for the 'Brute Force' Option
We have written previously about Dr. Lucien Leape, father of the modern safety movement, who has called for "Regulation over Exhortation". In the May 2013 issue of HealthLeaders he was asked:
"Tell me more about the regulatory agency that would compel patient safety in hospitals, what you call the 'brute force' option."
Dr. Leape answered:
"I was joking about 'brute force'. What I mean is regulation as opposed to exhortation. This agency would do what the FAA does, which is to say, 'Here are the standards. We expect you to follow them. And we're going to come around and inspect and if you're not doing them, we're going to rap your wrists and expect you to shape up and really get serious about it."
He continued:
"It's inconceivable to me that hospitals can continue to not follow practices that are known to make a real difference"
The NDF wrote Dr. Leape at Harvard suggesting that pressure ulcers constitute a hospital error that his proposed agency should regulate. He responded, in part:
"I think pressure ulcers are indeed an example of something that health care organizations should be held accountable for. Failure to prevent them, when we know how, is negligence, pure and simple."
In line with Dr. Leape's thoughts, the NDF plans to concentrate its efforts on educating Congress that pressure ulcers are preventable, and that all hospitals must be required to have on hand sufficient pressure redistribution support surfaces for all admitted patients identified as being at-risk. This is the NDF "Prevention Protocol".
"Tell me more about the regulatory agency that would compel patient safety in hospitals, what you call the 'brute force' option."
Dr. Leape answered:
"I was joking about 'brute force'. What I mean is regulation as opposed to exhortation. This agency would do what the FAA does, which is to say, 'Here are the standards. We expect you to follow them. And we're going to come around and inspect and if you're not doing them, we're going to rap your wrists and expect you to shape up and really get serious about it."
He continued:
"It's inconceivable to me that hospitals can continue to not follow practices that are known to make a real difference"
The NDF wrote Dr. Leape at Harvard suggesting that pressure ulcers constitute a hospital error that his proposed agency should regulate. He responded, in part:
"I think pressure ulcers are indeed an example of something that health care organizations should be held accountable for. Failure to prevent them, when we know how, is negligence, pure and simple."
In line with Dr. Leape's thoughts, the NDF plans to concentrate its efforts on educating Congress that pressure ulcers are preventable, and that all hospitals must be required to have on hand sufficient pressure redistribution support surfaces for all admitted patients identified as being at-risk. This is the NDF "Prevention Protocol".
Monday, January 26, 2015
Hospitals Shown How to Stop Causing Pressure Ulcers
The National Decubitus Foundation, home of the NDF Prevention Protocol, has created a prominent link on its home page (www.endbedsores.org) to allow hospitals to easily find a mentor who will provide guidance to show the hospital how to stop causing pressure ulcers. Many hospitals have reduced their bedsore incidence rate to near zero. Eight of these hospitals have volunteered through the Institute for Healthcare Improvement (IHI) to provide guidance to hospitals that are still causing bedsores. Now hospitals have no excuse for continuing to cause pressure ulcers.
Thirteen states now require hospitals to post their medical errors, including Stage III and IV pressure ulcers. The NDF will now concentrate on urging the other 37 states to follow their lead. Where information is available, the NDF will contact the worst performing hospitals to show them how they can get help.
Hopefully this is the start of the end of hospitals causing pressure ulcers.
Thirteen states now require hospitals to post their medical errors, including Stage III and IV pressure ulcers. The NDF will now concentrate on urging the other 37 states to follow their lead. Where information is available, the NDF will contact the worst performing hospitals to show them how they can get help.
Hopefully this is the start of the end of hospitals causing pressure ulcers.
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