Modern Healthcare - - Opinions Editorials -

“When the so­lu­tion to a lethal prob­lem is in­ex­pen­sive and easy to im­ple­ment, there’s no rea­son why that prob­lem should per­sist. Yet even though most so-called sur­gi­cal-site in­fec­tions are pre­ventable, they are still the sec­ond most com­mon kind of hos­pi­tal-based in­fec­tion. Doc­tors and hos­pi­tals must take the ba­sic steps needed to stamp them out. ... Se­vere cases cost the U.S. health­care sys­tem an es­ti­mated $17 bil­lion. And ac­cord­ing to a new study of over 360,000 gen­eral surgery pa­tients from across the coun­try, sep­tic shock is 10 times more fre­quent a post-op­er­a­tive com­pli­ca­tion than heart attacks—and ends up killing 10 times as many peo­ple. ... There are na­tional guide­lines aimed at pre­vent­ing sur­gi­cal-site in­fec­tions, and stud­ies have shown that they work. The guide­lines in­clude rel­a­tively sim­ple mea­sures. ... By mon­i­tor­ing ev­ery pa­tient for four ba­sic cri­te­ria—el­e­vated heart rate, higher tem­per­a­ture, higher res­pi­ra­tory rate and higher white blood cell count—the Hous­ton-based au­thors of the study re­duced the mor­tal­ity rate from in­fec­tion in their in­ten­sive-care unit by more than half. That’s a lot more peo­ple who got to go home. Not ev­ery death from sep­tic shock is avoid­able, but no more lives should be lost sim­ply be­cause some­one wasn’t watch­ing closely.”

—Bos­tonGlobe “The Na­tional Health Ser­vice is the third rail of Bri­tish pol­i­tics. Bri­tons cher­ish the his­toric achieve­ment of bring­ing de­cent med­i­cal care within ev­ery­one’s reach, while com­plain­ing reg­u­larly about the bureau­cratic rigid­ity— and bristling at any sug­ges­tion of change. Now the new coali­tion govern­ment is propos­ing a sweep­ing round of re­forms in­tended to elim­i­nate lay­ers of bu­reau­cracy and de­liver bet­ter, more per­son­al­ized care by giv­ing pri­mary-care doc­tors more power over treat­ment de­ci­sions and re­fer­rals to spe­cial­ists. That makes sense. ... Thought­ful de­bate will be needed as these pro­pos­als are fash­ioned into de­tailed leg­is­la­tion—more thought­ful, we can only hope, than the re­cent highly politi­cized de­bates here over health­care re­form. ... The coali­tion has wisely shielded the Na­tional Health Ser­vice from the ex­ces­sive aus­ter­ity cuts it has pre­scribed for ev­ery other govern­ment depart­ment. ... Giv­ing doc­tors more power over re­fer­rals and in­tro­duc­ing for-profit health­care man­age­ment com­pa­nies will in­tro­duce some Amer­i­can fea­tures to the Bri­tish sys­tem. That will bring po­ten­tial risks as well as po­ten­tial ben­e­fits. Ex­pe­ri­ence in the United States—where pa­tients’ in­ter­ests are too of­ten short­changed—shows that strong reg­u­la­tory safe­guards will be needed to make these re­forms work.”


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