Becker's Clinical Quality & Infection Control

12 PATIENT SAFETY & OUTCOMES Meritus Health CEO: Make health inequity a 'never event' By Erica Carbajal I t's time for healthcare organizations to label health inequities as "nev- er events" and abandon the idea that eliminating them is a "journey" or "marathon," Maulik Joshi, DrPH, president and CEO of Hagerstown, Md.-based Meritus Health, wrote in a March 25 opinion piece published in Medpage Today. To make real progress on health inequities, bold goals must be set, just as with other outcomes. That means going beyond marginal improvements and setting a goal of zero never events related to healthcare inequity, Dr. Joshi wrote. "Marginal improvement goals (e.g., 5 percent or 10 percent improve- ment), are designed in a way that you may think a little 'extra effort' will be all that is needed to achieve success," he said. "All or nothing goals, however, necessitate a redesign with innovative and dramatic improve- ments." In practice, this demands healthcare organizations capture disparity mea- sures in their "top quality" dashboard with a goal of zero disparity, similar to other patient safety measures. Dr. Joshi also offers the example of en- suring all employees feel equally included in employee engagement and inclusion surveys. Beyond goal-setting, making health inequities never events would likely require organizational culture and value shifts. Overall, deeming health inequity a never event requires a 100 percent reduction mindset, ac- countability at every level of the organization, tracking of inequality mea- sures, and a laser focus on prevention rather than response. n Cape Cod hospital to begin TeamBirth initiative By Ashleigh Hollowell T he birthing center at Cape Cod Hospital in Hyannis, Mass., has become one of nine hospitals in the state to participate in a new, national labor and delivery care model, capecod.com reported April 27. The model, known as "TeamBirth," prioritizes check-ins with all members of a patient's care team as well as family members to ensure seamless communication about birth preferences and patient status. It's a model that has so far rolled out at only a few other hospitals nationwide. The initiative was developed by Ariadne Labs, a joint health center at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health in Boston. Early data has suggested "a positive impact on patient safety and birth outcomes, including the reduction in Cesarean sections," capecod.com reported. n The rise of 'elective injuries' By Mackenzie Bean T he rise of platforms such as TikTok and Instagram has created a new enemy for hospital emergency departments: viral social media challenges. e challenges encourage social media users — usually children or teens — to attempt risky or dangerous behaviors that can require emergency care. One of the first internet challenges Becker's reported on was the "Hot Water Challenge," which first gained popularity on YouTube in 2017. e trend challenged people to drink boiling water through a straw or pour it on someone who was sleeping. Various challenges have gone viral in the years since, prompting warnings from clinicians, police and federal agencies. In 2021, physicians warned against the "Milk Crate Challenge," a viral phenomenon in which participants attempt to walk up a pyramid of milk crates until they reach the top or fall. Hospitals nationwide saw a range of injuries tied to the challenge, including shoulder dislocations, ACL tears, broken wrists and spinal-cord injuries, according to e Washington Post. At the time, Shawn Anthony, MD, an orthopedic surgeon at New York City-based Mount Sinai Hospital, said these "elective injuries" were consistent with those he oen sees from an accidental fall off a ladder or skiing accidents. Many physicians also expressed concern that the social media challenge was placing more stress on hospital EDs already overwhelmed with a flood of COVID-19 patients. Other viral challenges have involved the improper use of over-the- counter medicines. In 2020, clinicians warned about a viral challenge that encouraged teens to take excess doses of Benadryl to get high or hallucinate. Some hospitals, including Cook Children's Health Care System in Fort Worth, Texas, reported an uptick in patients who overdosed on the allergy medication. Another challenge, dubbed the "NyQuil Chicken Cooking Challenge," even prompted an FDA warning in 2022. Most recently, viral challenges have surrounded the ingestion of dangerous amounts of alcohol or incredibly spicy food or gum. e viral challenges outline one of the dark sides of social media and its sometimes devastating consequences. e "Hot Water Challenge" was linked to the death of an eight-year-old girl in 2018 who required a tracheotomy aer ingesting boiling water through a straw. at same year, another internet phenomenon dubbed the "Fire Challenge" le several kids in the hospital with critical burns aer pouring rubbing alcohol on themselves and lighting it on fire. n

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