Category Archives: Health Care Quality

Mumps: Old Disease, New Health Challenge

We are now seeing the largest mumps outbreak in the U.S. in the past 20 years. As of May 2, there were 2,597 reported cases, with the largest number in Iowa, where the outbreak began on a college campus. The rest of the cases are in the surrounding Midwestern states. The outbreak has not reached North Carolina yet, but in a mobile community where people do travel, it certainly could.

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UNC’s Pediatric Rapid Response Team

Developing a rapid response team is one of the six recommended interventions in the Institute for Healthcare Improvement’s 100,000 Lives Campaign. UNC Hospitals has been a part of this national campaign since it began last year.

A small number of medical centers, believed to be less than 20 nationwide, have created rapid response teams for their pediatric patients. Last August, the N.C. Children’s Hospital at UNC Hospitals became the first in North Carolina to activate its Pediatric Rapid Response Team.

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Hospital-Acquired Infections at UNC Health Care

Last month, the Congress held a hearing to examine the financial and human impact of hospital-acquired infections (HAIs).

The main points raised in the hearing were:

¢ CDC estimates that there are approximately 1.7 million hospital-acquired infections resulting in 99,000 deaths each year.

¢ The financial costs of hospital-acquired infections are estimated to be extremely high. Extrapolated nationally, costs were estimated to be $46 billion.

Currently, there is no hospital reporting of nosocomial infections at the state level in North Carolina The rate of infection acquired at UNC Hospitals has remained stable for 15 years (2.6 percent 3.2 percent), although patient acuity with these infections has gone up. Because HAI rates are not collected nationally, these numbers cannot be benchmarked against nationally representative figures. However, we can compare them to the voluntarily collected data that enters the CDC's surveillance system we find that UNC's numbers for procedure-associated rates (e.g., central-line associated bacteremia, ventilator-associated pneumonia) are equal to or below the rates reported there. UNC is taking the initiative to address HAIs nonetheless, through three exemplary programs:

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Electronic Health Records in Family Medicine

In light of my recent blog entry about electronic health records (March 2, 2006), I’d like to provide a link to an editorial in the current issue of the Annals of Family Medicine: “Keeping our Eye on The Ball: Managing The Evolution of Electronic Health Records.”

The editorial was co-written by several authors, including two distinguished professors at UNC: Warren Newton MD, MPH and Donald Spencer, MD, MBA.

Annals of Family Medicine EHR editorial

Please enjoy our continued discussion of this topic.

Merger Makes a Stronger NQF

The movement to improve health care quality has been underway for decades. There has been progress on several fronts, especially recently including greater awareness of the problem, agreement on how to measure and report quality, and even growing consensus about the best ways to deliver the highest quality care in a clinical setting. At the same, there has been confusion about roles and responsibilities in the quality improvement arena. There are a growing number of organizations today, representing varying interests in the quality effort. In some cases, the work they do is complementary; in others, it's conflicting or confusing.

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Mandatory Electronic Medical Records

Electronic medical records hold great promise for improving quality of care. Development of a national electronic health records system, however, is progressing slowly. Today, less than ten percent of physician practices use an electronic medical record. It surprises me that some health care professionals still question the benefit of moving from paper to computerized records. It's time all health care providers large and small embrace and invest in medical records technology for the benefit of their patients.

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The State of Our Union’s Health

I was a bit disappointed that the President did not spend more time discussing health care in his State of the Union address last week. I hope people listening did not conclude that the issue is dramatically less important than addressing terrorism, improving education or reducing dependence on foreign oil. The points the President did emphasize about personal ownership and responsibility for one's own health care underpin the details of his health care policy. Those details will be discussed and debated over the next several months in a manner that I hope will fully inform consumers about their important role in consumer driven health care.

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Quality in the Eyes of Patients

The press coverage we received in The New York Times made me wonder if patients have been treated with a little more dignity this week in hospitals across the nation?

I know we dedicate great resources to systematic quality improvements that are designed to reduce medical errors and complications, and increase our standard of care. But, as the article suggests, there is another important part of delivering quality care.

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