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WHAT THE VA DOES RIGHT -- Patients in VA
hospitals are more
likely to receive optimal care than patients in
other hospitals.
The VA's information technology system tracks
and measures
the care of each patient, resulting in
significantly higher
compliance with best practices.
Story here...
http://www.nysun.com/article/51962
Story below:
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What the VA Does Right
BY BETSY McCAUGHEY
The average hospital patient is given the wrong medication or the wrong
dose at least once a day, according to the Institute of Medicine, a
research organization that advises Congress.
The good news is that these mistakes are less likely to happen in a
hospital run by the Department of Veterans Affairs. Surprised?
Recent news accounts might lead you to believe that VA hospitals are a
national embarrassment. That may have been true at one time. Not any
more. VA hospitals have undergone a remarkable turnaround in the last
decade. On average, they earn higher marks for patient safety and
quality of care than most other hospitals in America.
The shameful conditions of Walter Reed, which is an Army hospital
unaffiliated with the Department of Veterans Affairs, have misled the
public. The situation has been exacerbated by attacks from politicians
in both parties who are excoriating the VA without knowing the facts.
The VA system is well ahead of most hospitals in protecting patients
from medication errors. How? By adopting bar coding. The nurse scans the
barcode printed on the patient's bracelet, indicating the name and dose
of each medication the patient should be getting. Then the nurse scans
the barcode on the pre-packaged medication to make sure it's a match.
Another new technology — computer physician order entry — is designed to
stop doctors from prescribing the wrong medication. With CPOE, the
doctor enters the prescription at a computer terminal instead of
scribbling it on a pad. The computer is programmed to identify incorrect
doses or a medication that conflicts with other meds the patient is
already taking. If the computer sounds an alarm, the physician has to
override it. In Australia, Great Britain, New Zealand, and much of
Western Europe, hospitals have already adopted CPOE, but most American
hospitals have resisted it. The exception is the VA hospital system,
which has installed CPOE nationwide.
The VA has also pushed ahead of most hospitals in America by investing
in electronic medical records, allowing a patient's medical history to
be accessed in a few seconds. The VA database is a resource for medical
researchers and the envy of the private sector.
The director of the National Center for Patient Safety at the Department
of Veterans Affairs, Dr. James Bagian, points out that the VA is ahead
on a wide range of other safety initiatives. One is preventing injuries
related to falls, by providing fragile patients with easy to wear padded
hip protectors. Mr. Bagian is zealous about patient safety. He described
the difficulties of getting older patients in and out of hip-protectors
and the importance of preventing life-altering fractures.
VA hospitals are also ahead of the industry in fighting one of the most
feared, drug-resistant hospital infections, methicillin-resistant
Staphylococcus aureus or MRSA. In 2002, the VA Pittsburgh Healthcare
System launched a pilot program that reduced MRSA infections by a
stunning 85%. How? By enforcing meticulous hand hygiene, screening to
identify patients carrying the bacteria, and taking precautions to
prevent the bacteria from spreading to other patients via gloves, wheel
chairs, stethoscopes, nurses uniforms, and doctors' lab coats. Now the
VA is instituting the same approach nationwide, including providing
rapid MRSA testing equipment.
Patients in VA hospitals are also more likely to receive optimal care
than patients in other hospitals. In the late 1990s, the VA
re-engineered its health care system using information technology to
track and measure the care each patient was given. The result is
significantly higher compliance with best practices.
According to a study in the May 2003 edition of the New England Journal
of Medicine, patients in VA hospitals, compared to Medicare-eligible
patients in nongovernment hospitals, received better care in 12 out of
13 measures. Measures included care for diabetes, depression, congestive
heart failure, and preventive cancer screenings. A RAND study of 12 VA
hospitals published in 2004 in the Annals of Internal Medicine showed
similar results, though it also found a higher mortality for coronary
bypass procedures in those hospitals.
Not all 1,400 hospitals operated by the Department of Veterans Affairs
are models of excellence. A recent internal VA report acknowledges that
some hospitals are in need of repair, with mold, leaky roofs, and
defective plumbing. Also, the department's inspector general recently
cited the James A. Haley Medical Center in Tampa, Fla., for serious
shortcomings, and another report cited substandard conditions at the
Nashville and Murfreesboro, S.C., facilities.
Physical shortcomings aside, the VA delivers better care than most
hospitals. It shouldn't be a surprise that the American Customer Service
Satisfaction Index, based at the University of Michigan, shows that
patients in VA hospitals are more satisfied with their care on average —
84% to 74% — than patients in private sector hospitals.
Ms. McCaughey, the former lieutenant governor of New York State, is the
founder and chairman of the Committee to Reduce Infection Deaths,
www.hospitalinfection.org
, a nonprofit campaign to improve hospital hygiene and procedures.
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Larry Scott --
