News
November/December 2013
News
Strategic Radiology Establishes PSO to Improve Quality and Safety
Early this year Strategic Radiology Patient Safety Organization LLC was announced as a component entity of Strategic Radiology LLC, an affiliation of 16 group practices representing more than 1,200 radiologists. The new patient safety organization (PSO) was listed by the secretary of the Department of Health and Human Services on June 19, 2013, signifying that its certifications have been accepted by the Agency for Healthcare Research & Quality (AHRQ) and making it the first radiology-specific PSO in the country.
PSOs improve healthcare quality by aggregating and analyzing data about adverse events; the PSO then helps its client healthcare organizations develop systems to identify risks and prevent patient harm based on what it learns from those analyses. To encourage participation, the adverse event data and analyses reported to or conducted by a listed PSO (called patient safety work product) are deemed privileged and confidential. Creation of a safe environment for transparent sharing and learning is one of the key reasons that Strategic Radiology (SR) formed its PSO. Randal Roat, chief operating officer for SR, explains:
Strategic Radiology’s mission is to promote radiology excellence by providing quality patient care utilizing collaborative best practices. The SR Quality Committee’s work on peer review is fundamental to our mission, but we had concerns about maintaining confidentiality given that our member practices are located in many different states. By forming the PSO, we can engage in very meaningful efforts to improve quality without fear of negative consequences.
Directing operations for the PSO is nurse and quality expert Lisa Mead RN, MS, CPHQ, SR’s director of quality and patient safety. Prior to joining SR, she was the chief administrative officer for Scottsdale Medical Imaging, an affiliate of Southwest Diagnostic Imaging, one of SR’s member groups. When asked about her motivation for this project, Mead points out that quality improvement work is often a natural fit for radiologists. “Some of a radiologist’s greatest strengths—observation and pattern recognition—are crucial competencies for impacting quality,” says Mead.
She also asserts that this PSO’s activities are likely to have broad implications for other radiology providers as they seek to improve quality. “AHRQ’s common formats are meant to provide a structured means of reporting patient safety work product, but what’s currently available was not developed for use in radiology. We will collaborate with our members to determine what type of events should be reported and how to report them in way that makes sense in the radiology discipline. We are really pioneering more pertinent quality tools for use throughout the specialty.”
SR’s PSO will serve as a national model, and Mead confirms their plans to be visible and share knowledge through educational forums. When pressed on how SR will actually impact radiology quality outside its own membership, Mead stopped short of committing to contract with non-SR organizations. “We’re just getting started, developing policies and procedures and going through the process of contracting with our Strategic Radiology member practices. Future strategies might also include offering contracts to other organizations, like hospitals and radiology groups, but we haven’t made a final determination on that yet.”
Ultimately Mead believes that the organization can have a far-reaching impact on healthcare at large regardless of whether outside organizations contract with the PSO. “We are enlisting our more than 1,200 member radiologists to become evangelists for quality in their own hospitals and professional organizations. This alone will have a tremendous impact.”
Strategic Radiology’s commitment to learning and quality improvement is substantial, but it represents just one component of the organization’s larger agenda to maintain the independence of its members and safeguard the future of the independent radiology group practice model. Roat is quick to point out that successful radiology groups must focus on delivering value to their hospitals if they want to maintain their position in the marketplace, and in today’s environment that particularly means providing high quality care to patients. Mead sees SR’s quality objectives as integral to its other overall organizational initiatives. “Quality is just good business strategy. When you are focused on it, everything changes.”
Teri Yates is the founder and principal consultant for Accountable Radiology Advisors, a healthcare consulting practice that specializes in advancing the delivery of radiology services. She may be contacted at teriyates@accountableradiologyadvisors.com.
Alarm Dangers Top ECRI’s Health Technology Hazard List for 2014
Each year, ECRI Institute issues a list of the “top 10” hazards associated with the use of medical devices. The 2014 list highlights topics that warrant particular attention for the coming year. A 16-page executive briefing about the hazards is available for free download at www.ecri.org/2014hazards. It describes the following safety issues:
- Alarm Hazards
- Infusion Pump Medication Errors
- CT Radiation Exposure in Pediatric Patients
- Data Integrity Failures in EHRs and other Health IT Systems
- Occupational Radiation Hazards in Hybrid ORs
- Inadequate Reprocessing of Endoscopes and Surgical Instruments
- Neglecting Change Management for Networked Devices and Systems
- Risks to Pediatric Patients from “Adult” Technologies
- Robotic Surgery Complications due to Insufficient Training
- Retained Devices and Un-retrieved Fragments
Clinical alarm hazards remain at the top of the list due to their prevalence, their potential to result in serious patient harm, and the increased attention they will receive from the Joint Commission in the coming year. New topics this year include hazards related to radiation exposure in hybrid operating rooms and complications arising from insufficient training in the application of robotic surgery.
Innovative System Ensures Reliable Care for Patients at Risk of Pressure Ulcers
Despite known and effective methods for identifying risk and preventing hospital-acquired pressure ulcers (HAPUs), pressure ulcers remain the most prevalent preventable hospital-acquired condition. Turning patients at certain intervals is a proven approach to preventing HAPUs, but this routine task is often delayed or skipped when nurses are drawn unexpectedly into demanding or emergent situations.
Inspired by recent advances in wireless sensors, the founders of Leaf Healthcare (leafhealthcare.com) sought to create an effective application of technology to better manage patient care tasks, such as turning protocols, that are routine and important. The system by Leaf Healthcare use a patient-worn wireless sensor, a wireless mesh network, and server-based application software. A sensor-based accelerometer with a 2-week battery life is applied to the chest of patients at risk for pressure ulcers. The system monitors patient movement and position changes over time, and correlates those position changes with prescribed turn protocols necessary to prevent pressure ulcers. This solution relieves caregivers the task of turning patients who have already turned themselves, communicates turn periods in a way that can be easily understood and accomplished when time is available, and ensures patient turns are not missed.
Currently undergoing trials at El Camino Hospital, in Mountain View, CA, the system notifies caregivers when patients need to be turned via conveniently located dashboard displays. An application programming interface (API) is also under development to allow for notification via messaging middleware to mobile devices such as smartphones and wireless VoIP handsets. The dashboard provides visual feedback so that caregivers can identify those patients that need to be turned.
For more information, see an expanded version of this article on www.psqh.com under Product News.