VHIG Digest: Vol. 3, No. 5
This Week’s Top 3 Stories in Patient Safety and Quality Improvement in Healthcare
By Scott Hagan, School of Medicine, Class of 2013
1. Privacy Curtains in Hospital Patient Rooms Carry Dangerous Bacteria
In a study with preliminary results presented at the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy, Dr. Michael Ohl and colleagues from the University of Iowa found that the privacy curtains used in hospital carry bacteria such as MRSA carrying a significant morbidity risk. Dr. Ohl found that these infected curtains could impose a significant risk for patients, especially those in medical and surgical intensive care units who are predisposed to worse outcomes from iatrogenic infections. Dr. Ohl and his team swabbed 43 hospital curtains several times a week to determine the speed at which curtains become diffusely infected with dangerous bacteria. The researchers found that 12/13 curtains showed cultures positive for contamination within a week, and that, by the end of the study, virtually all privacy curtains (41/43) showed signs of contamination on at least one occasion.
Dr. Ohl expressed during the conference that hospitals should now take greater precautions to account for the risk of iatrogenic infections via infected privacy curtains. One potentially effective and simple intervention that Dr. Ohl suggested was for medical teams to wash their hands when entering a patient room after they had already opened the privacy curtains to prevent transfer of pathogens from curtains to the patient through the provider’s hands.
2. Agency for Healthcare Research and Quality (AHRQ) Launches Initiative to Improve Communication between Patients and Providers
The AHRQ, an agency under the Department of Health and Human Services (HHS), announced a new initiative aimed to improve patient-provider communication by encouraging patients to feel more at ease in asking important questions regarding their health, and by encouraging providers to be prompt questions that allow patients to express their more important health concerns. As part of the initiative, AHRQ has developed a page on their website that helps patients prioritize the questions they wish to ask during encounters with health care professionals. The agency has also launched a series of PSA videos to help spread the message about the importance of asking questions during clinic appointments. To reach out to physicians, AHRQ is launching ads for the program in NEJM, JAMA, Annals of Internal Medicine, and other prominent medical journals.
3. Study Outlines Reasons for Delays in Percutaneous Coronary Intervention (PCI) for Patients with ST-Elevated Myocardial Infarction (STEMI)
In a study released by the Circulation, a journal of the American Heart Association, Dr. Timothy Henry and colleagues of the Minnesota Heart Institute Foundation found that 33% of patients experiencing an ST-Elevated Myocardial Infarction (STEMI) have delays in receiving a potentially life-saving percutaneous coronary intervention (PCI). An especially important reason for delays in care is that many community hospitals do not have the capacity to perform PCIs, thus necessitating transfer of unstable patients to tertiary care centers. The study found the following to be the most important reasons for delays in care:
awaiting transportation ─ 26 percent;
emergency department delays ─ 14 percent;
diagnostic dilemma ─ 9 percent;
initial negative test for heart attack ─ 9 percent; and
cardiac arrest ─ 6 percent.
Of the patient sample investigated in the study, 30% received treatment within 90 minutes, and 66% received treatment within 120 minutes. Of the remaining 34% that received treatment outside of 120 minutes, over 2/3 of the delays could be attributed to the referring facility that was unable to provide invasive treatment. The study’s authors believe that this data should provide an impetus to the American Heart Association and other players to encourage better coordination of regional systems of care for patients with STEMIs.