News in brief - Oct. 27, 2003

Nev. wait-time lawsuit settled - Beleaguered Calif. hospital exec resigns - Federal government investigates medical student survey - 18 types of hospital injuries lead to almost 33,000 deaths - Minnesota surgeon, teacher elected president of otolaryngology group - Quality improvement seen as more promising than breakthroughs

Nev. wait-time lawsuit settled

A Nevada pain management specialist who was sued by a patient upset about the time he spent waiting has issued an apology and donated $500 to charity to settle the lawsuit filed in small claims court.

Ty Weller, MD, signed a written apology to Aristotelis Belavilas and donated the money to the Nevada Childhood Cancer Foundation. The settlement ends the dispute, and Dr. Weller will not appeal a judge's ruling in late July that Belavilas should be compensated for his time.

Belavilas told a judge he had waited for three hours to receive a pain injection and didn't receive any medication while waiting. Dr. Weller said he had scheduled Belavilas on a day that was already full so Belavilas could get the injection before he left for Greece. He also said his staff had updated the patient because the doctor was running behind after a morning surgery went far longer than expected.

Beleaguered Calif. hospital exec resigns

The executive director of the Ventura, Calif., hospital embroiled in a lawsuit with physicians on its medical staff resigned in October. Community Memorial Hospital Executive Director Michael Bakst announced his resignation from a position he's been in for nearly 25 years.

The resignation came after deliberation that included input from the medical staff on what would best allow the hospital to "maintain its position in the very top ranks of California community hospitals," said a press release from Community Memorial.

The medical staff sued the hospital earlier this year, saying the hospital inappropriately took away its autonomy. Physicians are concerned that the hospital won't allow physicians with a financial interest in a competing entity to hold a leadership position or to vote as a staff member, that the hospital took control of the staff dues account and that the hospital adopted a code of conduct and gave itself authority to investigate and discipline physicians who fall short of the standards. The AMA and California Medical Assn. have supported the physicians suing the hospital.

Federal government investigates medical student survey

The Office for Human Research Protections, part of the U.S. Dept. of Health and Human Services, is investigating whether an Assn. of American Medical Colleges questionnaire given to medical students by their individual schools is administered in agreement with federal law and ethical standards.

Public Citizen, a nonprofit consumer advocacy group, said the investigation was in response to a letter it sent OHRP. Public Citizen claims the questionnaire violates standards for research on human participants because it has not undergone a formal ethics review at most universities or the AAMC. Public Citizen also says some schools force students to answer the questionnaire, which covers topics such as sexual harassment and personal debt, by making it a graduation requirement.

18 types of hospital injuries lead to almost 33,000 deaths

Eighteen specific hospital injuries are estimated to cause almost 33,000 deaths, 2.4 million extra days of hospitalization and $4.6 billion in extra health care costs, said a study by researchers at the U.S. Agency for Healthcare Research and Quality and Johns Hopkins University published in the Oct. 8 issue of the Journal of the American Medical Association.

The researchers calculated the figures using year 2000 discharge data from some 994 hospitals in 28 states. They found that consequences ranged from an extra 11 days in the hospital, $57,727 in extra costs and a 21.9% increase in risk of death after surgery for postoperative bloodstream infections, to little or no extra length of stay, cost or risk of death for birth and obstetric trauma.

It was estimated that bloodstream infections led to about 3,000 deaths a year in U.S. hospitals. The next-most-serious injury was reopening of surgical wounds, which researchers estimated caused 405 deaths a year, 9.4 days of extra hospitalization and $40,323 in added costs.

The researchers, led by Chunliu Zhan, MD, PhD, at AHRQ's Center for Quality Improvement and Patient Safety, said their findings "clearly support the Institute of Medicine's contention that medical injuries are a serious epidemic confronting our health care system."

Minnesota surgeon, teacher elected president of otolaryngology group

Robert Henry Maisel, MD, chief of otolaryngology at the Hennepin County Medical Center in Minneapolis, recently was elected president of the American Academy of Otolaryngology--Head and Neck Surgery for the 2004-05 term.

Dr. Maisel, professor of otolaryngology at the University of Minnesota in St. Paul, will assume the office at the organization's annual meeting in September 2004 in New York City. He earned his medical degree in 1967 and completed the otolaryngology residency program at the Washington University School of Medicine and Barnes Hospital in St. Louis. After two years as a U.S. Navy surgeon, Dr. Maisel moved to Minnesota in 1975, joining the state university medical school and the Hennepin County Medical Center.

Dr. Maisel has held several positions in the American Academy of Otolaryngology--Head and Neck Surgery. He is active in the Minnesota and Hennepin County medical communities and is past president of the Minnesota Academy of Otolaryngology.

Quality improvement seen as more promising than breakthroughs

Seeking to get the ball rolling on starting a "coordinated, comprehensive and coherent" national health care quality management system, National Quality Forum President Kenneth Kizer, MD, kicked of his organization's annual meeting with a bold statement.

"Systematizing quality improvement has the potential to improve health and health care more than any foreseeable technological and scientific breakthrough in the next 20 years, including finding cures for diabetes, heart disease or cancer," Dr. Kizer said at the NQF annual meeting Sept. 29 in Washington, D.C.

While previous quality improvement cultures were marked by individualistic efforts, ad hoc organizations and competitiveness, Dr. Kizer said the quality culture of the future will be collaborative, coordinated and feature continuous measures and evaluations. Obstacles to improving quality included liability concerns and a lack of focus, standardized data, payment incentives and organizational support.

"Quality improvement is likely to be a unifying force for change in health care," Dr. Kizer said, adding that driving this unifying force were knowledge of deficiencies, rising costs, increased regulation and purchaser activism.

He noted that purchaser activism has manifested itself in such entities and efforts as The Leapfrog Group, the Pittsburgh Regional Healthcare Initiative and California's pay-for-performance plan.