The End

The first post on this blog was added on November 12, 2004 – it’s hard to believe I’ve been writing online about various aspects of healthcare for almost ten years.

When I started this site, originally named MSSPNexus, (Medical Staff Service Professionals) the focus of my writing was current news and standards pertaining to hospital medical staff administration.  Later, as my career took a different path, I added risk management and over the past few years patient blood management into the mix.

In 2004 being a healthcare blogger was a heady experience; there weren’t that many of us and we formed a sort of online friendship, especially through Nick Gene’s Medical Grand Rounds.  We were sometimes interviewed, either by one another or by traditional news media.  KevinMD came along in 2005, and his blog remains one of the best and most active medical sites on the web.  Nurse Kim’s Emergiblog was always a fascinating read.  Of note, she recently posted that she is shutting down her blog.  Dr. Mike Sevilla soon found that it is difficult to remain anonymous on the web, and he continues to write under his real name.  There were a host of others, many of whom contributed to the first grand rounds hosted on this site.

sunset_valleyOver the past couple of years Supporting Safer Healthcare has been sadly neglected.  There are many concerns about protected health information and social media, some justified, and some over-the-top paranoid.   We who write weigh every word and image carefully before posting.  There are also security issues, this blog was hacked by spammers a couple of years ago and had to be rebuilt from the ground up.

My current hospital position in bloodless medicine/patient blood management is fascinating and contributes to patient safety and good quality healthcare, although from a different perspective than medical staff administration and risk management.  I have learned more about the clinical aspects of healthcare, and my interactions with patients are often the most rewarding part of the job.  The down side is that the time and focus it requires can be a bit daunting.  I’ve been left with little creative energy for writing.

If I may offer one parting word of advice to everyone, find out of you are anemic and if you are, get treatment.  It’s often as simple as building up your body’s iron stores through changes in nutrition or iron supplements.  In many cases not being anemic (in other words, having a good blood hemoglobin count) is the single biggest protection against needing a blood transfusion during a hospital stay.  Research continues to mount showing that patients who do not need transfusions recover more quickly and with fewer complications.

Progressive hospitals everywhere are developing patient blood management programs that are designed to conserve a patient’s own blood supply and avoid the need for transfusion whenever possible.  In the hospital where I work the program is growing out of the body of knowledge acquired over the past 15 years of being a center of excellence for bloodless medicine patients, i.e., those who decline blood under all circumstances. Historically, that has been primarily Jehovah’s Witnesses, but others are now requesting our services in increasing numbers. If your hospital doesn’t have such a program encourage leadership to contact one that does.  There is also a professional society devoted to PBM, the Society for the Advancement of Blood Management, which offers professional education and resources.

It’s time to close this chapter of my professional career.  For those of you who have been readers of this blog for all or part of the past ten years, thank you. The older posts will remain online for now.  It has been my pleasure to be of some small service in sharing news and insights that affect both the delivery and safety of healthcare.  Many of you are gatekeepers for patient safety – a worthwhile role to be sure.  Keep up your good work. Patients, and at some point isn’t that all of us, need you.

Rita Schwab
MSSPNexus / Supporting Safer Healthcare


 

The Patient Safety Movement

ZERO Preventable Patient Deaths by 2020

The Patient Safety Movement is connecting People, Ideas and Technology to confront the large scale problem of over 200,000 preventable patient deaths in US hospitals each year by providing actionable ideas and innovations that can transform the process of care, dramatically improve patient safety and help eliminate patient preventable deaths. We are doing this one solution, one commitment, one hospital, one act of kindness and love, and one patient at a time. The movement is breaking down silos between hospitals, medical technology companies, patient advocates, patients, the government and all the stakeholders affected in healthcare—all of us. Together we are pushing toward ZERO preventable deaths by 2020.

Find out more at http://patientsafetymovement.org/

Choosing Wisely – Critical Care Societies Collaborative

Healthcare professionals tend, like everyone else, to make some choices based on habit or training.  The web site Choosing Wisely encourages physicians and patients to question some of those routine choices.

Choosing Wisely® aims to promote conversations between physicians and patients by helping patients choose care that is:

  • Supported by evidence
  • Not duplicative of other tests or procedures already received
  • Free from harm
  • Truly necessary

One of the lists on the site is from the Critical Care Societies Collaborative; five things physicians and patients should question:

1.  Don’t order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions.

2.  Don’t transfuse red blood cells in hemodynamically stable, non-bleeding ICU patients with a hemoglobin concentration greater than 7 g/dL.

3.  Don’t use parenteral nutrition in adequately nourished critically ill patients within the first seven days of an ICU stay.

4.  Don’t deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation.

5.  Don’t continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort.

Read the explanations for these five recommendations here:

http://www.choosingwisely.org/doctor-patient-lists/critical-care-societies-collaborative-critical-care/