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1. Change focus of physician rounds to improve patient care 2. New Florida law cracks down on physician handwriting 3. SARS could reappear in cold and flu season

Patient Safety Monitor Alert, August 6, 2003

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1. CHANGE FOCUS OF PHYSICIAN ROUNDS TO IMPROVE PATIENT CARE

Traditional hospital rounds that call for medical students and residents to visit patients and review their cases might contribute to longer hospitalizations, according to a new study from John Hopkins Medical Institute. Instead, patients might benefit if the team of physicians work on developing goals for recovery, researchers say. The study was recently published in The Journal of Critical Care Medicine.

The study involved 112 patients from the hospital's surgical oncology intensive care unit (ICU). During daily rounds, the medical team would visit each patient for approximately 25 minutes and develop a plan of care for the day. At the end of the rounds, the patient's primary nurse and the resident on call were questioned on the daily goals and what each team member needed to do to help the patient meet the goals.

Researches evaluated the length of time patients spent in the ICU and found that creating daily goals helped reduce the average length of stay by 50 percent. Shorter hospital stays are usually tied to higher patient satisfaction and fewer medical errors, says Peter Provonost, MD, PhD, co-author and lead researcher of the study.

2. NEW FLORIDA LAW CRACKS DOWN ON PHYSICIAN HANDWRITING

Poor handwriting contributes to approximately 6 percent of medication errors, harming more than 700,000 patients each year, according to the Agency for Healthcare Research and Quality. In 1999, a Texas jury awarded $450,000 to the family of a man who died after a pharmacist misread a doctor's prescription and gave the patient the wrong medicine.

To help combat these types of errors, a new Florida law effective July 1 requires doctors to type or clearly print out all prescriptions and include complete dosing information. Although some physicians have complained about the new law, many pharmacists believe it will help eliminate confusion and will save them from calling physicians to clarify the prescriptions.

3. SARS COULD REAPPEAR IN COLD AND FLU SEASON

Health officials in Washington, D.C. are already working on ways to contain future outbreaks of severe acute respiratory syndrome (SARS), because infectious disease specialists caution it might become a more widespread problem later this year. Virginia officials reported three probable SARS infections and seven suspected cases earlier this year.

If an outbreak occurs, Maryland, Virginia, and the D.C., area could use the Department of Health and Human Services' emergency command center to communicate with other doctors and hospitals throughout the region. Officials will develop regional plans to protect medical workers and patients from unnecessary exposure to the SARS virus, while allowing hospitals to remain open and treat routine illnesses. Precautions would include not transferring patients to a new hospital and requiring medical workers to only work in one facility. Officials are also considering the possibility of setting up one large facility to treat infected patients who are not critically ill. Some infectious disease experts have concerns about people who are voluntarily quarantined in their homes and want hospitals to know how to react if a patient arrives with SARS-like symptoms.

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