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.