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We often note here that quality improvement in hospitals seems excruciatingly slow to happen, and engaged patients and families need to keep their eyes wide open, because sometimes a fix doesn’t require being a genius. We’re in our 13th year after To Err, yet this morning SPM member Paul Bearman spotted this article by Maura Lerner in the Minneapolis Star Tribune and posted a note on our member listserv.
What I love about the story is how intelligent change can be so wonderfully effective.   A small tweak reversed critical failures in discharge prescribing.
He and his colleagues decided to do a spot-check of 37 patients who were discharged from the hospital to nursing homes over three months in 2008 and 2009.
The most common problems: Hospital physicians had prescribed the wrong doses, duplicate medications or omitted medications. The project worked so well, Thompson said, that some doctors now call the pharmacist before they write the discharge orders. Share the Star Tribune article with your hospital (and nursing home’s) pharmacy staff.
I personally know of two cases in my own family, in the past year, where medications were overlooked or wrong at discharge.
Kudos to Bruce Thompson and team at Hennepin County Medical Center – and to all the people there who gladly adopted the change. The doctor’s original thought is still, in a way, being inspected by the pharmacist before the order is being written.

I hope that the pharmacists aren’t continually finding and fixing the same problems, whether before or after order writing. That pharmacist inspection step is going to be prone to failure, before or after order writing, since 100% human inspection is never 100% effective. I appreciate the efforts being made in hospitals, but what about the walking wounded in the clinics. Participatory Medicine is a model of cooperative health care that seeks to achieve active involvement by patients, professionals, caregivers, and others across the continuum of care on all issues related to an individual's health. Turning Safe Search OFF may display content intended for mature audiences.You must be at least 18 years old to continue. Please enter at least one email addressYou are trying to send out more invites than you have remaining. MASSACHUSETTS BOARD OF REGISTRATION IN NURSING A Study of Selected Complaint Cases to Identify Evidence-based Strategies to Prevent the Occurrence of Nursing.
Personal InjuryThe most common types of personal injury claims are road traffic accidents, accidents at work, tripping accidents, assault claims, accidents in the home, product defect accidents (product liability) and holiday accidents. If the negligence of another party can be proved, the injured party may be entitled to monetary compensation from that party. HCPCS Disclaimer: HCPCS codes and Home Health Consolidated Billing codes provided by Medline are intended as general guidelines only.

It’s a great example of the positive impact pharmacists can make when positioned properly in the healthcare system.
From my own experiences in a large HMO, I finding about 50% errors, and thanks to the pharmacist that caught the last one.
Participatory medicine is an ethical approach to care that also holds promise to improve outcomes, reduce medical errors, increase patient satisfaction and improve the cost of care. They include errors in diagnosis (diagnostic errors), errors in the administration of drugs and other medications (medication errors), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Having an attorney becomes essential because cases become extremely complex, such as in medical malpratice cases. You must address all coverage and reimbursement issues (including the correctness and accuracy of codes) with your individual payers. More importantly, without adequate dissemination it can be difficult for other institutions to benefit from the practices reported here and ultimately to generate improvements for patients.
It is your responsibility to ensure the accuracy and appropriateness of each claim you submit, in accordance with all applicable payer requirements.

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