Lessons From America's Safest Hospitals
More than 180,000 people die every year from hospital errors. Here's what the top medical centers are doing to improve your odds

by Beth Howard, AARP The Magazine, April/May issue

About 400,000 drug-related injuries occur each year in hospitals, according to an Institute of Medicine study. To help solve the problem, many of the safest hospitals have embraced the use of a computerized provider order entry (CPOE) system, which forces doctors to enter prescriptions into the computer electronically. "It basically eliminates transcription errors," says Anthony J. Ardire, M.D., senior vice president for quality and patient safety at Lehigh Valley Health Network in Allentown, Pennsylvania.

The system also has built-in safety alerts — for example, it won't allow doctors to prescribe more medicine than is generally recommended. Since implementing the system and introducing bar coding, in which a patient's bracelet is scanned to ensure the right patient is getting the right medication at the right dose, Lehigh Valley's medication-error rate has been reduced from 2 in 100,000 doses to 2 in 1 million doses.

AARP The Magazine has teamed up with The Leapfrog Group, which rates hospitals on safety and resource use, to showcase what some of the most innovative hospitals are doing to prevent errors. For example, the safest hospitals in America use surgical checklists, have fully integrated electronic medical records, and place a premium on transparency.

Virginia Mason and Kaiser Permanente, which provide both outpatient doctor visits and in-hospital care, have integrated their CPOE systems with electronic medical record keeping, so new drug orders can be checked against the patient's existing medication record for possible interactions and allergies. When a patient leaves the hospital, the system updates his or her medication list.

Virginia Mason also takes the unusual step of tracking medications prescribed outside the hospital — staff can learn if a patient has actually filled a prescription. That could change the treatment if the hospital staff notices that a patient admitted with high blood pressure, for instance, hasn't been filling prescriptions. More >>

11th Annual CPOCT Forum

The Role of Point-of-Care testing in a Disaster (Plan):

Thursday, August 1, 2013

Make plans to attend this program on Thursday, August 1st at the George Brown Convention Center during the AACC Meeting and sponsored by the AACC Critical and Point-of-Care Testing Division

• 7:30 - 8:00 a.m. Hot buffet breakfast  I  8:00 - 10:00 a.m. Presentation

“The Role of Point-of-Care Testing in a Disaster (Plan)” features a Medical Technologist Health Services Officer, who is involved in an array of missions related to disaster and emergency response and a panel of POCCs. The forum will cover various aspects of a disaster planning including:

• An example of a Community based cooperative plan
• A hospital based plan
• A discussion of a guidance document under development in the field.

Join the CPOCT division for a hot breakfast and scientific presentation and hear keynote speaker Daniel Hesselgesser, along with our expert panel of POCCs, Diane Davis; Kerstin Halverson and Peggy Mann. The $20.00 also includes entry to Thursday’s Expo. Click here for more details and to register.

Order More Tests? With Diabetes, May Be ‘YES’
CAP Today, March 2013, Feature Story, By Jan Bowers

In patients with diabetes mellitus, hemoglobin A1c testing frequency is largely in line with recommended guidelines. In those same patients, LDL testing is not performed frequently enough, and urine protein testing frequency falls far short of recommendations.

Those are the results of a recently completed Q-Probes study of whether and how laboratories monitor the frequency of diabetes testing, and how closely the frequencies in their institutions hew to the American Diabetes Association recommended guide-lines.

“It’s important to focus on both over- and underutilization, because sometimes in the lab we tend to focus only on whether we’re performing tests that may not be necessary,” says Peter L. Perrotta, MD, medical director of clinical laboratories at West Virginia University Hospital, professor of pathology at West Virginia University School of Medicine, and a coauthor of the CAP study. But there’s another side, he says: “Tests that should be ordered are not, or they’re not ordered frequently enough.” More >

Bedside Glucose Testing Systems
Cap Today, March 2013, Brendan Dabkowski

New to the CAP TODAY lineup of point-of-care blood glucose systems is the Roche Accu-Chek Inform II, which the FDA cleared last fall. It offers meterlevel wireless technology, conducts extensive integrity checks with each test, has an advanced laser bar-code scanner, and provides up to three unique patient identifiers.

On the market since 2004, HemoCue’s Glucose 201 DM analyzer has “withstood the test of time,” says product marketing manager Terry Carmichael, who adds that the recent focus has been to develop more flexible connectivity solutions. HemoCue plans to make available options that allow clients to select how they connect HemoCue devices to their [information] system.

Abbott Diabetes Care is working with hospitals to help them achieve their patient safety goals. The Precision Xceed Pro blood glucose and beta-ketone monitoring system is built on Abbott’s “three pillars of patient safety”—bedside accuracy, cross contamination prevention, and hospital compliance.

Nova Biomedical’s StatStrip measures and corrects for common interferences such as hematocrit, acetaminophen, and ascorbic acid. StatStrip biosensors eliminate the need for calibration coding, and the system’s large color display presents multiple patient identifiers.

Ten bedside glucose testing systems from six companies are profiled. All information is supplied by the companies. More >

Between the ever-growing list of pros and cons for Point-of-Care Testing (POCT) versus traditional lab testing and the potential impact of POCT in hospital facilities in regards to treatment, it can be difficult to keep up. Here, Advance for Administrators for the Laboratory have put together a review from some recent articles focused on POCT, ranging from accuracy and reliability of testing to assessments and record-keeping.

A Pathologist’s Take on POCT
By Richard A. McPherson, MD, MS

Point-of-care testing (POCT) devices have largely been designed to provide tests for critically ill inpatients on intravenous therapy who need close monitoring of their electrolyte and fluid balance. The medical necessity for POCT in elderly patients being seen in their own homes or assisted living facilities takes on a different form, as the testing technologies are often used in combination with history and physical examination to determine whether patients require higher level care or can remain in their present locations. Click here for more

Evolving World of POCT
By Maureen R. Bush, MLS(ASCP)CM, and Sheldon Campbell, MD, PhD, FCAP

Although point-of-care testing (POCT) has its critics when its accuracy is compared to “traditional” laboratory testing, its value in offering expedient results in both conventional and unconventional settings often outweighs the argument. What’s more, new applications for POCT continue to be explored, which makes this an area to stay abreast of from technology, personnel and regulatory standpoints. Click here for more

A Need for Speed
By Valerie Neff Newitt

Point-of-care testing (POCT) is rooted in an urgent need for speed, particularly where infectious diseases and public health intersect. Sheldon Campbell, MD, PhD, FCAP, Department of Laboratory Medicine, Yale University School of Medicine, says a POCT “explosion” has had a radical effect in rapid identification and treatment of people with HIV.   Click here for more

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Last updated: 05/13/2013 Questions or corrections: editor@pointofcare.net. © 2013  BACK TO TOP