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Checklists more effective when physicians are prompted to use them

Checklists have been used successfully to improve surgical safety and cut infection rates in the intensive care unit, but a study suggests that checklists are even more effective when physicians are prompted by a colleague to take action on information gathered using the quality improvement tool. A study of 265 critical care patients at Northwestern Memorial Hospital in Chicago found that intensivists who relied on checklists alone did not reduce mortality rates. However, the death rate was cut in half when the checklist was accompanied by residents who asked the attending physicians how to act on information related to matters such as antibiotic prescribing, ventilator use and central-line placement. The residents were asked to nudge physicians if the checklist indicated a need for a question, and the residents were given a script of what to ask. "We always saw the checklist as sort of a data repository meant to trigger a decision," said Curtis H. Weiss, MD, lead author of th ...

GAO urges tighter antibiotic resistance checks

The federal government should step up monitoring of antibiotic use and antibiotic resistance to help stem overuse of the drugs, which is rendering them ineffective, says a report by the U.S. Government Accountability Office. The GAO is calling on the Centers for Disease Control and Prevention to better track human antibiotic use and antimicrobial-resistant infections in inpatient health care facilities. "Without more comprehensive information about the occurrence of cases of antibiotic resistant infections and the use of antibiotics, the agency's ability to understand the overall scope of the public health problem, detect emerging trends, and plan and implement prevention activities is impeded," said the June report. The Dept. of Health and Human Services responded with a letter detailing several initiatives, including a survey of acute care hospitals and enhancements to surveillance systems such as the CDC's National Antimicrobial Monitoring System. "We believe that when t ...

HHS awards $95 million to school health centers

Washington -- The Obama administration awarded $95 million to build or renovate 278 school-based health centers across the country, the Dept. of Health and Human Services announced July 14. Grants, which range from $10,000 to $500,000, were awarded to centers in 41 states and the District of Columbia. Clinics receiving the money serve communities where a large percentage of the population is eligible for assistance from Medicaid or the Children's Health Insurance Program. For example, Health Establishments at Local Schools received a $313,000 grant that will help the organization's clinics become part of a medical home project in Huntsville, Ala., said HEALS Executive Director Connie Carnes. HEALS is working to coordinate patient care with physician practices and other facilities through its electronic medical record system. "We'll be part of a model that will keep our kids healthy and keep them out of the ERs," Carnes said. HEALS operates four clinics and is planning to launc ...