Archive for April, 2017

Healthcare is the Third Leading Cause of DEATH in the United States

April 24th, 2017

That was a headline in an E-mail that I received today from Michelle, and the premise of the content of that E-mail was that one cause of the medical errors which contribute to a significant number of deaths in America’s hospital is the continuous use or overuse of safety alerts in Information Technology programs.  Their hypothesis was that these alert are programmed to happen so often that the healthcare professionals begin to ignore them altogether and thus miss the significant ones. They referred to this as ALERT FATIGUE.  Interesting premise and there most probably is some truth to this.

Michelle’s E-mail was promoting Wolters Kluwer Clinical Drug Information’s (CDI) Technology, and they wanted me to call them to write a blog about their technology.  Obviously, I didn’t, but they did get a free plug here so that I’d have some reason to start this entry with that attention-getting headline.  I’m sure alert fatigue plays some part in some medical errors.

But the number one cause of medical errors that can lead to death is humanness. One of my scientists would become infuriated if someone compared going to the moon to curing cancer because, according to him, the moon shot was primarily controlled through engineering and cancer cures require deep science.  Of course, he was referring only to those portions of the trip that were not science related which were, hmmm? None?  It was the combination of science and engineering that made it work, but the humans sure as heck played a major part in its success. Just like in healthcare, the medical errors can come from science and engineering, but most of all, those errors come from humans.

In my book, “Taking the Hell Out of Healthcare,”I stressed patient advocacy. At the tender age of 13, I observed my grandfather die needlessly because there was construction dust in an operating room that kept him unnecessarily bedridden for a week.   The inactivity resulted in a DVT (deep vein thrombosis) that killed him.  From that day forward, it was clear to me that the patient better have an advocate for as many hours a day as possible because it could save their life.  More importantly, it had better be someone who knows a little something about healthcare because it only takes one mistake to begin a cascade of unhappiness.

I’ve always believed there is a potential profession in patient advocacy. Physician Assistants or Nurse Practitioners could work to ensure the patient is treated, medicated, and nurtured appropriately, and they would make a small fortune from those who could afford them.

What about the rest of us? Just having someone who cares a little bit about your well-being standing nearby to ask prudent person questions when you’re sleeping, confused, or befuddled by the medical speak that’s going on around you could save your life.

I’m not a doctor, not a scientist, and surely not a genius, but I do know that humanness is what leads to errors which lead to death. Those errors are human errors. They may be because someone didn’t learn about something in school or because they forgot, or they were tired, or sleepy, or angry, or fearful, but they do happen, and if someone simply says, “What’s that pill for, and why does my friend need that pill?” It could lead to appropriate answers.

I’ve seen hundreds, no thousands of documents detailing medical errors that could have resulted in liabilities for the hospitals where I worked, and those documents always told the story of how one professional forgot to communicate something to the next professional or how someone misunderstood a written order or they didn’t check a wristband, and the story goes on and on.

Get someone. Pay someone if you must in order to stand by you. The wonderful people who work in hospitals are there because they care, but long hours, traumatic situations, labor pressures, and more contribute to accidents.  Make sure you’re not one of them.

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Planes, no trains, and Uber

April 5th, 2017

 As I had hinted at a few weeks ago, I’ve officially transitioned now from being Han Solo to being Yoda. OK, I’m not green. Yes, I’m not as smart as Yoda, and I have no secret, magical powers, but in many ways, my transition into my eighth decade has become a personal challenge to keep getting it done. I’m just not always sure what it is.

This week I flew to Los Angeles to serve as a new trustee on a board of directors at the Southern California University of the Health Sciences. The huge challenge that my daughter presented to me was to attend that board meeting on Thursday and still make it back to celebrate my birthday. All my plans were made. I would Uber to the airport, jump on the earliest red-eye flight home, spend one hour at the Newark Airport, fly to Pittsburgh, get a cab to my place, and drive to Johnstown for the beginning of a birthday bash.

At exactly 8:15 p.m., the gate agent said, “We’ll board in about 10 minutes.” Then in 15 minutes, another gate agent said, “They have discovered a malfunctioning joint on one of the airplane’s tires. We will let you know in 20 minutes if we can find another plane.” This was the dreaded reality of trying to get from one coast to the other. Remarkably, in 20 minutes they said, “We found another plane for the Newark trip. Go to Gate 71B.”

We stood in line at Gate 71B for about 45 more minutes. It was now well after midnight Eastern time, and we were all tired. Because I had no status with this airline, my seat was just a few rows in front of the back lavatory, and it was a tiny space. The boarding process was incredible with least 40 people not able to put their luggage in the overhead compartments.

We took off 84 minutes late, flew at 551 miles per hour across the United States, and landed 10 minutes after my flight to Pittsburgh left. I went to the service desk to find that the next flight was late.

Then it was canceled. Then the next flight had 20 people on the waiting list, and they anticipated that the next three flights would be canceled. But either way, my trip home would not take place that day.

It was then that I made an impulsive decision. I left the airport, went outside, and hit my Uber app. It was impossible to imagine that anyone would drive me five-and-a-half hours to Johnstown from the Newark airport without charging me at least $1,200, but then Ali pulled up in his 2016 Toyota Camry, looked at the distance of the trip, smiled and said, “No, it’s OK. Let’s go.”

Ali was from Yemen. He was a kind, a 32-year-old father of three who now lives in Brooklyn. Ali drove me through the fog, heavy rain, the wind, some ice, past lots of trucks, and he did it with skill.

We arrived in Johnstown at 3:30 p.m. I paid and then tipped him generously, but I wanted to high five him and thank him for helping me celebrate my big birthday. It was an incredible gift for me and my family.

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The chicken coop 

April 2nd, 2017

It started out as a family project and evolved into a full-blown farming experience. My daughter and her husband bought six chickens. OK, they were baby chickens, you know, – chicks, peeps. Of course, it was fun at first as each one of their kids played with them and took responsibility for feeding them, changing their bedding and providing them with water.

Throughout the spring, summer, and fall, there were plenty of frustrating days with the kids as they attempted to herd their free-range chickens into their pen for the night, and there were plenty of times when parents and kids argued over whose turn it was to collect eggs, catch chickens, and change bedding after cleaning out the pen.

Watching the coop evolution itself was fascinating as they moved their chicken family from a little coop, added fencing, and then put them in a bigger coop that was insulated-light heated.

Miraculously, those six birds made it through an entire summer without incident. Then, in the early fall, the first attack hit. Initially, they thought it was a four-legged critter, but then they found the remnants of the bird and figured it was eaten by a chicken hawk.

As the winter went on, the attacks did as well. Each call to me came with sadness and compassion as they described the latest horrific occurrence and eaten chicken. It was like they had created “Pickin’ Chicken” for the local predators. They’d tell me how the other chickens had stopped laying eggs due to PTSD, and how sad it was that their birds were becoming animal food.

As of last week, there were only two hens and a rooster left. The carnage had taken its toll on the kids, but in a discussion with my daughter this morning when she was describing how ruthless those chicken hawks are, it suddenly hit me that this experience was textbook because it was undeniably representative of real life.

Back when I was a chicken or a sitting duck, my primary boss walked into my board meeting one night and, out of the clear blue sky said, “There’s only one thing wrong with this place, and it’s Nick Jacobs. I’m making a motion that you take a vote right now to fire him, tonight.” Boom! Chickenhawk attack! Apparently, I’d upset him, and this was his response.

Just then one of my board members looked at him and said, “My father told me that there would only be afew people in my life who I would care about as a truly good friend, and I’ve felt that about Nick since the first time I met him.” Following that endorsement, the motion fell short of getting even one vote. That boss got up and stormed out of the boardroom in frustrated anger.

After this, in our own symbolic way we put fencing over the top of our figurative coop, hung shiny CDs, and got a fake owl. OK, not really, but we did take steps to protect ourselves from this human predator who was after me.

As time went on, I watched him try to take out several other hypothetical chickens inappropriately. As soon as I’d see him swooping in on someone who was competent but did not acquiesce to his bullying, I’d offer them a job. (He finally self-destructed.)

Remember, no matter how hard you try, there will always be predators lurking to bring turmoil into your life.

By the way, my daughter and family bought 10 peeps and a new coop today, and they found out it was a Fox!

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