Dr. Brita's Blog

Feb. 21, 2019 - Welcome to part two of a three-part blog series about the drug shortage crisis. Part one covered the rapid increase in prices and the types of drugs most commonly affected. Here in Part two we’re delving deeper into the impact on hospital systems’ ability to manage drug spending and shortages.

These posts are inspired by insights from the January 2019 report, “Recent Trends in Hospital Drug Spending and Manufacturer Shortages,” which was issued jointly with the American Hospital Association, Federation of American Hospitals and American Society of Health-System Pharmacists. 

Feb. 8, 2019 - We’re all familiar with skyrocketing prescription drug prices and the challenges posed by drug shortages. Thanks to a new report, we now have a better understanding of the extent of the problem.

The Drug Shortage Epidemic: How Bad Is It, Really?

Jan. 25, 2018 - The drug shortage crisis continues with no end in sight.  The number and duration of prescription drug shortages is growing, according to the U.S. Food and Drug Administration (FDA). The Annals of Internal Medicine also reported that prescription drug shortages cause an estimated $230 million in additional costs annually due to rising prices of drugs under shortage and the higher costs of substitutes. However, there are real consequences beyond the hard-dollar costs. 

You may be hearing the term “Clinical Process Improvement” (CPI) more frequently in conversations about controlling waste in healthcare. Across the industry, there is growing interest in the role of CPI solutions to unlock the value embedded in clinical data and improve workflows, processes and quality of care. But the definition is still evolving and what was once a ‘quiet crisis,’ is finally getting some of the attention it deserves. One catalyst for all this talk about CPI is its designation as a new category by healthcare advisory firm KLAS. In April 2018, KLAS released its report titled “Clinical Process Improvement 2018: Paving the Way for Improved Clinical Processes.”

In the battle against infection, we all need a clear line of defense. Healthcare-associated infections (HAIs), such as Clostridium difficile (C. diff) and catheter-associated urinary tract infections (CAUTI), take a heavy toll on patient outcomes, length of stay, Medicare reimbursements and more. They are formidable adversaries causing problems throughout hospitals and health systems. Thankfully, health systems have a secret weapon that can make a major dent in infection rates. Hospitals around the country are reducing infections through clinical process improvement. They accomplish this by streamlining workflows to remove unnecessary variation and ensure best practices are followed.

In my two most recent blog posts, ‘Why process improvement, technology and common sense are critical to patient safety’ and ‘Pairing process improvement and technology to increase clinician satisfaction,’ I shared several articles illustrating the essential interplay between clinical process improvement and technology. Today’s post follows the same model to examine approaches for reducing waste in healthcare.

New models of care depend on adopting strategies for transforming clinical practice to improve quality, reduce costs, and meet the needs of patients and families. With actionable insights into their processes, clinicians are empowered to suggest and help implement effective changes like standardizing clinical content to deliver highly reliable health care. Monitoring and measuring how clinical processes are adopted and their impact on outcomes are essential to high-impact care redesign.

At #HIMSS18, clinical leaders came together to discuss the strategies they've implemented, or are implementing, to drive appropriate utilization, higher levels of clinician satisfaction, and improve patient safety and quality. Click the button below to download the dialogue.

In my recent blog post, ‘Why process improvement, technology and common sense are critical to patient safety,’ I shared three articles illustrating how process, technology and critical thinking all have a role in ensuring quality of care. Today’s post follows the same model to examine how process improvement and technology work together to impact clinician satisfaction.

Patient safety is the number one concern of any healthcare provider, yet the tools put in place to help guide clinicians in providing appropriate care are often hindering it. Whether it’s out-of-date or confusing workflows documented in electronic health record (EHR) systems or difficulty in using the systems themselves, the technology does not always contribute to better patient care. Process improvement and common sense must be applied to ensure quality of care.

I’ve read several articles on this topic recently — all published in March 2018 — that I think are worth sharing. Each points to the need for process, technology and critical thinking. The first, Medical staff lacked ‘critical thinking’ in accidental overdose, coroner finds, involves a patient who was given the wrong medication and died from a drug overdose six hours after knee surgery. Hospital staff missed more than 15 opportunities to spot the problem, according to the coroner’s report, which recommended changes to the hospital’s EHR to strengthen patient verification methods and modifications to hospital procedures for administering medication.

Grappling with the evolving guidelines and regulations surrounding opioid prescribing is a significant challenge for health systems across the country. Over-prescription of opioids, such as morphine, oxycodone and hydrocodone, happens in a variety of ways, according to a report authored by a panel of clinical executives at a leading U.S. health system and described in an article in the Sept. 8, 2017 issue of Health Affairs. As the article states, overtreatment and opioid misuse has “driven an epidemic of opioid addiction and drug overdoses, now the leading cause of accidental death in the United States.”