Targeting birth injuries

The lede:

A group of 16 hospitals last month announced a collaboration on a 21-month patient safety initiative to eliminate preventable birth injuries in their facilities, building on the success of an effort spearheaded by the Institute for Healthcare Improvement.

Three in 1,000 deliveries involve serious perinatal injuries that can result in cerebral palsy, birth asphyxia or permanent neurological disability, said officials involved in the initiative. Many of these can be prevented if physicians follow evidence-based guidelines and do a better job recognizing when infants are in distress, initiating timely cesarean births, properly resuscitating depressed babies and appropriately using labor-inducing drugs and vacuum or forceps, they added.

The whole shebang.

Mining Medicare data for drug safety

The lede:

Under intense criticism for its slow response to drug and device safety problems, the Food and Drug Administration last month announced a new initiative to detect adverse event patterns and warn physicians earlier.

The effort, known as the Sentinel Initiative, marks a significant shift from relying on physicians and patients to report adverse events toward a program of high-tech, active postmarket surveillance.

The whole shebang.

What stops doctors from treating pain?

The lede:

Seven in 10 doctors agree that chronic noncancer pain is undertreated in the U.S.

Nearly half of 150 practicing primary care physicians surveyed said they used nonclinical considerations to determine whether to prescribe opioids to treat such pain. In a recent study by the American Pain Foundation, the doctors ranked regulatory and law enforcement scrutiny as the biggest barriers.

The whole shebang.

Rationing disaster care

The lede:

The deadly aftermath of Hurricane Katrina and concerns about a pandemic avian influenza have driven disaster preparedness and surge capacity planning, but physicians and others are starting to wrestle with perhaps an even trickier set of issues.

What if, despite efforts to ramp up capacity and provide disaster response at the local, state and federal levels, the number of seriously ill patients exceeds the supply of critical care resources needed to keep them alive? Who should get care?

The whole shebang.