Smart IV Pumps Don't Necissarily Improve Patient Safety

Northwestern Memorial researchers have published a study demonstrating that “smart” IV pumps do not improve patient safety on their own. You can find the actual study here.

“The objectives of the study were to determine the actual types, frequency and severity of medication errors associated with IV pumps, and also determine if errors could have been prevented with the smart pump technology alone,” says Marla Husch, RPh, lead author of the study. “We found that by itself the smart pump technology has little potential of improving care and reducing harm but by integrating the smart pump software with other information technology components, hospitals will have checks and balances in place to reduce the number of errors and further increase patient safety.”

This could be a classic case of making lemonade out of lemons: a hospital adopts new technology based on expected benefits, when the expected benefits are not realized they figure out why and publish the results. This outcome is certainly a win for the industry, if not for Northwestern Memorial.

I've posted on smart pumps before, with write ups on Alaris, Baxter, and Hospira. There was also a similar study published last month that faulted workflow surrounding the use of smart pumps as being critical to realizing real improvements in patient safety.

Ironically, Northwestern Memorial is the same hospital that did a study looking at the risk of infection from rapidly proliferating computer keyboards found in clinical areas. Infection control and risk management folks should check it out.

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New York Hospitals Face Excess Bed Capacity

The New York Times describes (registration required) the fall out of political patronage, heavy government regulation, and a late 90's building boom on New York state's hospitals. In a little more than two years, 12 New York hospitals have closed, and the state estimates there may still be as many as 20,000 excess beds. On the state level, New York has 20% more hospital beds per person than the national average. New York's hospitals were deregulated in 1997, and the resulting “constructive deconstruction” brought on by market factors has been as chaotic as expected.

In study after study, the biggest difference between New York and the rest of the country is in length of stay, widely considered a measure of the quality of both care and management. Patients spend about 37 percent longer in the hospital in New York than nationally for similar cases, Solucient found, which contributes greatly to higher costs.

UPDATE: Here's an follow up article on what's happening in Buffalo, NY.

UPDATE: Here's another follow up article from the Poughkeepsie Journal.

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