Pain Management, Diagnostic Error, Affordable Care Act Mandate
Not rendering correctly? View this email as a web page here.
May 2016
Dear Colleagues,

We are living through the transformation of healthcare delivery. Right now, providers around the country are trying new ways to help patients feel truly a part of the care process and to make delivery of care safer and more convenient. While this transformation is not always a pretty process, it is a necessary one. This issue of The Clarity Post brings you a wide array of topics that demonstrate how the reach of healthcare is broadening and identifies some of the potential pitfalls we must stay mindful of in order to keep our patients safe.

Please take a few minutes to learn how many of your colleagues are working to keep the patient at the center of care and how vigilance can improve the lives of the patients we serve. We appreciate you taking the time to read on.

Anna Marie Hajek
President & CEO
Clarity Group, Inc.


Risk Prevention Strategies - Decreasing the Pain
Our country is in the middle of an opioid epidemic, and healthcare providers may not realize it, but they could be inadvertently contributing to the prescription drug abuse problem. Clarity recently held a webinar to raise the awareness regarding pain management risks and to discuss the importance of developing comprehensive risk management strategies that aim to prevent, recognize and treat prescription drug misuse.

Listen to the Recording.

Related Resources:

      - The opioid epidemic and CDC Guidelines at a glance
      - Guideline for prescribing opioids for chronic pain fact sheet
      - Checklist for prescribing opioids for chronic pain


Addressing Risk, Quality & Safety (RQS) in Telemedicine
Do you offer telemedicine services? Do you have a risk management plan that includes telemedicine? Telemedicine is a way of delivering healthcare, and as such, it is subject to the same RQS exposures traditionally associated with healthcare delivery. In our White Paper, How Would You Know if You Had a Problem With Your Telemedicine Services?, we discuss why it is important to create a culture of safety and implement an early warning system to track and manage risks associated with telemedicine.

Read the White Paper.
Clarity's Sample List of Risk Management Considerations for E-visits

Diagnostic Error - The Patient Perspective
Last year, the IOM made waves in healthcare with its report, Improving Diagnosis in Health Care. Since the release of the report, a number of organizations have issued recommendations to reduce diagnostic error and improve patient safety. Most of these recommendations focus on physicians and health systems, but one project uses the process, “Citizen Juries,” to offer a different perspective on the topic. This project engages patients as well as healthcare professionals in order to develop informed and practical patient-focused strategies for reducing diagnostic error. 

Learn more about the project and the recommendations.

Health IT Safety Issues & RecommendationsLocked_Computer.png
We are a tech-driven society, so it is no surprise that consumer-based technology is now infused into healthcare. Health IT has helped improve patient care, but it has also opened us up to new risks and opportunities for error. In February, NQF released a report listing the technological areas where it sees potential problems and its suggested remedies.

For an overview, read: NQF: 9 health IT safety issues and what to do about them
Full report: Identification and Prioritization of Health IT Patient Safety Measures

Reducing Medical Errors Through a Culture of Safety
You can no longer avoid the headline - medical errors officially the third leading cause of death in U.S. A study published in the BMJ confirms this statement and echoes the 2013 research findings that determined 210,000-400,000 patients die each year due to preventable adverse events. Healthcare is looking for answers to this problem and many patient safety leaders are pointing to safety cultures.

At Midland Memorial Hospital in TX, they promote a culture of safety through daily huddles. These huddles create transparent forums for staff to discuss patient safety issues and have been well received at the organization. In an H&HN Daily article, Nursing Leader Bob Dent, R.N. from Midland Memorial Hospital offers insight into how they are improving patient safety through the huddles.

Critical Access Hospitals are Safer, Less Expensive for Common Surgeries
According to a new study in JAMA, a Medicare patient is no more likely to die within 30 days of undergoing a common surgery at a rural hospital than at a larger hospital, and the risk of a patient suffering a major complication after a surgery is lower at a rural hospital. 

This study comes at a crucial time for rural hospitals because they are in the middle of a national debate over their designation policies and reimbursement payments. As the author of the study puts it, “[the findings] contrast previously published literature about nonsurgical admissions in these same settings and inform legislators about the valuable role critical access hospitals provide in the U.S. health care system.”

Read Science Daily's article for more key findings from the study.


Related Resources: Preventing Surgical Complications
Surgical errors can still happen at any organization and to anyone, so it is important that we are proactively looking for ways to improve our delivery of care. The following are resources to help you in that quest:
      - WHO Surgical Safety Checklist and the Checklist Implementation Manual
      - WHO Guidelines For Safe Surgery: Safe Surgery Saves Lives
      - The Joint Commission’s Reducing the Risk of Wrong Site Surgery
      - The Joint Commission’s Safe Surgery Solutions

Ibrahim AM, Hughes TG, Thumma JR, Dimick JB. Association of Hospital Critical Access Status With Surgical Outcomes and Expenditures Among Medicare Beneficiaries. JAMA. 2016;315(19):2095-2103. doi:10.1001/jama.2016.5618.

Social Media Risk Management
The ever-evolving social media culture is prompting healthcare providers to consider the risks and benefits of incorporating it into the workplace. Social media can be a valuable tool when used properly, and as it continues to rise in popularity, it will be hard avoid. To protect your organization and patients from experiencing any issues related to social media, it is important you have a clear set of guidelines in place.

The following resources highlight some of the risks and best practices associated with social media and can serve as guides as you develop your own policies and procedures:

      - Accenture Report - A Comprehensive Approach to Managing Social Media Risk and Compliance
      - Journal Article - Social Media and Health Care Professionals: Benefits, Risks, and Best Practices
      - National Council of State Boards of Nursing Guidelines
      - Federation of State Medical Boards Guidelines


Lessons from PSOs & the AHRQ Common Formats
Clarity PSO is honored to be a part of AHRQ’s publication, Lessons From PSOs on Applying the AHRQ Common Formats for Patient Safety Reporting. In the brief, Tom Piotrowski, RN, MSN, CSSGB, Executive Director of Clarity PSO shares our experience and approach to adopting the AHRQ Common Formats – a set of common definitions and reporting formats to help providers uniformly report patient safety events. Clarity PSO was the very first PSO to demonstrate the effectiveness of using the AHRQ Aggregate Common Formats, and we are now fortunate enough to be one of the few PSOs reaping results from this reporting. The brief lets PSOs share information with each other on how they implemented the Common Formats, and we are proud to be a leader in this area and offer our insight.

Read the brief for an in-depth look at the PSO program and the AHRQ Common Formats.

50+ Bed Hospitals & the Affordable Care ActAct_Now_Post_It.png
CMS recently finalized the patient safety requirements for hospitals with 50+ beds that want to participate in the Healthcare Insurance Marketplace. By January 1, 2017, these providers must conduct work through a patient safety evaluation system, which in most cases requires the use of a PSO. Don’t wait to take action. Clarity PSO can help you meet this requirement and provide you with many other valuable services!

For more information about the mandate, read our Press Release.

Besides the mandate, why should you join a PSO?
PSOs serve as independent, external experts who can collect, analyze, and aggregate data locally, regionally, and nationally to develop insights into the underlying causes of patient safety events. Communications with PSOs are protected, so you can dig deep into matters of patient safety and share sensitive information without the fear of liability. Ultimately, PSOs help healthcare providers learn from quality and safety events to prevent them from occurring in the future.

Learn more in AHRQ's Brochure.


A Success Story from Northwest Michigan Surgery Center
Northwest Michigan Surgery Center (NMSC) uses Clarity’s patient safety management tool, the Healthcare SafetyZone® Portal, to capture far more than traditional incident reports; NMSC customized the system to meet its needs and tracks everything from adverse events and patient complaints to HIPAA breaches and work orders.

In our Case Study, Ambulatory Surgery Center Finds Creative Uses for Electronic Reporting System, learn how the Portal helped NMSC become more efficient and how the organization has expanded its use of the system.

Clarity Group, Inc.  ♦  773-864-8280  ♦  ♦