Current Awareness a key component in Patient Safety

Keeping abreast of the changes in evidence is crucial in delivering quality patient care. This seems like a no-brainer, but still it is a lesson that is learnt again and again. And really, as a medical information professional, a key reason why we exist.

Has anyone had a chance to look at the following article (full citation and abstract below)?

"Longer lengths of stay and higher risk of mortality among inpatients of physicians with more years in practice."

In the article, the authors examine quality of care in an urban hospital for patients, measuring patient outcome indicators such as length of stay and patient mortality rates and compared the results with the independent variable of number of years in practice. The results? As the title indicates, patients who are treated by physicians with more years in practice stay progressively longer in hospital. And there is an increased mortality rate in patients treated by those with 20+ years experience.

What does this mean? While experience is crucial, incorporating evidence into practice is essential.

How do you keep abreast of current evidence? Are you using any alert services to provide you with the information you need? And most importantly, where are you looking for Patient Safety alerts?

I've put some links to Patient Safety websites that are useful in my delicious account: http://www.delicious.com/kathryn.ranjit/patient_safety. If there are any others you are checking out, please comment below or create a post about your favourite Patient Safety awareness site.

Article citation and abstract:

Southern, W. N., Bellin, E. Y., & Arnsten, J. H. (2011). Longer lengths of stay and higher risk of mortality among inpatients of physicians with more years in practice. The American Journal of Medicine,

Abstract

BACKGROUND: More physician years in practice have been associated with less frequent guideline adherence, but it is unknown whether years in practice are associated with patient outcomes.

METHODS: We examined all inpatients on the teaching service of an urban hospital from July 1, 2002 through June 30, 2004. Admissions were assigned to attending physicians quasi-randomly. Years in practice was defined as the number of years the attending physician held a medical license. We divided physicians into 4 groups (0-5, 6-10, 11-20, and 20 years in practice), and used negative binomial and logistic regression to adjust for patient characteristics and estimate associations between years in practice and length-of-stay, readmission, and mortality.

RESULTS: Fifty-nine physicians and 6572 admissions were examined. Although the 4 inpatient groups had similar demographic and clinical characteristics, physicians with more years in practice had longer mean lengths of stay (4.77, 5.29, 5.42, and 5.31 days for physicians with 0-5, 6-10, 11-20, and 20 years in practice, respectively, P .001). After adjustment, inpatients of physicians with more than 20 years in practice had higher risk for both in-hospital mortality (odds ratio 1.71; 95% confidence interval, 1.06-2.76) and 30-day mortality (odds ratio 1.51, 95% confidence interval, 1.06-2.16) than inpatients of physicians with 0-5 years in practice.

CONCLUSION: Inpatient care by physicians with more years in practice is associated with higher risk of mortality. Quality-of-care interventions should be developed to maintain inpatient skills for physicians

This article is available through document delivery at the U of C. If you are interested in getting a full text copy, simply copy and paste the citation into an email to plcinfo@ucalgary.ca or tbccinfo@ucalgary.ca.

Delicious

Delicious is a social bookmarking web service (http://www.delicious.com/), for storing, sharing and discovering web bookmarks (websites) for our interest groups. Use it like your favourites you save on your computer. The great thing about Delicious bookmarks is they are portable, accessible anywhere with an Internet connection. Key benefits to Delicious:

• access your bookmarks anywhere
• tag your favourites to sort them
• share your favourite sites with others
• see what other people are bookmarking

All bookmarks posted to Delicious are publicly viewable by default; however, you can mark specific bookmarks as private.

I have started my collection of bookmarks on Patient Safety here:
http://www.delicious.com/kathryn.ranjit/patient_safety

and started a collection of bookmarks on social media and health care here:
http://www.delicious.com/kathryn.ranjit/social_media

Ready to build your own online bookmark collection?
1. Go to http://www.delicious.com/
2. Click on “Join Now” at the top left corner

Patient Safety Must Include Patient Education

Why does 'Patient Education' matter?
An informed patient is a patient who can contribute to the 'safety net' that we health care providers, attempt to surround them with during their visit. We have many such safety nets in place: confirming physician orders, tw0-nurse checks and proper patient lifting techniques, if only to name a few. However, patient knowledge can contribute to that safety net as well: knowing their medications, understanding treatment plans and even recognizing unsafe situations.

Good Education versus Bad Education
Patients might find that they can't get much (or any) information from their health-care provider. Pamphlets or brochures aren't always available and they're usually only written at a Grade 6 level. As a result, patients will look elsewhere...and they might wind up knee-deep in the wrong resources. I think we can all agree that we have access to a wide variety of information these days, but can come from a variety of so-called 'experts' who are really just very opinionated! Numerous 'medical websites' exist on-line, where patients can view medical information written as though it were 'fact', when it really isn't much more than rumour or hearsay.

For Example, Let's Look at Blood...
A patient might be scheduled for surgery and they might also have heard about the possibility of autologous blood donation. The patient feels that this is something they'd like to pursue so they ask their surgeon about it. Their surgeon might or might not be able to provide much detail about the subject, so the patient decides to investigate on their own.

Now, Alberta Health and Wellness has some excellent material on the site: MyHealth.Alberta.ca This site is a good resource with noted authors, dates of updates and other indicators of good medical resources. The trouble is, it's not easy for the average patient to find this site if they don't know to look for it!

If a patient were to do a simple Google search on 'autologous blood', they would most likely come across: BloodBook.com This site doesn't have all the quality markers, but certainly looks bold and flashy...and it was easy to find.

If we don't look at quality Patient Education as an integral part of Patient Safety, we'll miss that opportunity to strengthen the safety net around our patients.

What is Patient Safety?

According to AHS, Patient Safety is the "the reduction of harm associated with health care."

http://insite.albertahealthservices.ca/3383.asp

Through AHS, you are well supported to share, report and learn about what is happening in the organization in terms of patient safety.

How are you incorporating Patient Safety principles in your role in AHS? How do you seek information outside of the organization? We will explore these questions and more in the coming weeks.

Possible topics or posts for discussion:

• Defining Patient Safety - what does it mean to you?
• Key concepts in Patient Safety
• Patient Safety in "White Literature"
  -key databases, journals, point of care tools
• Patient Safety in "Grey Literature"
  -Organizations, Health Technology Assessment, Health Economics, Drug and Devices Approvals, Advisories/Warnings
• online journal club?

Writing Good Content

• Useful and unique:
  contribute to the dialogue with your own ideas, make it current, useful, unique and relevant to our group.
  
  
• Original content and be brief:
  It's about both writing your own and fair use of other people's content (always giving credit for it).
  
  
• Start with good headlines:
  Sometimes it's the only thing your audience will see before making a decision about whether to read the post.
  
  
• Make the post scannable:
  Your reader should be able to quickly glance through the post and pick up the main points without reading too deeply.
  
  
• Write in a plain, concise, common-sense style:
  The key is simplicity, even on a complex topic.

Our discussions are all around the topics that you are the content experts at, so relate to your own experience and be open to different opinions.

Basic Blogging

Basic blogging rules:

1. “Chunk” the information into brief concise sentences.
2. Keep the information within the size of a screen. Try to reduce the amount of scrolling down the page the user has to do.
3. When using images, ensure that they are an appropriate size which compliments the text (see Image Guidelines).
4. Keep the title brief.

To post to the blog:

1. Log into your account at: www.blogger.com
2. Click on create content on the left side of the page.
3. Select Blog entry from the list.
4. In the Title box, type in the title of your blog post. Keep your title brief and concise.
5. Add content by typing directly into the body area of the edit screen. If you already have a story written in a Word document you can copy and paste from the Word document.
6. Please refer to Editing the Content Area - Body Section for full details on using the body section.
7. Keep in mind the content of your post should be contained within one ‘screen’ size. This is for the convenience of the user, the less scrolling the post requires the better.
8. Leave Input format, Book outline, Revision information, XML sitemap, URL path settings, URL redirects, Authoring information and Publishing options settings as default.
9. Scroll to the bottom of the page. Click on “Save”. Your post will now appear on the home page.

What is Social Media?

Social media is the use of web-based and mobile technologies to turn communication into interactive dialogue, such as blogs, Twitter and Facebook. Distinct from industrial or traditional media, such as newspapers, television, and film, they are relatively inexpensive and accessible to enable anyone (even private individuals) to publish or access information, compared to industrial media, which generally require significant resources to publish information.

One of the foundational concepts in social media has become that you cannot completely control your message through social media but rather you can simply begin to participate in the "conversation" in the hopes that you can become part of that conversation.

The main increase in social media has been Facebook (www.facebook.com). It was ranked as the number one social networking site. The main increase in social media has been Facebook. It was ranked as the number one social networking site. Other examples of social networking websites LinkedIn (http://www.linkedin.com/), MySpace (http://www.myspace.com/), Ning (http://www.ning.com/).

Blogs are usually maintained by an individual or a group on a particular subject with regular entries of commentary, or descriptions of events. Most recent entries are commonly displayed first. Most blogs are interactive, allowing visitors to leave comments and it is this interactivity that distinguishes them from other websites. Blogger (www.blogger.com) is one of the most popular platforms for blogs. While a blogger's anonymity is often tenuous, a blogger's code of conduct is often developed to justify acceptable behavior and online security can also be enhanced by not making the Blog publicly available.

Some of the social media tools that can help with collaboration or/and authority building are Wikis such as Wikipedia (www.wikipedia.org/) and Wetpaint (www.wetpaint.com/), social bookmarking sites including Delicious (www.delicious.com) and Google Reader (www.google.com/reader). In addition, Content Management Systems (i.e. Drupal at drupal.org) and Document Managing and Editing Tools (i.e. (Google Docs) are very widely used.

Social media also plays an important part in multimedia and entertainment. People use Youtube (www.youtube.com) for video sharing, Skype (www.skype.com) for livecasting, Flickr (www.flickr.com/) for photography and art sharing, and SecondLife (secondlife.com) to create virtual worlds.

References:

Social Media. Available from Wikipedia at http://en.wikipedia.org/wiki/Social_media. Retrieved July 4, 2011.

Rutledge, P. (2010). Research Survey Launched: Social Media and Influence of Photos on Body Image. Retrieved July 4, 2011 from: http://mprcenter.org/blog/2010/08/04/research-survey-launched-social-media-and-influence-of-photos-on-body-image/

"Statistics". Facebook. http://www.facebook.com/press/info.php?statistics. Retrieved July 4, 2011.