Saturday, August 25, 2012

HAI "Best Practices" database?


August 26, 2012   

Jorge Palacios

   California Department of Public Health (CDPH-CHCQ-HAI)

Re: Prevention of Hospital Associated Infections in our Veteran’s Hospitals

Dear Mr. Palacious,

 Once again, thank you and the staff of the California Department of Public Health (CDPH) for the work being done concerning patient safety.

 My advocacy for the prevention of Hospital Associated Infection (HAI) in our Veteran’s Hospitals and my review of the revised CDPH web site has led me to a few basic questions. Perhaps these questions should be directed to the Healthcare-Associated Infection Advisory Committee (HAI-AC), please let me know for future inquires.

1.      There is no reference to either accepted, planned or surveillance of “best practices” in the State of California concerning HAI on your website, do you agree with this statement?

2.      Is the CDPH monitoring developments concerning “best practices” concerning the prevention of HAI programs being funded by the U.S. Department of Health and Human Services in other states?

3.      Would the CDPH or the HAI-AC object to my advocacy, “hai-five”, soliciting California elected officials concerning the development of a “best practices database” for the prevention of HAI in the State of California to be followed  by the solicitation of our United State’s Federal elected officials to locate granting opportunities to establish and operate a pilot program.

4.      Could this database be offered “free of charge” combined with an initial “voluntary” participation to all California Medical Facilities, perhaps categorized System, Hospital, ACS?

 

Please understand my request does not ask for the “development” of the “best practices”, they already exist, in my opinion, some in the Government sector but most in the private sector but I would imagine the private sector HAI programs would be, if accepted, purchased at fare market value.

 Good or bad “practices” to start would not matter, your current “surveillance” system would be an excellent method to drive continuous improvements and drive the entire process to the level of “evidence based medicine” our Veteran’s deserve in my opinion!

 No response to this e-mail by September 11, 2012 would be considered a “no-comment” and would give my advocacy the direction to elevate my enquires to my State of California elected officials.  

 Do bare in mind that our  advocacy, “hai-five”, is dedicated to “supporting those who help others”, including all of the staff at the CDPH and hopefully the CDPH will consider our activities as an asset in the long term goal of “preventing” HAI in our medical facilities!

 

Sincerely,

Michael H. Slavinski 

 


 

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars”

 

Ps The attached picture is another U.S. Peace Corps project, a community incinerator. It is actually part of a “food security” project, not what you might think! It starts with a “micro bank” for the farmers, next teaching women groups how to process “shea” in the dry season to generate income to procure food in the non-productive seasons and the incinerator, if the pigs eat the plastic bags they “die”, you can understand the exemption of the “carbon footprint”, it also takes out a lot of mosquito breeding containers.

How important is “food security”, they are farmers, not enough land or anything else and the “rainy season” was three months late this year, “thank you global warming”!

 Sometimes I think my advocacy for the prevention of HAI in our Veteran’s Hospitals is just a bit too much but just watching what our kids are doing on the other side of the world makes my efforts seem quite humble!

Sunday, August 19, 2012

Preventing HAI and a quiet revolution!


Preventing HAI and a quiet revolution!



One plan to "prevent" Hospital Associated Infections(HAI) in our Veteran's Hospitals!



 The "hai-five" advocacy for the prevention of Hospital Associated Infections (HAI) in our Veteran's Hospitals is progressing well. After spending the first year attempting to understand the mechanics of the medical system and why HAI is in them, well, one of our observers used the cliché "Rome was not built in a day", in my opinion, scale wise, you would have to toss in the Mongol Hoards as well to come even close to the complexity of  the human body and our current medical system.

 How to help our Veterans, that was easy, "fix the entire system", no problem, the men and women of our armed forces never gave up on us!

 What revolution, in my opinion, it started recently at the U.S. Department of Health and Human Services:



  Re: Public comment of Phase 3 in the 5-year National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination (HAI Action Plan).



OK, cut paste, wooo, rewind! "Prevention" I have been reading the "religion" of "reducing" the occurrence of HAI for the past year, in my opinion, the term "reducing" in a long term goal is a free pass for HAI to cost our mothers, fathers, sisters, brothers and veterans their lives for a long time and cost our "medical system" a.k.a. "us" billions of dollars every year!

"Evidence based" medicine is the "answer" for most ailments, there are just too many variables to rely on the human mind, 99% correct most of the time! In the case of HAI, Ventilator Acquired Pneumonia (VAP) in particular, easily preventable, it is evidence of the fact that patient safety is still dependant upon the commitment of the health care provider and may well lead to your or a loved one's death! To prevent V.A.P., just follow the documented procedures, many facilities have not had an occurrence of V.A.P. in years and we need to start certifying these V.A.P. free facilities in my opinion and pass the success story with the Veteran's Hospitals A.S.A.P.



Where is the "revolution", here we go, August 16, 2012,  U.S.A. Today, "C.diff hits half-million Americans every year", bad story, most of the problem is the E.P.A. making some bad decisions concerning disinfectants, the real story, the press is very well educated on the issue, the origin of my advocacy:








Where is the "Beef",



Hospital Consumer Assessment of Healthcare Providers and Systems Survey

 (HCAHPS pronounced "H-caps") Scores:



A 27-item survey for measuring patient's perceptions of their hospital experience!

 My comment to this:



Will H.C.A.H.P.S. scores have a tight correlation with H.A.I. occurrences?  The question is yet unanswered but I do believe HCAHPS will be no friend of HAI!



Hospital Readmission Rates, currently hospitals will forfeit about $280 million according to Kaiser Health News, 2012, in Medicare funds over the next year as the government begins a wide-ranging push to start health care providers based on the quality of care they provide.



Through in some random score cards and it will soon be easy to distinguish a safe and efficient healthcare facility, the Patient Protection and Affordable Care Act, not great but the center of the "Revolution"!

 The focus of my advocacy is directed at the good people of the California Department of Public Health for the U.S.D.H.H.S. is waiting for "best practices" to be developed at the State level with the intent of standardizing the process of "Preventing" HAI in our medical facilities and the Veteran's Administration is watching the actions at both  levels.

 In the mean time I am going to encourage the Veteran's Administration to investigate Anthem Blue Crosses "Patient Safety First" program until the U.S.D.H.H.S. starts implementing these "best practices", this one is in plane English:



"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars”





The picture, it is not about the bike, in one of my professional communications, in error, I described the genitic link between the Irish and Tater-tots, so behind my desk I have a picture of my Irish Grandmother and my Grandfather from somewhere east of France and described my wife as Brooklyn Irish. The responce, " I think your sense of humor might be a family trait"! The family tree on that side of the family, pretty much a "woodpile" until now! This advocacy is dedicated to "supporting those who help others", it is pretty cool to see how these people work and I have a different view of the picture and my family tree, "thank you and have fun"!