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Risk Watch e-column
April 2007
An update of risk management news, issues and items of interest
Report Outlines Ways to Curb Medication Errors in California
Electronic prescribing is the best way to avoid medication errors, concluded a report released on March 6.
The report was prepared by the Medication Errors Panel, a group created by the California state legislature and comprised of healthcare, consumer advocacy and academic representatives. The report was funded by the California HealthCare Foundation and the Kaiser Family Foundation.
Among the report’s error-reducing recommendations:
- Adding the purpose of the medication to the prescription label
Labeling bottles in different languages
Creating a public education campaign
Establishing a state-funded pilot project to collect data on the prevalence of medication errors at California pharmacies.
The report reflects Gov. Arnold Schwarzenegger’s push to have all prescriptions in California transmitted electronically by 2010.
Source: California HealthCare Foundation
Analysis Concludes Planned Cesareans Are Riskier than Normal Births
According to a study released in the March issue of Obstetrics and Gynecology, pregnant women who undergo elective cesareans have a higher incidence of being readmitted to the hospital within 30 days of giving birth.
The primary reasons for the readmissions are wound complications and infections.
Researchers from the Boston University School of Public Health examined data for 470,857 births between 1998 and 2003 in order to reach their conclusion.
In a subset of 244,088 mothers who were considered low risk, the researchers identified 3,334 women who had elected to have a cesarean delivery. The outcomes of these mothers were compared to those who planned to have a vaginal birth (in the end more than 20,000 women in this group had an unplanned cesarean).
The researchers found that 19 mothers per 1,000 who had a planned cesarean were readmitted to the hospital in the month after giving birth. The rate for those who had planned vaginal births was 7.5 per 1,000. When the researchers included those women who had unplanned cesareans, the rate did not change.
The researchers recommend that when counseling women about their delivery options, physicians and staff make patients aware of the readmission risk associated with planned cesareans—even for those with few or no risk factors.
Source: Obstetrics and Gynecology
Joint Commission: National Strategies Needed to Serve Diverse Patient Population
The Joint Commission has issued a set of recommendations to help healthcare providers address language and cultural issues affecting the increasing multicultural patient base.
The recommendations, which can be found in the report “Hospitals, Language and Culture: A Snapshot of the Nation, Compiled List of Resources,” are the result of a study of how 60 hospitals across the country are providing care to their diverse populations. The study outlines how these healthcare facilities are treating patients who do not speak the same language or share the same customs.
Among the study’s recommendations:
- Quality Improvement and Data Use—Hospitals should implement a uniform framework for systematic collection of data on race, ethnicity and language, and should stratify by language, race and ethnicity, service and technical quality measures such as those reported through the Hospital Quality Alliance.
- Workforce—Hospitals should work with their staff to find ways to meet the needs of diverse populations, and should provide ongoing training to staff on how and when to access language services. Accrediting bodies should require continuing education and training that supports the provision of culturally and linguistically appropriate care.
- Patient Safety and Provision of Care—Hospitals should formalize their processes for translating patient education materials into languages other than English and should use healthcare interpreters and cultural brokers to facilitate communication and education.
- Language Services—Hospitals should establish written policies regarding language services, including a prohibition on the use of family members and children as interpreters except in the case of an emergency.
The Joint Commission says that it will now educate its surveyors to better assess compliance with accreditation standards related to linguistically and culturally appropriate care.
Source: The Joint Commission
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