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Study: Many doctors say they don't feel patient safety has improved
Opinions differ on new resident work limits
JCAHO warns of surgical fire risk

Patient Safety Monitor Alert, July 1, 2003

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STUDY: MANY DOCTORS SAY THEY DON'T FEEL PATIENT SAFETY HAS IMPROVED

Has the state of patient safety improved since the landmark 1999 Institute of Medicine report, "To Err is Human" was released? Many doctors say no.

According to a new study by the Scottsdale, AZ-based The HSM Group, Ltd., only 41 percent of 400 doctors surveyed say that patients are now safer than they were in 1999. However, only three percent say that patient safety has decreased since then. In addition, less than 25 percent of the physicians say they would be "very confident" in hospital care for their own mothers if they couldn't personally oversee the care.

Go to www.hsmgroup.com to find the study, which is titled "What America's Doctors are Saying."

OPINIONS DIFFER ON NEW RESIDENT WORK LIMITS

Some staff at teaching hospitals applaud new rules limiting resident working hours took that took effect this week, but others worry about unforeseen consequences, according to the Boston Globe.

Andrew L. Warshaw, MD, chairman of surgery at Massachusetts General Hospital in Boston, told the Globe that he doubts the new rules will work. Others cited concerns that residents will not receive sufficient experience or that hospitals who rely on resident labor will not be able to meet patients' needs. However, others are enthusiastic about the change, noting that well-rested doctors are less likely to make mistakes that injure patients. For instance, Robert Barbieri, MD, chief of obstetrics and gynecology at Brigham and Women's Hospital in Boston, has already moved trainees into 12-hour-or-less night shifts and says he appreciates how well-rested they seem.

The rules, issued by the Accreditation Council for Graduate Medical Education, forbid medical residents to work more than 80 hours a week or more than 24 hours in a row caring for patients.

JCAHO WARNS OF SURGICAL FIRE RISK

Are surgical fires common? No, says the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)--but when they do happen, they're traumatic.

According to a Sentinel Event Alert issued by the JCAHO last week, about 20 serious injuries and two patient deaths result from an estimated 100 surgical fires each year. The JCAHO recommends that hospitals take measures such as

- training staff to control heat sources through a variety of methods
- developing procedures for how staff should respond to fires in the operating room
- reporting surgical fires to organizations such as the JCAHO, ECRI, and the Food and Drug Administration, and state agencies in order to raise awareness

Go to www.jcaho.org to read the alert.

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