Issue link: https://beckershealthcare.uberflip.com/i/790284
58 CMO / CARE DELIVERY This Physician Almost Died in Her Own Hospital: What She Learned From the Experience By Mackenzie Bean R ana Awdish, MD, a critical care physician at Henry Ford Hos- pital in Detroit, shared how her own near-death experience in- spired her — and the hospital — to provide better patient care in an article published in the New England Journal of Medicine. In 2008, Dr. Awdish almost bled to death when a tumor ruptured in her liver, sending her into multisystem organ failure at Henry Ford Hospital. She received 26 units of blood, was put on a ventilator, suffered a stroke and lost the baby she had been carrying for seven months. Dr. Awdish's recovery included five major operations and she had to relearn how to walk and speak. "[A]s a patient, I learned things about us — physicians and other med- ical professionals — that I might not have wanted to know," she writes in the article. "I learned that though we do so many difficult, technical things so perfectly right, we fail our patients in many ways." Dr. Awdish discovered numerous shortfalls in communication, un- coordinated care and an apparent lack of empathy through the ex- perience. In one instance, she was shocked to overhear a physician describe her as, "trying to die on us" — a phrase she admitted to using during her critical care fellowship. She also detailed damaging phrases colleagues used like, "Are you sure your pain is an eight? I just gave you morphine an hour ago," and de- scribed feeling helpless when trying to solve billing issues over the care of her unborn baby. e experience changed Dr. Awdish's vision of who she wanted to be as a physician and what she wanted her organization to embody. "As systems, we have to recognize and acknowledge our mistakes, our shortcomings, just as individual physicians do," she wrote. "We need to reflect on times when our care has deviated from what we intended — when we haven't been who we hoped to be. We have to be transpar- ent and allow the failure to reshape us, to help us reset our intention and mold our future selves." Henry Ford Hospital responded to Dr. Awdish's experience by revising employee "onboarding" training and creating new training programs focused on empathetic, coordinated care. n Nevada Woman Dies of Superbug Resistant to All 26 Available Antibiotics By Brian Zimmerman A woman in Reno, Nev., died of a bacterial infection resistant to all antibiotics available in the U.S. in ear- ly September 2016. The case was publicly reported for the first time on Jan. 12 in the CDC's Morbidity and Mor- tality Weekly Report. The unidentified woman was in her seventies and had pre- viously traveled to India — where multidrug-resistant bacte- ria are more common — for an extended period of time. In India, the woman was hospitalized multiple times over two years for a right femur fracture and subsequent bone infec- tion of the right femur and hip. After being admitted to an acute care hospital in Reno on Aug. 18, clinicians detected an infection with carbapenem-resistant Enterobacteriace- ae — specifically Klebsiella pneumoniae — resistant to all 26 different antibiotics available in the U.S. The patient was cared for in isolation and tests on pa- tients in the same unit did not find additional CRE, ac- cording to the CDC report. The report's authors concluded that U.S. healthcare facili- ties should obtain a patient's history regarding exposures to healthcare environments outside of the region during patient screening and consider testing for CRE when a patient reports healthcare exposure in an area with higher rates of CRE activity. "I think this is the harbinger of future badness to come," James Johnson, MD, a professor of infectious diseases medicine at the University of Minnesota in Minneapolis, told STAT when asked about the case. Dr. Johnson said it's likely others in the U.S. are harboring these bacteria in their guts and could become sick at some point in time in the future. On the dangers of the growing threat of antibiotic resis- tance, Dr. Johnson told STAT: "People have asked me many times 'How scared should we be?' ... 'How close are we to the edge of the cliff?' And I tell them: We're already falling off the cliff. It's happening. It's just happening — so far — on a relatively small scale and mostly far away from us ... so it doesn't have the same emo- tional impact." n