Becker's Clinical Quality & Infection Control

29 QUALITY IMPROVEMENT & MEASUREMENT Harmful medical errors fall 38% with improved provider-family communication, study finds By Mackenzie Bean A n intervention designed to stan- dardize communication between clinicians and families during pa- tient rounds led to a 38 percent reduction in harmful medical errors, according to a study published in the BMJ. Staff members at Boston Children's Hospi- tal created the intervention, called I-PASS, which dozens of hospitals have adopted nationwide, according to STAT. e intervention outlines a standardized approach to conducting patient rounds that entails standing by a patient's bedside and asking the patient and family if they have any questions or concerns. Clinicians then share any medical updates and outline the patient's treatment plan using plain language. At the end of the interaction, families are asked to repeat the care plan to clinicians. "We oen assume understanding without confirming it," lead study author Alisa Khan, MD, a Boston Children's pediatrician and professor at Boston-based Harvard Medical School, told STAT. Under the guidance of Dr. Khan and her team, seven hospitals in North America implemented the I-PASS intervention in pe- diatric inpatient units between Dec. 17, 2014, and Jan. 3, 2017. e overall rate of medical errors did not change aer implementing the intervention. However, preventable adverse events fell 37.9 percent three months post-intervention. "Although overall errors were unchanged, harmful medical errors decreased and family experience and communication processes improved aer implementation of a structured communication intervention for family-centered rounds coproduced by families, nurses, and physicians," the researchers concluded. "Family-centered care processes may improve safety and quality of care without negatively impacting teaching or duration of rounds." n Study: Adverse events declining in VA hospitals By Megan Knowles V eterans Health Administration medical cen- ters saw a drop in reported adverse events in the operating room that were linked to patient harm, according to a study published in JAMA Network Open. The study looked at patient safety adverse events and close calls for adverse events reported from 86 VHA medical centers. Researchers analyzed surgical procedures that took place between Jan. 1, 2010, and Dec. 31, 2017. Categories of incorrect procedure types analyzed in the study were wrong patient, wrong side, wrong site, wrong procedure or wrong implant. Events in- cluded those in or outside the OR, adverse events or close calls, surgical specialty and harm. The research- ers compared these results with previous studies of VHA-reported wrong-site surgery. The review produced 483 reports (277 adverse events and 206 close calls). The rate of in-OR re- ported adverse events with harm has continued to drop, the researchers found. "[VHA] organizational efforts continue to … en- hance policy to promote a culture and behavior that minimizes events and is transparent in reporting occurrences," the researchers concluded. n Tablets, inpatient portals linked to lower readmission rates By Julie Spitzer O ffering patients access to an inpatient portal is correlat- ed with lower 30-day readmission rates, according to a study published in the Journal of the American Medical Informatics Association. A team of researchers enrolled 426 English- or Spanish-speak- ing patients from two cardiac medical-surgical units at an urban academic medical center for the study and divided the partic- ipants into three groups: tablet with an inpatient portal, tablet with general internet access and no intervention. The inpatient portals offered patients access to their EHR data, along with general internet access. Patients that were offered a tablet with an inpatient portal expe- rienced lower 30-day hospital readmission rates at 5.5 percent, compared to 12.9 percent for the tablet-only group and 13.5 percent for the usual care group. Patients in the inpatient portal group were more likely to use the tablet to look up health information online (89.6 percent) compared to the tablet-only group (51.8 percent). "Healthcare providers reported that patients found the portal useful and that the portal did not negatively impact healthcare delivery," the researchers said. "These results illustrate [the] benefit of providing hospitalized patients with real-time access to their electronic health record data while in the hospital." n

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