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Parallels Between Burnout and Workplace Violence in Health Care

Posted By Administration, Tuesday, November 22, 2016

Next Professional Learning Series Webcast to address overlapping solutions to
two pervasive and growing problems.


by Patricia McTiernan

     
  Michael Privitera, MS, MD    
         

 

Burnout among health care professionals is on the rise, as is workplace violence in health care settings. Could efforts to reduce the overlapping organizational contributions to these problems be a strategy to prevention?

 

Michael Privitera, MS, MD, professor of psychiatry at University of Rochester School of Medicine and Dentistry, has long studied and written widely about this question and related issues. As medical director of the University of Rochester Medical Center Clinician Wellness Program and current chair of the Medical Society of the State of New York Task Force on Physician Stress and Burnout, he also sees the impact of burnout, bullying, and violence firsthand.

 

“Burnout affects the worker, other staff, the institution, and patients on a daily basis,” says Dr. Privitera. “We can no longer look at burnout as a problem for individual health professionals to solve on their own.”


Workplace violence, while not as common as burnout, includes not only physical harm, but also psychological and emotional harm from bullying, intimidation, or harassment.


Dr. Privitera has found that while the organizational contributors to burnoutsuch as time and production pressures, changes in technology, and regulatory requirementsare increasingly recognized, some of these same factors may also contribute to increased workplace violence in health care. Likewise, he suggests that some of the same efforts at reducing burnout may also help reduce workplace violence.


“The more we recognize and address overlapping root causes of burnout and workplace violence, the more effective and long lasting our interventions could be,” he says.

 

  Dr. Privitera will speak on this topic at the next Professional Learning Series Webcast, The Overlap between Organizational Contributions to Burnout and Workplace Violence…Is There Overlap of Solutions? Wednesday, December 7, 2:00-3:00 pm Eastern Time. Register at http://bit.ly/burnoutviolence  

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Does your organization have programs in place to address burnout and workforce violence? Comment on this post below. Note: to post a comment you must be logged in. Register or log in.


Patricia McTiernan is editor of the P.S. Blog. Contact her at pmctiernan@npsf.org.

Tags:  burnout  workplace violence 

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Two Myths About the Flu Shot That People Should Stop Spreading

Posted By Joanna Carmona, Wednesday, November 16, 2016
Updated: Wednesday, November 16, 2016

by Joanna Carmona 

 

  flu
 

 

Have you ever heard someone say “I’m not getting the flu shot because it will give me the flu” or “Flu vaccines don’t prevent the flu”? If you have, you aren’t alone. These types of myths are perpetuated every time the flu season pays us a visit, so it’s time to re-visit the facts so you can make an informed decision about the flu shot.

 

The early results thus far during the 2015-2016 flu season show that 66.7% of health care personnel have received flu vaccination coverage, according to this survey by the Centers for Disease Control and Prevention (CDC). Our hope is that this number will continue to rise during the remainder of this flu season and beyond to create healthier communities. The position of the National Patient Safety Foundation is in support of mandatory influenza vaccination for health care workers.

 

Now, if we’re seeing that health care personnel vaccination isn’t at 100% yet, it’s even more important for everyone to know the facts about vaccinations. It’s possible that we all need a quick refresher, so here it is.

 

Myth 1: “I’m not getting the flu shot because it will give me the flu.”

 

The facts

The influenza vaccine cannot give anyone the flu. Vaccines are made with inactivated (i.e., not infectious) flu vaccine viruses or with no flu vaccine viruses at all (called recombinant influenza vaccine). In randomized, blinded studies, other than increased soreness/redness at the site of the vaccine, there was no difference in outcomes among those who received a flu vaccination and those who received a saline injection.

 

Myth 2: “Flu vaccines don’t prevent the flu.”

 

The facts

Recent studies show that vaccines reduce the risk of flu illness by about 50% to 60% among the overall population, according to the CDC. While the effectiveness of the flu vaccine can vary from year to year, vaccination reduces the risk of more serious flu outcomes and may make the illness milder in those who were vaccinated but still get sick.

 

If you are not concerned about getting the flu, think of others. Being able to protect people around you, including those who are more vulnerable to the illness such as babies and older people, may give you the extra motivation to get vaccinated. The first step to healthier communities is being informed, so if you’ve made it this far, consider yourself informed. Now spread the word and share this post.

 

Want to know more about flu vaccinations? Join the conversation on social media at #UnitedAgainstFlu and visit the American Hospital Association website.

 

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Joanna Carmona is communications coordinator at the National Patient Safety Foundation. Contact her at jcarmona@npsf.org.

 

 

Tags:  flu shot  flu vaccine  NPSF 

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Member Spotlight: Elizabeth Duthie

Posted By Joanna Carmona, Wednesday, November 9, 2016
Updated: Wednesday, November 9, 2016

The American Society of Professionals in Patient Safety (ASPPS) is a membership program for professionals

and others interested in patient safety. This is part of a series of member profiles. 


by Joanna Carmona 


Elizabeth Duthie is a lifetime

member of ASPPS

 

Elizabeth Duthie, RN, PhD, director of patient safety, Montefiore Medical Center

 

What does patient safety mean to you?

“It means teamwork. Knowing that someone has your back and will help if things start to go off the rails is an incredibly powerful tool for error prevention. Another critical aspect of patient safety is taking a proactive approach. Asking Where can things go wrong and how do I prevent it? and adopting the aviation philosophy which is What’s the worst thing that could happen and how can I prevent it? is another error prevention strategy we should strive for in health care.

 

"NPSF runs the most impressive

patient safety conference in the nation."
—Elizabeth Duthie

Why did you join the ASPPS?

“NPSF provides excellent educational opportunities. There’s literature alerts, convening of expert panels, and disseminating of cutting edge information. NPSF has really excellent networking possibilities and you can meet so many people at their conferences. Speaking of conferences, I have to say that NPSF runs the most impressive patient safety conference in the nation.”

 

What are some of the biggest challenges you’ll face as you start your new position as patient safety director at Montefiore Hospital?

“The biggest challenge that I have found is leveraging learning after an adverse event occurs. I get that we need short-term fixes for problems after harm occurs, but we can’t stop there. We need to clearly identify the underlying systems if we are to achieve sustainable safety gains.”

 

What keeps you up at night?

“What gives me a worried heart is the tremendous burden of suffering that comes from medical error— the horrible physical and emotional burden for patients, families, and clinicians. In the workplace it has a ripple effect. I have watched colleagues become frightened about their own practice after witnessing the trauma high-performing clinicians experience after a serious sentinel event. They realize if it can happen to him or her, it can happen to me. It just rocks everyone’s world. The drive to stop that harm and the subsequent suffering is what fuels my passion for creating safer systems.”

 

In your opinion, what’s the future of the patient safety field?

“We need to better understand how to build partnerships between providers, clinicians, patients, and families across the continuum of care. I believe the future is when everyone works together not to just deliver excellent care within the hospital but has a commitment to see that excellent care extended into the community.”

 

What is something most people don’t know about you?

“With the help of a retired comic, I performed stand-up comedy in one of my prior jobs. I would come up with jokes about work and perform 10-minute sets at the end of meetings to provide comic relief during the work day!” 

 

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Joanna Carmona is communications coordinator at the National Patient Safety Foundation. Contact her at jcarmona@npsf.org.

 

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Tags:  ASPPS Member Spotlight 

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Five Ways to Take Action Against Antibiotic Resistance

Posted By Administration, Tuesday, November 1, 2016

November 14-20 is Get Smart About Antibiotics Week.


by Patricia McTiernan, MS

Get Smart - Test Your Knowledge About Antibiotics

Take the CDC's quiz about proper use of antitbiotics.

     
     
   

 

According to the Centers for Disease Control and Prevention (CDC), each year, more than 2 million people in the United States get infections from germs that are resistant to antibiotics, and at least 23,000 of these people die as a result. The CDC considers antibiotic resistance to be among the most pressing threats to public health today, and the drive is on to increase education and awareness about the issue.


Antibiotic resistance happens when bacteria stop responding to the drugs intended to kill them. This happens over time, as bacteria adapt and change. Inappropriate use of antibiotics contributes to the problem, because when a strain of bacteria is weakened, but not killed, it can develop ways to survive, or resist, effects of antibiotics.


The CDC leads Get Smart About Antibiotics Week, November 14-20. In advance of the week, here are five ways health care practitioners, patients, and organizations can take action.

  1. Collaborate. It is important for all members of the health care team to work together and with patients and families to reduce the inappropriate use of antibiotics. Pharmacists and infection control professionals can help advise clinicians on the best antibiotic to use in each case. Clinicians can help patients understand when antibiotics are needed and instruct in the safe use of antibiotics. Find resources for patients and for health professionals.

  2. Stop the spread of bacterial infections. Practicing good hand hygiene consistently every time, with every patient, is the easiest way to reduce the spread of bacteria that cause infections. This applies to health professionals, but also to patients and family members. If you need a refresher course in handwashing, here’s how to do it right.

  3. Prescribe correctly and adhere to prescribing instructions. Estimates suggest that more than half of the prescriptions for antibiotics written in the US each year are, in fact, not necessary. When a bacterial infection is present and antibiotics are the best choice, health care practitioners need to be careful to use an antibiotic that will be effective while causing the least risk of side effects. Clinicians can learn more about safe prescribing.

    Patients need to understand the importance of taking antibiotics exactly as prescribed. Moreover, like all medicines, antibiotics come with risks that patients and families should recognize.

  4. Practice antibiotic stewardship. By instituting an antibiotic stewardship program, health care practices and organizations can improve individual patient outcomes, reduce the burden of antibiotic resistance, and reduce health care costs. The CDC has tools to help organizations get started on antibiotic stewardship.

  5. Share what you learn. Used appropriately, antibiotics save lives and allow for advanced treatment of disease. Yet, according to materials from the CDC, if antibiotic resistance continues unabated, “we risk turning back the clock to a world where simple infections could kill people as they did a century ago.” The World Health Organization and others recognize this as a global threat. Spread the word to your professional colleagues, neighbors, friends, and in your community.

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Do What are your plans for Get Smart about Antibiotics Week? Comment on this post below and visit the CDC at https://www.cdc.gov/getsmart/week/. Note: to post a comment you must be logged in. Register or log in.

 

Sources:

Centers for Disease Control and Prevention, Fact Sheets, https://www.cdc.gov/getsmart/community/index.html
Pew Charitable Trusts. How Antibiotic Resistance Happens. http://www.pewtrusts.org/~/media/legacy/uploadedfiles/phg/content_level_pages/issue_briefs/antibioticresistancepdf.pdf


Patricia McTiernan, MS, is editor of the P.S. Blog. Contact her at pmctiernan@npsf.org.

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Tags:  antibiotic resistance  CDC  infection 

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The Patient's Voice in Action

Posted By Administration, Friday, October 28, 2016

If you are involved in patient safety, you’ve probably heard your share of bad news.
This is a good news story.


by Patricia McTiernan, MS

Marian Hoy attended the 2016 NPSF
Congress on a patient scholarship and
"the lightbulbs just went off.”

 

In January of 2014, Marian Hoy, then 66 years old, became ill with what she thought might be the flu. “I felt bad for three days,” she recalls. “There were red flags that it wasn’t just the flu, but I didn’t recognize them.”

A former Dallas police officer and police trainer, Ms. Hoy lives in a small town outside of Austin, Texas. Her illness led her to become so disoriented that she called the town’s chief of police and asked him to bring her a soft drink. “I know the police chief,” she says, “but I never would have called him for that had I not been suffering confusion.”

 

When she realized the trouble she was in, she called the EMTs and was taken in the middle of the night to the hospital that she chose, Seton Southwest, part of Ascension Healthcare. Doctors there discovered that scar tissue from a long-ago surgery had surrounded Ms. Hoy’s small intestine and stopped her system. She underwent surgery to repair the problem, and in the days afterward she experienced complications that included sepsis and pneumonia.

“Everything was going south” for a time, she recalls now. “I would say to the doctor, ‘am I in danger?’ because I couldn’t say the words, ‘am I going to die?’ And he would say, ‘No, Ms. Hoy, you are not in danger.’

 

“In other words," she says, "he thoughtfully used my own words, so as not to frighten me.”

 

If you’ve read this far you are probably thinking, “Wasn’t this supposed to be a good news story?” Indeed, Marian Hoy spent three weeks in the hospital, and she recovered very well. But that’s not the only good news. When she tells her story, it’s all about her experience of care.

“They treated me like I was the only patient they had,” she says. “They gave me very individual care. When I called for a nurse, they were there in minutes. My doctors, surgeons, internseverybody knew my labs over the 24-hour period, but they came to my bedside to talk to me to see if I could put together a declarative sentence and understand their questions, something I was unable to do when I was admitted. And they spoke to me with language I could understand.”


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Patient Experience Matters

Patient experience of care has been defined as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” A 2013 study found “patient experience is positively associated with clinical effectiveness and patient safety,” and supports the use of patient experience as a measure of quality.

Ms. Hoy’s experience puts a face to that research. Grateful for the care she had received, she wrote a letter of thanks. She was subsequently recruited to join Ascension’s system-wide Patient and Family Engagement Steering Committee. Through her work with Ascension, Ms. Hoy became aware of the NPSF Patient Safety Congress and was awarded a patient scholarship to attend the 2016 meeting.

 

“When I went to Arizona for the NPSF Congress, I had no idea what to expect,” she says now. “I was extremely naïve about safety in hospitals. I don’t know that a lot of patients understand the gravity of patient safety issues. The lightbulbs just went off.”

As a former law enforcement officer, Ms. Hoy was particularly interested in issues discussed during a breakout session on workplace violence in health care, which is on the rise. “Until we include an in-depth discussion of how today’s violence can and does impact the hospital setting, I don’t think we’ve completed the conversation on safety,” she says.

Today, Ms. Hoy serves on three patient advisory boards within the Ascension system. She is intent on sharing her experience because, “they saved my life, and there is no way one can repay that debt.”

She wants people to know about it. But she is also adamant about urging others to speak up and bring an advocate with them if they can when they visit the doctor or hospital.

“Participate in your own illness, ask questions,” she says. “If your doctor doesn’t want to answer questions, find another doctor. This a conversation about your health.”

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Do your health care practitioners make it easy for you to be engaged in your care? Comment on this post below. Note: to post a comment you must be logged in. Register or log in.


Patricia McTiernan, MS, is editor of the P.S. Blog. Contact her at pmctiernan@npsf.org.

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Tags:  2016 NPSF Congress  patient advocate  Voice of the Patient 

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