'patient safety' posts

When you think of emergency rooms or emergency departments, “patient satisfaction” probably isn’t the first phrase that comes to mind. As an Emergency Medicine nurse, and having travel-nursed throughout the United States for the past 20 years, I’ve come to the realization that the traditional way of doing things is broken. In fact, about eight years ago, I was so disillusioned with my career that I decided to leave nursing.

But then, an amazing new opportunity came my way.

The nurse recruiter for the local agency I had been working with knew I was planning to leave the field, but informed me of an opportunity being developed at Swedish Medical Center in Issaquah. In short, Swedish was building a new freestanding Emergency Department (ED) that would offer something to patients that — at the time — was unheard of: an experience solely dedicated to patient satisfaction and respecting the patients’ time. This new way of thinking and new opportunity with Swedish re-energized my desire to stay in the field, and I accepted the challenge this job offered.

Fast-forward eight years and we’ve succeeded in our goal to make our Emergency Department experience second to none, and one that others try to emulate.

It’s not your typical ED.

Patients in the area know that when they come to the Swedish/Issaquah Emergency Department (and other Swedish Emergency Departments like Mill Creek and Redmond), they will experience a “no-wait” philosophy. You won’t sit around in a waiting room; rather, you’ll be taken directly to an exam room with your care started immediately. And, now we’re being nationally recognized for our achievements.

The Issaquah ED was ...

During the past several weeks there has been much in the news about contaminated steroid compounds being used by pain management clinics around the country for steroid injection procedures. The result has been a significant number serious spinal meningitis cases, including some fatalities, in patients who received these injections. These tainted compounds have all been traced to a single company, the New England Compounding Center, located in Massachusetts. According to the CDC (Center for Disease Control) none of these compounds were shipped to Washington State. Nonetheless, this has raised questions of steroid injection safety among many patients who have received them as part of their pain management regime.

Steroid injections for the reduction of pain in specific areas have been used safely for decades by pain management specialists. They have been shown to be a viable and effective treatment option for a large number of patients who could not find adequate pain relief through other less invasive treatment methods. The issue surrounding the current crisis is not one of steroid injection safety or efficacy so much as it is one of ...

It happens so quickly. You’re innocently chopping up vegetables for dinner when you find yourself on the receiving end of a cut — ouch! “Cuts are very common,” says Steven Rittenberg, M.D., who specializes in Internal Medicine at the Swedish Issaquah Primary Care Clinic. “However, there are some practical ways to prevent them, and some specific steps for treating them that can save you a trip to the doctor.”

Avoiding The “Ouch!”

Preventing cuts in the home is largely common sense, but life gets busy and we get careless, so here are a few reminders:

• Keep knives sharp. Although this may sound counter-intuitive, a sharp knife slides more easily through an item avoiding a slip that may cut something you didn’t intend to cut, like your finger.
• Pay attention. Resist the temptation to become distracted while using a knife.
• Cut away from, not toward, yourself.
• Don’t hold food that you are cutting; use a cutting board.
• Don’t leave knives in dangerous places — loose in a drawer, in the sink, on the counter or facing up in the dishwasher — especially if you have children.
• When handing someone a knife or sharp scissors, hold the flat part of the knife blade or closed blades of the scissors so they can grasp the handle.
• Don’t pick up broken glass; sweep or vacuum it up thoroughly.

Treating It Right

When a cut does occur, the proper treatment will help to avoid infection or other complications:

New technologies have the potential to improve patient outcomes but need to be carefully studied so that patients will maximally benefit.  Robotic thymectomy for myasthenia gravis and thymomas was introduced at Swedish in May of 2009 after careful evaluation of our outcomes with traditional sternotomy and VATS thymectomy.

One of the more challenging aspects of being a surgeon is to understand how new technologies can benefit your patients and how those technologies might become part of your practice. If you’ve watched Grey’s Anatomy, read Time magazine or the Wall Street Journal or surfed the web recently, you’ll be aware of the da Vinci surgical robot. The robot has allowed many different surgical specialties to operate in confined areas of the body with tiny instruments placed through equally small incisions thereby avoiding a larger incision. In thoracic surgery, one of the confined spaces is an area in front of the heart where a gland called the thymus resides.

Most people don’t even realize they have a thymus nor do they know it’s responsible for the development of immunity. However, for a small number of patients the thymus can be source of disease either by generating a tumor called a thymoma or by producing antibodies that block transmission of nerve impulses making the patient fatigue or weaken very quickly which is called myasthenia gravis (MG). Removing the thymus gland (thymectomy) is an important part of the treatment in both diseases.

Traditionally, thymectomy is accomplished ...

Our medical director for quality and patient safety, Mary Gregg, MD, MHA, blogged for the Washington State Medical Association about medication safety - what we as patients can do to help keep us safe:

Medications fight illnesses, prevent disease and help improve quality of life. But it’s important to take them safely and as directed.

As a cardiac surgeon, I’ve seen the consequences of not taking medications properly. I once had a heart attack patient come to the hospital. After a successful surgery inserting a stent to prevent blockage in his artery, he was discharged with a prescription for a medication to prevent clots. For one reason or another, the patient didn’t fill his prescription as instructed for several days and he ended up in the ER for emergency heart surgery.

Some easy simple steps to prevent medication errors:

Welcome to Swedish’s new blog. Thank you for taking a moment to check it out. We’re excited to have a forum where our physicians and clinical staff can interact with the community and share their expertise and perspectives on health issues.

On this blog, you’ll get a chance to meet different members of the team at Swedish, from our health educators and nurses to our primary-care physicians and specialists. They’ll share tips on how to keep you and your family safe and healthy, and they’ll tell you about promising new breakthroughs in medicine, including innovative treatment options and diagnostic tools being used here at Swedish.

We also plan to use this blog to report on Swedish’s work in the community. As a nonprofit, we’re passionate about strengthening the health-care safety net and improving the health of our region. We’re looking forward to using this blog as a way to highlight our community health initiatives and tell you about some of the nonprofit agencies we’re partnering with to reach underserved populations.

But we don’t want this blog to be just a one way conversation. We encourage questions, comments and ideas for blog topics. The more interactive, the better. With your input, we hope to make this blog a valuable resource that will inspire and motivate people to take charge of their health and do their part to create a healthier community.

With this being the first installment of our blog, I thought it appropriate to include a few thoughts on patient safety in this initial post.