CIENCIASMEDICASNEWS: AHRQ WebM&M: Morbidity & Mortality Rounds on the Web

sábado, 14 de julio de 2012

AHRQ WebM&M: Morbidity & Mortality Rounds on the Web

July Issue of AHRQ Web M&M Discusses Approaches to Improve Clinical Competence in Medical Trainees

The July issue of AHRQ Web M&M features a Spotlight Case involving a second-year resident and intern who performed a diagnostic and therapeutic fluid removal on a 67-year-old patient without supervision. The resident had performed this procedure several times in the past, and did not seek the supervision of the night hospitalist, who was available to supervise procedures overnight. Shortly after the procedure, the patient had significant internal bleeding, which was resolved by emergency surgery and a long hospital stay. A commentary on the case is provided by Jeffrey H. Barsuk, M.D., associate professor of medicine at Northwestern University Feinberg School of Medicine, Chicago. The Perspectives on Safety section features an interview with David Blumenthal, M.D., chief information officer and innovation officer at Partners HealthCare System, Boston, and the former National Coordinator for Health Information Technology. Physicians and nurses can receive free CME, CEU, or training certification by taking the Spotlight Quiz. Select to access AHRQ’s Web M&M site.

Cases & Commentaries

SPOTLIGHT CASE

Not-So-Therapeutic Tap

Following gallbladder removal, a patient presented with abdominal pain and fluid in her abdomen. The admitting team, comprised of a second-year resident and intern, decided to perform a paracentesis (fluid removal) without supervision. The patient had a complication necessitating emergency surgery and an ICU stay.
Commentary by Jeffrey H. Barsuk, MD, MS

CME/CEU credit available for this case

Misleading Complaint

A man presented to the emergency department (ED) complaining of knee problems, and the triage nurse wrote down the chief complaint as "bilateral knee pain." The ED physician diagnosed a musculoskeletal injury and prepared to discharge him, but the patient was noticeably unsteady. Further examination and imaging revealed a subdural hematoma requiring urgent neurosurgical intervention.
Commentary by Krishan Soni, MD, MBA, and Gurpreet Dhaliwal, MD

Sloppy and Paste

An elderly man presented to an emergency department (ED) with new onset chest pain. In reviewing the patient's electronic medical record (EMR), the ED physician noted a history of "PE," but the patient denied ever having a pulmonary embolus. Further investigation in the EMR revealed that, many years earlier, the abbreviation was intended to stand for "physical examination." Someone had mistakenly copied and pasted PE under past medical history, and the error was carried forward for years.
Commentary by Robert Hirschtick, MD

Perspectives on Safety

Health IT and Patient Safety

INTERVIEW

In Conversation With… David Blumenthal, MD, MPP
Dr. Blumenthal recently returned to Harvard after a 2-year stint as the National Coordinator for Health Information Technology, where he was responsible for implementing the “Meaningful Use” health care IT incentive system in American hospitals and clinics.

Listen to an audio excerpt of the interview

(.MP3 | 14.4 MB)

PERSPECTIVE

Patient Safety and Health Information Technology: Learning from Our Mistakes
by Ross Koppel, PhD

This piece examines the promised benefits of health information technology alongside the challenges of implementation and idiosyncrasies of available systems.