Tuesday, September 13, 2011

Doctors Improving Quality

I spent the day today with 60 physicians and nurses at a symposium focused on quality improvement and reducing mortality from sepsis.  Sepsis (overwhelming infection) is the number 1 cause of hospital deaths and the mortality rate can be as high as 60% if the patient goes into shock from infection.  Survival depends upon thousands of independent pieces coming together in an organized way.  A patient doesn't come to the emergency department and say "I have sepsis".  He may arrive by ambulance or be brought in by a relative and simply feel weak, or confused or have a fever.

To make the diagnosis, the doctor or nurse has to be thinking sepsis is a possibility and it is critical to get the right tests and treatments within a very short time frame.  There are complicated steps that must be taken quickly and the entire hospital team (lab, pharmacy, transport, doctors and nurses)  must act in a coordinated way to treat the patient with the right tests, antibiotics, and massive fluids.  None of this happens without processes being put into place and that is where quality improvement teams come in.

It is so gratifying to see my clinical colleagues spending their precious time learning ways to improve the quality of care of our patients.  No-one gets paid to go to these conferences and quality improvement takes a lot of time and effort.  I believe our patients would be surprised to know how dedicated we are to improving hospital care and when a patient with sepsis is discharged to resume their normal life, how much teamwork went into that successful outcome.

 Addendum:  Although I like to refrain from politics on this blog, I couldn't help but contrast the selflessness of my colleagues today, focusing their precious time (for no pay) on improving patient care, with the shocking Tea Party GOP debate where Texan Ron Paul and his audience supporters believe a 30 year old should die in a hospital rather than have any government funded health care.  It's every man for himself.


Liz said...

i know what you mean about trying to refrain from talking politics and your blog but THANK YOU for posting the clip of this shocking, horrifying and frightening streak in the current climate.
liz at http://pockshrink.blogspot.com

Nikko Marasigan said...

Kudos for the time and effort and for every doctors ensuring quality health to their patients.

Michael Kirsch, M.D. said...

Toni, not sure that Ron Paul, a physician, actually advocated the point in your addendum, but clearly the audience was shameless. While I offer no defense, elections and hyperpartisanship can spawn vitriol and meanness. Great points about medical quality. In the contest of Germs vs Man, I fear that the former often have the upper hand. We help the adversary by overprescribing antibiotics.

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