Hospital News Making Headlines

Most hospitalists help manage patients throughout the continuum of hospital care, often seeing patients in the ER, admitting them to inpatient wards, following them as necessary into the critical care unit, and organizing post-acute care.

If you were keeping up with the news at all this week, you know that hospitals have been under recent, intense scrutiny with regard to patient security and offsetting medical errors. Specifically, the healthcare industry's focus on medical privacy and compliance has led to a lack of awareness of the seriousness of patient identity theft, according to a new report on hospital security policies by Healthcare IT News.

The 2008 Health Information Management Systems Society's (HIMSS) Analytics Report: Security of Patient Data, which surveyed 263 health professionals in January, found that:

• Loopholes in data management standards allow data breaches to go unreported, preventing an accurate measurement of frequency;
• 56% of organizations surveyed that had data breaches notified the patients involved;
• On average, respondents ranked their familiarity with HIPAA medical privacy rules at 6.53 on a scale of one to seven;
• Security policies focus on preventing violation of privacy, rather than preventing fraud or malicious intent;
• Of the respondents who experienced a fraud-related breach, 62% described the breach as an unauthorized use of information, while 32% described it as wrongful access of paper records; and
• 18% of organizations that experienced a breach said there was a negative financial impact, although the average cost of a breach was estimated as high as $197 per lost record and $6.3 million per incident.

The report found few data breaches attributed to malicious intent.

"Until healthcare organizations expand their data security measures to address the threat of data compromise as well as privacy and compliance, patients will continue to be at risk," says Brian Lapidus, COO, Kroll Fraud Solutions.

Additionally, high-profile medical errors, like operating on the wrong body part or receiving a mistaken dose of drugs, while equally, if not, more serious than patient identity theft, have found a new competitor. For the fifth straight year, an analysis of errors in the nation’s hospitals found that the most reported patient safety risk is a little-known but always-fatal problem called “failure to rescue.” The term refers to cases where caregivers fail to notice or respond when a patient is dying of preventable complications in a hospital.

Between 2004 and 2006, failure to rescue claimed more than 188,000 lives, amounting to about 128 deaths for every 1,000 patients at risk of complications, according to the latest report from healthcare ratings organization HealthGrades. The mistakes, tracked in 16 areas, accounted for more than 238,000 preventable deaths over three years and an estimated $8.8 billion in unnecessary medical costs.

“Failure to rescue is a marker that should concern anyone who’s ever been a patient in a hospital. It predicts whether even simple procedures suddenly could go wrong, says Michael DeVita, MD, professor of critical care medicine at the University of Pittsburgh School of Medicine.

Every year, at least 61,000 people die from failure to rescue mistakes. However, the deaths have decreased by more than 11 percent since 2004. In turn, four important post-operative indicators worsened:

• Respiratory failure,
• Pulmonary embolism or deep vein thrombosis,
• Sepsis, and
• Abdominal wounds that split open after surgery.

Overall, the rate of patient safety problems has remained steady at about 3 percent of Medicare hospitalizations. The percent of patients who died after enduring one or more mistakes dropped by nearly 5 percent, to about 26 percent.

“So far, the best way to deter the problem has been through the use of rapid response medical teams,” DeVita says. “The notion is to build an intensive care unit around any patient anywhere in the hospital building in just a few minutes,” said DeVita, who has cut unexpected deaths from 6.5 per 1,000 admissions to half that number.

The concept has been so successful that the Joint Commission, the national non-profit hospital accreditation agency, now requires hospitals to have a system to detect patients in crisis and to respond immediately.

Says DeVita, "For consumers, if a hospital doesn’t have a rapid response team, I think they shouldn’t be there."