My lede:

Patient safety experts have long touted the aviation industry’s use of checklists and foolproof communication procedures as a model for how doctors and hospitals can reduce the toll of medical errors.

Now a group of prominent physicians and quality experts argues that health care should copy a voluntary public-private aviation safety partnership that has reduced fatal crashes by more than half since the mid-1990s.

The whole shebang.

My lede:

Two new reports shed harsh light on the institutional review boards that are charged with protecting human research subjects from harm.

The Assn. of American Medical Colleges in 2001 recommended that IRB members disclose any financial conflicts, yet 27.4% of review boards still do not require it, according to a survey of 107 IRB chairs reported in the April Academic Medicine.

“We’ve been talking about conflicts of interest in clinical research for almost 20 years now, and the fact that nearly 30% of IRBs in medical schools don’t have policies that require disclosure is completely astounding to me,” said Eric G. Campbell, PhD, senior author of the study and associate professor of medicine at Harvard Medical School in Boston.

The whole shebang.

My lede:

Nearly 20% of Medicare patients discharged from hospitals were readmitted within 30 days, costing taxpayers $17.4 billion, according to an April 2 study in the New England Journal of Medicine.

About 10% of rehospitalizations were planned to continue needed care, the study found. But as many as 40% of them — or about 1 million readmissions — were preventable, said Stephen F. Jencks, MD, MPH, lead author of the study (content.nejm.org/cgi/content/abstract/360/14/1418/).

The whole shebang.

My lede:

For ages, doctors have used lists and other reminders to help them give the right care to patients. Recently, the use of checklists in areas such as surgery and infection control has delivered remarkable results, greatly reducing morbidity and mortality.

Beginning in April, residents working in the intensive care unit at the Washington Hospital Center in Washington, D.C., got a different kind of reminder when caring for patients — an ethics checklist.

The whole shebang.

My lede:

The American Psychiatric Assn. in March said that to erase the risk of bias, it will phase out the $1.5 million in drugmaker money it uses to fund continuing medical education. The same month, the American College of Cardiology declined to distribute nearly half a million dollars in industry-funded, logo-branded tote bags, lanyards and badges at its annual scientific session.

The moves reflect physician organizations’ growing sensitivity about potential conflicts of interest. And if an expert panel has its way, the actions will mark the start of a shift toward reducing medical societies’ reliance on financial support from pharmaceutical companies, drugmakers and industry firms.

The whole shebang.

My lede:

About one in 50 patients leaves the hospital early, disregarding the doctor’s orders. These patients are three times more likely to be re-hospitalized within a month, according to a recent review of more than two dozen studies since 1970 that examined the phenomenon of “self-discharge.”

Patients who leave early after being admitted for a heart attack are 40% more likely to die or be readmitted with another heart attack or unstable angina in the next two years, said the study in the March Mayo Clinic Proceedings.

The whole shebang.

My lede:

Rules approved in March by the Massachusetts Public Health Council bar drug- and device-makers from providing gifts to physicians and require them to publicly disclose most payments to doctors exceeding $50.

The new regulations implement a state law enacted last year and bar industry gifts such as pens, notepads and food in physician offices. The restrictions are meant to reduce health care costs and physician conflicts of interest.

The whole shebang.

My lede:

Catheter-related bloodstream infections kill at least 30,000 patients in the intensive care unit each year, the Centers for Disease Control and Prevention estimates. About 250,000 hospital patients contract these infections annually, costing an estimated $9 billion in extra care.

Yet, within three months of implementing a simple set of interventions in 2004, more than 100 Michigan ICUs slashed their central-line associated bloodstream infection rates by 66%. The median infection rate dropped from 2.3 per 1,000 catheter days to near zero. The program, which focuses on using checklists of evidence-based interventions and changing hospital culture, was funded by the Agency for Healthcare Research and Quality.

The whole shebang.

My lede:

Scores of competing pay-for-performance programs using uncoordinated sets of quality measures have made it hard for physicians to earn health plan incentive payments and yielded little in the way of better patient care.

That is why hopes were high for the Integrated Healthcare Assn., a California quality collaborative whose P4P program drew the cooperation of the state’s seven largest HMOs and 225 medical groups representing 35,000 physicians. The health plans aggregated their data to capture physician performance more accurately, and everyone agreed on a common set of quality metrics.

From 2004 to 2007, IHA — operating the country’s biggest P4P program — paid out $203 million in bonus payments. But the quality breakthrough many expected has yet to arrive, according to a study in the March/April issue of Health Affairs, a leading policy journal (content.healthaffairs.org/cgi/content/abstract/28/2/517/).

The whole shebang.