Patient Monitoring, Patient Safety, Patient-Controlled Analgesics, PCA

Continuous Electronic Monitoring Reduces Adverse Events and Hospital Expenditures: Physician-Patient Alliance for Health & Safety Awarded Permanente Journal Service Quality Award

The Physician-Patient for Health & Safety (PPAHS) is pleased to announce that its presentation on the national survey of hospitals on patient-controlled analgesia (PCA) hospital practices was awarded the Permanente Journal Service Quality Award. The award was presented December 10, 2013 at The 25th Annual IHI National Forum on Quality Improvement in Health Care.

For a pdf of the poster presentation, please PPAHS IHI Poster.

Respondents to the survey consisted of almost 200 hospitals from 40 states and provide a benchmark for measuring what hospitals are doing and not doing to ensure patient safety practices with PCA.

The survey is the first time that hospital practices regarding PCA have been surveyed nationally. Michael Wong, JD (Executive Director at the Physician-Patient Alliance for Health & Safety) says that the survey provides a benchmark of practices.

“The survey shows what hospitals are doing and not doing when initiating and continuing patients on PCA, which likely accounts for the adverse events and deaths related to PCA use” says Mr. Wong. “The survey found that hospitals across the country are not consistently assessing patients for risk factors. For example, almost one out of five hospitals are not assessing patients for being opioid naive, and about three out of 10 hospitals do not consider obesity as a patient risk factor, despite the indications of many studies that have shown the increased risk of using anesthesia with obese patients.”

Moreover, the survey also found that hospitals have been able to reduce adverse events, costs, and expenditures through continuous electronic monitoring of their patients.

“Hospitals that have implemented continuous electronic monitoring of patients are realizing tremendous patient safety benefits as a result,” says Mr. Wong. “In fact, 65 percent of the surveyed hospitals that electronically monitor said they have not only reduced incidences of respiratory depression and other adverse events significantly, but also lowered their post-surgical costs and expenses.  The remaining 35 percent stated that it was either too early to determine or that they have not yet determined what benefits they have derived from the technology.”

“Considering this positive finding of the survey,” says Frank Federico, RPh (Executive Director at the Institute for Healthcare Improvement and a member of the Patient Safety Advisory Group at The Joint Commission), “it seems obvious that hospitals that have not yet implemented continuous electronically monitoring of their patients on PCA would be wise to do so.  That’s not to suggest that continuous monitoring is a ‘silver bullet’ solution for reducing adverse events.  Clearly, the safe use of opioids is a multi-step process, and its success requires systemic collaboration within the hospitals that implement it.  However, the opportunity to reduce adverse events and death, and to decrease costs and expenditures is not only good for patients but for our healthcare system looking to achieve cost savings.

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