Are health workers' hands clean? Go ahead and ask
Doctors and nurses who fail to wash their hands at Beth Israel Deaconess Medical Center may hear about it from their patients. The hospital is adopting an unusual method to improve hand washing and cut down on dangerous infections among its patients. Starting today, nurses will review the importance of hand washing with all patients when they're admitted and tell them they should question their health-care workers about whether they've washed their hands before touching them. Staff will wear buttons declaring ''Go Ahead and Ask."
Beth Israel Deaconess executives said other hospitals that involve patients have increased hand washing by 35 to 60 percent. Executives at the Harvard Medical School teaching hospital will send empty soap and disinfectant containers to an outside firm that will analyze how much soap is used during specific time periods to determine if the program has increased hand washing. The hospital warns health-care workers to prepare themselves for questions. If a patient catches them with soiled hands, a hospital power-point presentation recommends a non-defensive response: ''Thank you for reminding me; I will do that now."
St. E's chairman of surgery resigns after just a year
In a mysterious departure, Dr. David Shahian, a well-respected cardiac surgeon, is resigning as chairman of the surgery department at Caritas St. Elizabeth's Medical Center just a year after taking the job.
Dr. Robert Haddad Caritas Christi Health Care system chief executive, recruited him to St. Elizabeth's from Lahey Clinic in Burlington, where he had been on the staff since 1982 and was chair of cardiovascular and thoracic surgery. Neither side will comment about the reasons for his departure, but staff members said they did not agree on various issues, including how best to improve the quality of the surgery program.
Mark Clement, the hospital's president, and Dr. Joseph McClellan, executive director of the Caritas Medical Group, sent the staff an e-mail late last month that did not shed much light on Shahian's unexpected departure. ''Over the course of the past year, Dr. Shahian, through his skills and leadership, has made numerous contributions to CSEMC and the surgical department," they wrote. ''At the same time, both CSEMC and Dr. Shahian have concluded that decisions regarding the direction of the organization can best be implemented with alternative leadership."
It's unclear where Shahian -- who recently advised state health officials on how to improve UMass Memorial Medical Center's troubled cardiac surgery program -- will land now. St. Elizabeth's will search for a new chief, but Shahian's departure is a setback for the Caritas Christi Health Care system, where Haddad is pushing for stability after a year and a half of upheaval.
Side benefit of premium care: access to bird flu protection
When concierge doctors promote their premium practices to patients, they cite the 24-hour cellphone access and same-day appointments. But for patients of at least one well-known Boston boutique practice, another benefit arrived in the mail last month: A pre-signed prescription for the antiviral drug Tamiflu. There's some evidence -- although hardly conclusive proof -- that Tamiflu could lessen the symptoms of bird flu, which some specialists fear could ignite a global flu epidemic.
Personal Physicians HealthCare, the concierge medical practice that Dr. Steven Flier and Dr. Jordan Busch began four years ago, mailed a letter and a Tamiflu prescription plus three refills to at least some of their patients on Oct. 17, telling patients they should use Tamiflu in the case of a ''pandemic strain only." They also advise patients to buy high-efficiency respirator masks like those found at
Three days later, Massachusetts public health officials issued an advisory, warning doctors and patients against stockpiling Tamiflu, fearing that hoarding will deplete supplies for people who need it most. In an e-mail, Busch said that his practice supports the health department's position and noted that his letter went out to patients beforehand. He did not say if the doctors asked patients to return the prescriptions.
Angioplasty data now online
For the first time last week, Massachusetts health officials released data about how many patients die after angioplasty to treat blocked arteries, and the mortality rates of the 18 area hospitals that perform them. Of 12,657 hospital admissions for angioplasty between April and December 2003, 216 patients died during their hospitalization -- a rate of less than 1 percent for non-emergency cases and nearly 7 percent for emergency patients.
Health officials said they did not find any significant variation among the hospitals' death rates -- which would be a possible indicator of poor quality care.
Read the hospital-by-hospital data at www.hcp.med.harvard.edu/massdac and click on reports.
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