US hospitals

The authors would like to acknowledge cooperation with the First Nations people of the NWT. The communities that gave us hospitality during our fieldwork, especially the people of Sambaa K e and the Sambaa K e Development Corporation. Field assistance was provided by Lawrence Cesar (Fort Good Hope) and Jessica Jumbo (Trout Lake). Invaluable moral and logistical support and knowledge was provided by Hendrik Falck, Scott Cairns, and Brendan Norman (all NTGO). 

It has repeatedly been shown that penicillin and tetracyclines retain their growth-promoting activity when used in the same agricultural surroundings for periods of 30 years or longer. Furthermore, tetracyclines continue to be effective in the treatment of both human and animal diseases. Atkinson and Lorian (19) found that coli. Staphylococcus aureus, Klebsiella pneumoniae, and Staph, epidermidis showed "virtually the same susceptibilities" to tetracycline in 242 US hospitals, 1971 to 1982. 

Shortly before nightfall we arrived at the first settlement. La Providencia ranch. The patron, Don Joaquin Garcia, the head of a large family, welcomed us hospitably and full of dignity. It was impossible to determine how many children, in addition to the grown-ups and the domestic animals, were present in the large living room, feebly illuminated by the hearth fire alone. 

Based on a review of data from 20 units, ranging from small, uncontrolled units to larger incinerators with sophisticated air pollution control systems, Rigo13 estimates an emission factor of 1.1 x 10 7g TEQ kg-1, assuming that US hospital incinerators combust approximately 3.0 x 109 kg of medical waste per year. Rigo estimates total emissions from US hospital incinerators to be 325 g TEQ yr-1. 

Warfield, C.A. Kahn, C.H. Acute pain management Programs in US. hospitals and experiences and attitudes among U.S. adults. Anesthesiology 1995, 83, 1090-1094. 

The Health Industry Business Communications Council (HIBCC) code was originally developed in the USA to establish its own codification structure for the full range of health sectors, but has come to be used mainly within the US hospital system. In the UK, HIBCC is also called the Health Industry Bar Code Convention by the Article Numbering Association (ANA), and also the Health Industry Business Code Council. In the Netherlands it is known as the Health Industry Bar Code (HIBC). The code is composed of five elements ... 

The Rocky Mount Incident, which began in July 1970, affected at least 378 patients in at least 25 US hospitals [3,4]. Forty patients died. 

However, while the objective of the report, and the thrust of its recommendations, was to stimulate a national effort to improve patient safety, what initially grabbed public attention was the declaration that between 44 000 and 98 000 people die in US hospitals annually as a result of medical errors. 

Singer, S.J., Gaba, D.M., Falwell, A. etal. (2009) Patient safety climate in 92 US hospitals differences by work area and discipline. Medical Care, 47(1), 23-31. 

The comparative database has been a tremendous lesomee for irrformation about patient safety culture in US hospitals. Hospital de-identified data from the database has been made available to researchers. In addition, hospital-identifiable data has been made available to researchers interested in linking patient safety culture to other measiues of quality and safety. Research proposals requesting identifiable data have to be approved by both AHRQ and hospitals that submit data to the database. 

Since the first annual comparative database report, published in 2007, which included data voluntarily submitted from 382 US hospitals, the number of hospitals and staff respondents included in the database report has grown each year. The Hospital SOPS 2012 Comparative Database Report displays results from 1,128 hospitals and 567,703 hospital staff respondents (Sorra et al. 2012). This large number of hospitals provides for a much more reliable and comprehensive set of benchmarks. 

Mode of survey administration When the first comparative database report was released in 2007, most hospitals administered paper surveys (56 percent), followed by web (25 percent) and mixed mode (both paper and web -19 percent). By 2012, with rapidly advancing technology, web surveys became the predominant mode (66 percent), followed by paper (21 percent) and mixed mode (13 percent). The one caveat in this trend is that paper surveys still seem to get the highest response rates in US hospitals - on average at least 10 percentage points hi er than other modes. So if response rates are a concern and a hospital has the capabihty and resources to conduct a paper survey, it is still best to administer it by paper. But if costs are an issue, it can often be very eost-effective to administer a web snrvey. User s Guides, available for eaeh of the SOPS surveys on the AHRQ web site (www.ahrq.gov), contain tips and guidance on how best to administer the survey and present results. 

Event reporting Event reporting is important for hospitals to understand patient safety risks and enable them to take steps to prevent and mitigate harm to patients. However, the status of event reporting in the US still shows considerable nnderreporting. A 2012 report from the Office of the Inspector General found that US hospital incident reporting systems captured only an estimated 14 percent of the patient harm events experienced by Medicare beneficiaries (Department of HHS 2012). 

Farley, D., Haviland, A., Champagne, S., Jain, A., Battles, J., Mimier, W. and Loeb, J. 2008. Adverse-event-reporting practices by US hospitals Results of a national survey. Quality and Safety in Health Care, 17, 416-23. doi 10.1136/ qshc.2007.024638. 

Hospital Survey on Patient Safety Culture Comparative Database Reports give benchmark data collected voluntarily from more than 1000 US hospitals. Survey results from these hospitals are averaged over the entire sample by topical composite or individual survey item. Two appendices report the average responses, which are broken down by hospital or respondent characteristics. 

Miss C eventually reeeived damages from the makers in the Far East in 2010 as eompensation for the distress and pain she had experienced as a result of a poor batch of catheters. Contrary to the findings of a previous study/ it is elear that such failures are not at all uncommon, as a review from 1993 of five failed catheters indicated. Other materials used include polyurethane and natural rubber, and these too have suffered failures, judging by the more than 18 adverse incident reports on the FDA Maude database from US hospitals, from about 2000 to the most recent report from March 2011. Several alerts have also been issued by the MHRA in the period up to 2008/9. Such problems highlight the importance of quality control of manufacture, and close eontrol of the polymers used in forming such products. 

Adler-MUstein J, Kvedar J, Bates DW (2014) Telehealth among US hospitals several factors, including state reimbursement and licensure policies, influence adoption. Health Aff (Millwood) 33 207-215... 

Klevens RM, Edwards JR, Richards CL, Horan TC, Gaynes RP, Pollock DA, et al. Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Rep2007 122 160. 

According to Elevens et al., the proportion of MRSA isolated in ICUs in US hospitals increased from 35.9% in 1992 to 64.4% in 2(X)3. However, a decrease in multidrug resistance among MRSA isolates was observed. The incidence of MRSA cenhal line-associated BSIs has decreased in recent years, presumably due to prevention efforts. ... 

Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstream infections in US hospitals analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis August 2004 39(3) 309-17. 

Klevens RM, Edwards JR, Tenover EC, et al. Changes in the epidemiology of methicilhn-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003. Clin Infect Dis February 2006 42(3) 389-91. 

Fig. 1. CTC as a compliance enhancer . Pie chart from a US hospital think tank study showing that among patients having virtual colonoscopy 60% had never had any prior colon cancer screening...

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