Patient Safety: Costs in Healthcare

For many years my mother worked part-time in a hospital in North Carolina in quality.  In researching cost and quality issues, she found that a significant amount of money and time was spent on a problem that was preventable.  It was a problem that patients got in the hospital.  It was painful and could be life threatening.  It was bed sores also known as pressure sores.

She spent an enormous amount of time trying to educate the hospital administration, nursing staff and fellow physicians in the need to prevent and treat bedsores.  She made some inroads:  the hospital hired a skin care expert who trained the staff.  But in the end, budget cuts reduced or eliminated jobs in quality control at that hospital.

One of the saddest and most disturbing ironies of her story is that, when she was a patient, dying of metastatic breast cancer in that hospital, she got a bedsore.  Because training was discontinued, the nursing staff did not know how to prevent this, nor did they know how to treat it. My mother was able to help my sisters and I find the skin care expert that had been hired.  Through her, we got the type of dressing that mother needed to promote healing.  We took over,  turning her, giving her bed baths and doing “bedpan duty”.

There was a patient in the next room over who had no family.  He also had a bedsore and we could hear him crying, actually suffering from the treatment he received.  My mother’s bedsore healed up as we took care of her, even though she had cancer.  We showed the nurses how we were caring for her and asked if they could use the dressing on the man next door.  Sadly, if it was not ordered by his physician, there was nothing that could be done for him.

The Institute of Medicine has just put out a substantial report, 45o pages, which describes what is wrong with healthcare in America.  It is called “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America.”  Continuously learning healthcare means that just because there is improvement, efforts in quality control cannot be stopped…it means continuous training and monitoring.  According to the report, in the US 1/3 of patients are actually harmed during their stay.

There are efforts to help.  Campaign Zero is an effort to “provide safety strategies to patients and their family-member advocates to prevent medical errors.”  OccupyHealthcare supports promoting patient safety to reduce healthcare costs.  Take a look at their websites and take this survey.


Just The Fats (whoops, I mean Facts) Ma’am

“How about super-sizing that?” commercials on TV taught us. Guess what? We’re the ones who have been super-sized. Adult obesity rates are increasing across the United States. In fact 16 states increased over the past year and not one experienced a decrease.

Obesity rates have grown fastest in Oklahoma, Alabama, and Tennessee, and slowest in Washington, D.C., Colorado, and Connecticut. The South continues to experience the most increases with nine of the 10 states having the highest adult obesity rates. States in the Northeast and West tend to have lower rates. Mississippi maintained the highest adult obesity rate for the seventh year in a row, and Colorado has the lowest obesity rate and is the only state with a rate under 20 percent.

Just as adult obesity rates have grown, childhood obesity rates are lumbering ever upward. The highest rates (20 to 25%) are in eight states, Texas, Louisiana, Illinois, Georgia, Kentucky, Tennessee, Arkansas and Mississippi. Just out from the CDC is a study of 17,000 Americans conducted between 2005 and 2008. It found that half of all Americans drink a sugared beverage each day. Males are more likely to consume the sugary drinks than females, especially teenage boys. Again, lower income adults are more likely to drink sugary drinks than more affluent. Portion size seems to be a factor. For example, regular Coca-Cola’s come in a 12-once can that has 140 calories. According to CDC and others, to be healthy, people should limit their intake of sugary beverages to 64 calories per day. How many people do you know drink only half a can of Coke? No one…there’s no way to save the rest of the can…it will go flat.

A link has been found between sweetened drinks and the increasing obesity rate in the US.   With the increase in obesity rates comes an increase in diabetes rates. Only 15 years ago the highest state-wide rated was just under 20%; now 20% s is the lowest obesity rate. In that short amount of time, the number of states with over 7% diabetes rates has increased from 4 to 43. Hypertension rates have also shot up, every state reports rates above 20% and nine report rates of 30%.

The BBC reported Sept 1 that there has been a 30% increase in strokes between 1995 and 2008 in people ages 5 to 44.

The cost of obesity is hefty too. Obese individuals spend an average of $1500 more annually on health care and consume 30% more of health care costs than healthy weight individuals. That’s one beefy price tag.

So, what’s to be done? Stay tuned…same Fat time…same Fat station!

(This information is a short summary of a 2011 report by the Robert Wood Johnson Foundation (RWJF).The map by the Trust for America’s Health (TFAH) can be found on as an interactive map. Two versions are available, one for adult obesity rates and the other for childhood obesity rates by state. To see an interactive map of obesity rates by gender in see the Kaiser Family Foundation website.