New restrictions on painkillers?

From the Bloomberg article:

The prescription painkillers Percocet and Vicodin should be banned and use of Tylenol, sold over the counter, should be reduced because the ingredient acetaminophen is linked to liver damage, U.S. advisers said.

Outside advisers to the Food and Drug Administration voted 20-17 today in Adelphi, Maryland, for the ban on Percocet and Vicodin, which also contain a narcotic.

Click here to access. This is going to be so interesting...the pendulum swings.

IOM Report recommends research for 100 health topics

From the National Academies news release:

A committee convened by the IOM developed the list of priority topics at the request of Congress as part of a $1.1 billion effort to improve the quality and efficiency of health care through comparative effectiveness research outlined in the American Recovery and Reinvestment Act of 2009. The committee's report provides independent guidance -- informed by extensive public input -- to Congress and the secretary of the U.S. Department of Health and Human Services on how to spend $400 million on research to compare health services and approaches to care.

Health experts and policymakers anticipate that comparative effectiveness research will yield greater value from America's health care system and better outcomes for patients. Despite spending more on care than any other industrialized nation -- $2.4 trillion in 2008 -- the United States lags behind other countries on many measures of health, such as infant mortality and chronic disease burden.

Click here to access the news release. Click here to access the IOM report (please note the executive summary can be downloaded for free).

Grassley seeks information about medical school policies

for disclosure of financial ties. Click here to access the June 24, 2009 news release.

Would Zeus approve?

From the New York Times column by Pauline Chen, MD:

In the policy journal Health Affairs, Francois de Brantes, a nationally known advocate of health care quality, and his co-authors propose a new health care reimbursement model that comes with a warranty. Developed with the support of the Commonwealth Fund and the Robert Wood Johnson Foundation, this model, called Prometheus Payment, first offers set fees to providers. The fees cover all recommended services, treatments and procedures for specific conditions but are also “risk-adjusted” for patients who may be older or frail.

Click here to access Doctor Chen's column.

NIQIE Educational Opportunity

The National Institute for Quality Improvement and Education (NIQIE) is holding its annual conference "Mastering Continuous Performance Improvement" September 9-11, 2009 in Chicago. The impressive faculty line up includes: Barbara Barnes, MD; Nancy Davis, PhD, FACME; Richard Hawkins, MD; Eric Holmboe, MD; and Don Moore, PhD. Click here to go to NIQIE's website and learn more about this important conference.

Open access KT article

Click here to access "Riding the knowledge translation roundabout: lessons learned from the Canadian Institutes of Health Research Summer Institute in knowledge translation" (just published in the online journal Implementation Science). A key lesson learned is that knowledge translation "is interdisciplinary and collaborative".

Alliance responds to CEJA Report (I-A-09)

Click here to access the response letter.

"ACCME Posts Responses to Spring 2009 Calls-for-Comment"

Click here to access.

Tobacco-control bill passed by U.S. Senate

From the USA Today article:

The legislation, approved by the House in April, is the most sweeping tobacco-control measure ever passed by Congress. It goes now to President Obama, who has said he will sign it.

Click here to access the article.

It's official -- it's a pandemic

The World Health Organization announced that H1N1 has met the scientific criteria for a flu pandemic. Click here to access the WHO announcement.

Check out Dr. Reece's blog posting

"Getting Real About Health Reform"; methinks he makes a number of spot-on points. Click here to access.

What WHO Definition?

From the Associated Press article:

The World Health Organization is gearing up to declare a swine flu pandemic, a move that could trigger both the large-scale production of vaccines and questions about why the step was delayed for weeks as the virus continued to spread.

On Wednesday, WHO chief Dr. Margaret Chan quizzed eight countries with large swine flu outbreaks to see if a pandemic, or global epidemic, should be declared. After Chan's teleconference, the agency announced that an emergency meeting with its flu experts would be held Thursday.
...
In May, several countries urged WHO not to declare a pandemic, fearing it would spark mass panic. The agency appeared to cave into the requests, saying it would rewrite its definition of a global outbreak so that it wouldn't have to declare one right away for swine flu.

But WHO officials have been concerned in recent days after seeing media reports and health experts discussing more swine flu cases than were being reported by the countries themselves.

Click here to access.

Patient-centered care

From the New York Times article:

Dr. Berwick, a Harvard pediatrician and president of the Institute for Healthcare Improvement in Cambridge, Mass., is a leading authority on health care quality. Last month in a national health policy journal, Dr. Berwick published an article titled, “What ’Patient-Centered’ Should Mean: Confessions of an Extremist.” In it, he writes that the United States will require health care systems that are radically different from most of the ones we have today if we are to deliver truly patient-centered care. These systems would transfer control from doctors to the patients themselves.

Some examples of this new model of care? Shared decision-making would be mandatory in all areas of care, with patient preference occasionally putting evidence-based care “in the back seat.” Patients and families would participate in the design of health care processes and services and would be a part of daily rounds.

Click here to access the NYT article. Click here to access the Health Affairs article (sub.req.).

Unintended consequences?

From the Boston Globe article "Doctors warn on patients' falls":

Patient falls and the injuries they cause are considered such a crisis that in October, the federal government stopped paying hospitals for extra care if a fall is deemed preventable. Now, a Boston doctor is warning the pressure to keep patients from falling may lead to greater harm through the use of restraints, reversing a trend of greater mobility among hospitalized patients.
...
Without well-established guidelines on preventing falls, Inouye said she fears restraints will be used. "We have to do something to counteract what may be people's natural tendency to think to stop falls, we've got to tie everyone up," Inouye said in an interview. "We want to open people's eyes to the fact that restraints are actually associated with lots of complications."

Click here to access the BG article.

Core measures and patient safety goals?

Check out the free full text article "Linking Joint Commission inpatient core measures and National Patient Safety Goals with evidence" published by Baylor University Medical Center. An excerpt:

Despite widespread dissemination of the core measures, safety goals, and related quality guidelines, there is significant variation in their application across hospitals (8–13). Reasons for this variance are complex and may include differences in guideline familiarity, provider training, and tools and systems to ensure that recommended care is provided and documented (8). In addition, hospital type, size, and location have been found to correlate with compliance rates (9, 12). Other hospital characteristics such as physician leadership and organizational support also appear to contribute to the consistent use of evidence-based processes of care (14–17).

Click here to access the article; it's worth a careful read by CME professionals.