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Health Updates on the Web
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The Patient Safety Group has compiled the latest in health, quality, and safety, news and reports.
AHRQ Innovations Exchange
Act Against AIDS
Apr-23-2014
The Act Against Aids Web site provides resources aimed at reducing complacency about HIV/AIDS and reducing the risk of HIV infection among at-risk populations. 
Always Events® Toolbox
Apr-23-2014
This toolbox contains tools and strategies to assist health care professionals in implementing Always Events® initiatives and meeting their patient- and family-centered care goals.
Daily Bathing With Antiseptic Agent Significantly Reduces Risk of Hospital-Acquired Infections in Intensive Care Unit Patients
Apr-23-2014
Nurses and nurse aids in intensive care units bathe patients each day using washcloths impregnated with an antiseptic agent, leading to a significant reduction in hospital-acquired infections.
Educational Resources for Clinical Trials
Apr-23-2014
This Web site offers consumers information and educational resources about participating in clinical research trials.
Emergency Department Uses Tool To Identify At-Risk Patients in Need of HIV Testing, Leading to Same Number of Newly Diagnosed Patients with Fewer Screening Tests
Apr-23-2014
An emergency department uses an eight-variable risk assessment tool to determine which patients should be tested for undiagnosed HIV, leading to the identification of the same number of HIV-positive patients as through universal screening, thus suggesting greater cost-effectiveness.
Guide to Patient and Family Engagement in Hospital Quality and Safety
Apr-23-2014
The Guide to Patient and Family Engagement in Hospital Quality and Safety is a tested, evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety.
Harnessing Disruptive Innovation in Health Care
Apr-23-2014

Hospital-Based Day Treatment Program Provides Family-Centered Services to Children With Chronic Illnesses and Emotional Issues as an Alternative to Outpatient and Inpatient Care
Apr-23-2014
The Hasbro Children’s Partial Hospital Program—a medical treatment day program for children ages 6 to 18 years old who have chronic medical illnesses and emotional issues—has demonstrated sustained positive outcomes of treatment on several measures, including quality of life, emotional symptoms, and family beliefs about illness.

AHRQ WEBMM
SPOTLIGHT CASE AND COMMENTARY: A "Reflexive" Diagnosis in Primary Care
Despite new back pain and worsening symptoms of tingling, pain, and weakness bilaterally, in both hands and feet, a man recently diagnosed with peripheral neuropathy was not sent for further testing despite repeated visits to a primary care clinic. By the time neurologists saw him, they diagnosed critical cervical cord compression, which placed the patient at risk for permanent paralysis.
CASE AND COMMENTARY: Clostridium Difficile Relapse Secondary to Medication Access Issue
Following a hospitalization for Clostridium Difficile–associated diarrhea, a woman with HIV/AIDS and B-cell lymphoma was discharged with a prescription for a 14-day course of oral vancomycin solution. At her regular retail pharmacy, she was unable to obtain the medicine, and while awaiting coverage approval, she received no treatment. Her symptoms soon returned, prompting an emergency department visit where she was diagnosed with toxic megacolon.
CASE AND COMMENTARY: CYP450 Drugs: Expect the Unexpected
Scheduled for a hip replacement, a man with AIDS presented with sciatica. The spine surgeon administered a corticosteroid injection to control his symptoms. Soon after the patient experienced sweats, abdominal pain, weight gain, elevated blood pressure, insomnia, and anxiety. He was diagnosed with Cushing syndrome due to an adverse interaction between the HIV medication and the corticosteroid.
In Conversation with...Tejal K. Gandhi, MD, MPH
Dr. Gandhi is President of the National Patient Safety Foundation and Associate Professor of Medicine at Harvard Medical School. We spoke with her about NPSF's evolving role in enhancing health care at a national level.
In Conversation with...Leah Binder, MA, MGA
Leah Binder is President and CEO of the Leapfrog Group. We spoke with her about Leapfrog's efforts to address key health policy issues and the development of the Hospital Safety Score.

BLOG
Hospitalist Potpourri
Apr-14-2014
I’m just back from the annual meeting of the Society of Hospital Medicine and, as usual, I was blown away. I’ve not seen a medical society meeting that is remotely like it. As Win Whitcomb, who co-founded SHM, wrote to me, the meeting is “a mix of love, deep sense of purpose, community, mission, changing-the […]
Patient Safety’s First Scandal: The Sad Case of Chuck Denham, CareFusion, and the NQF
Jan-30-2014
In retrospect – always in retrospect – it should have been obvious that, when it came to Dr. Charles Denham, something was not quite right. In a remarkable number of cases of medical errors, it’s clear – again, in retrospect – that there were signs that something was amiss, but they were ignored. The reasons […]
Global Health Hospitalists: Strange but Noble Bedfellows
Dec-19-2013
As my Division of Hospital Medicine has grown – now to about 60 faculty – I spend part of my time figuring out what direction we should go in. At times, the path is obvious. It didn’t take Wayne Gretsky to recognize that we needed expertise in healthcare IT a decade ago, or in cost […]
Lights, Camera, Action… In Healthcare
Oct-19-2013
About eight years ago I was desperate to improve my golf game. I just couldn’t straighten out my drives or hit my irons crisply. (Yes, I’m fully aware that this is a First World problem). I decided to try golf camp in Palm Springs for a few days. My sensei, a crusty ex-touring pro named […]



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