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Hospital Combats “July Effect”

Wed, 07/28/2010 - 7:59am

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Earlier this month, new studies indicated that being admitted to the hospital in July may increase the duration of a patient's stay in the hospital and increase a patient's risk of death.

Earlier this month, new studies indicated that being admitted to the hospital in July may increase the duration of a patient's stay in the hospital and increase a patient's risk of death.

A study by researchers from the University of San Diego of 244,388 deaths caused by medication errors indicated that a patient has about the same chance of a lethal medication error throughout the year with one exception. The study found that during the month of July there is a 10 percent increase of lethal medication errors in teaching hospitals.

The study suggests that the increase at teaching hospitals is due to the new residents who begin work in July. Dr. David Orentlicher suggests that new residents might put patients at risk because of inexperience, learning the system of a new hospital and long shifts – up to 36 hours.

A study by Robert Huckman and Jason Barro suggests that the length of stays and mortality rates at teaching hospitals increased between the months of July and August, corresponding with the hiring of new residents. However, the study indicates that it might not just be due to the new hires that the length of hospital stays and mortality rates increased, but also because of the mass departure of experienced workers which also occurs in July for hospitals. The authors of the study call this "cohort turnover."

During this month, known for the “July effect,” hospitals such as Mercy Philadelphia Hospital show a greater commitment to patient safety technology. The retained surgical sponge is the most common and dangerous retained surgical instrument, resulting in non-payment for follow-up care from the Centers for Medicaid and Medicare, through its designation as a “Never Event” – i.e. one that should always be prevented. Sponges left behind in patients can result in additional surgery and infection costs, litigation, unnecessary X-rays and excessive anesthesia.  

Mercy Philadelphia Hospital is using the SmartWand-DTX, an RFID-based solution that allows hospitals a low-cost way to begin the prevention of retained sponges, on a platform that can grow with the patient safety initiative (high resolution product photo available upon request). The system allows caregivers to wand over an unopened pack of sponges to get a count, then validate their “count-out” with another wand over used sponges after surgery. If the counts don’t match, the surgeon wands over the patient to locate the missing sponge.

Some patient safety statistics to consider: 

  • Today one in every 1,000 to 1,500 intra-abdominal surgeries results in a sponge left behind in the patient (published studies).  
  • Hospital infections add an estimated $30.5 billion to the nation's hospital costs each year (Committee to Reduce Infection Deaths).
  • The Institute of Medicine reported that deaths from preventable hospitals infections each year exceed 100,000: more than those from AIDS, breast cancer and auto accidents combined.
  • A recent study by Aon / American Society of Healthcare Risk Management quantified the cost of the average settlement greater than $100k/incident plus legal fees.

 Mercy Philadelphia Hospital is the first hospital in the Philadelphia region to utilize SmartWand-DTX – a sponge detection system which prevents retention of surgical sponges. Mercy Philadelphia has implemented DTX in its operating room as an innovative approach to improving patient safety.

"This state-of-the-art technology provides an additional level of safety for our patients undergoing surgery," stated Kathryn Conallen, Chief Executive Officer, Mercy Philadelphia Hospital. "We are now able to locate sponges quickly which provides for reduced operating time, reduced exposure to anesthesia, and reduced risk of infection for our patients.”

SmartWand-DTX was developed by ClearCount Medical Solutions, an innovator of patient safety solutions for the operating room. The system features tiny RFID chips sewn into each sponge which provides them with a unique identification that is easily counted and detected by a reusable wand. SmartWand-DTX is the only sponge detection system capable of verifying sponge counts.

“The SmartWand-DTX is a great choice for hospitals not only because of its capabilities but also because it is built on a platform that can grow to include a range of other applications for improving patient safety,” said David Palmer, Chief Executive Officer of ClearCount. “Mercy Philadelphia Hospital shows great foresight and leadership in its choice and we’re excited to be working with the Mercy team.”

One in every 1,000 to 1,500 intra-abdominal surgeries results in a sponge left behind in the patient, which can lead to hospital inefficiencies, unnecessary costs, serious infections and even death. Hospital infections add an estimated $30.5 billion to the nation's hospital costs each year.

ClearCount also offers its SmartSponge System®, for count reconciliation and detection of surgical sponges, which directly accounts for sponges in and out of surgical procedures. In the case of a non-reconciliation, an integrated SmartWandTM is available to detect and locate missing sponges.

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