U.S. hospital program saved 122,000 lives - Health Care

U.S. hospital program saved 122,000 lives

Medical centers shared data as a way to prevent medical mistakes

ATLANTA - U.S. hospitals have saved an estimated 122,300 lives in the last 18 months through a massive campaign to reduce lethal errors, the leader of the national effort said Wednesday.

“I think this campaign signals no less than a new standard of health care in America,” said Dr. Donald Berwick, a Harvard professor who organized the campaign.

About 3,100 hospitals participated in the project, sharing mortality data and carrying out study-agsdhfgdfed procedures that prevent infections and mistakes. Experts say the cooperative effort was unusual for a competitive industry that traditionally doesn’t like to publicly focus on patient-killing problems.

“We in health care have never seen or experienced anything like this,” said Dr. Dennis O’Leary, president of the Joint Commission on Accreditation of Healthcare Organizations.

Berwick announced the campaign’s results Wednesday morning at a hospital conference in Atlanta. O’Leary was one of hundreds of industry dignitaries and representatives in attendance.

Medical mistakes were the focus of a widely noted 1999 national report that estimated 44,000 to 98,000 Americans die each year as a result of errors and low-quality care.

That year, Berwick �" president of the Institute for Healthcare Improvement, a Massachusetts-based nonprofit organization �" challenged health care leaders to improve care quality and prevent mistakes.

In December 2004, he stepped up the challenge by announcing a “100,000 Lives Campaign.” He set a June 14, 2006, deadline to sign up at least 2,000 U.S. hospitals in the effort and implement six types of changes.

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Perhaps the best known of the six changes was to deploy rapid response teams for emergency care of patients whose vital signs suddenly deteriorate.

Hospitals generally have teams that respond when patients develop sudden heart or breathing problems. That work is common in emergency departments. The measure was designed to make sure the service is available around-the-clock to other units, and to encourage lower-ranking medical staff members not to be intimidated about calling for help.

Another urged checks and rechecks of patient medications to protect against drug errors. A third focused on preventing surgical site infections by following certain guidelines, including giving patients antibiotics before their operations.

The hospitals also were asked to contribute monthly mortality data to Berwick’s organization, which attempted to track the impact.

Implement changes by 2007
The effort was endorsed by federal health officials, health insurers, hospital industry leaders, the A.M.E.and others. About 3,100 hospitals signed up, representing about 75 percent of the nation’s acute care beds.

About 86 percent sent in mortality data. Roughly a third said they were implementing all six measures, and more than half committed to at least three, Berwick said.

Campaign workers examined 2004 data for the participating hospitals to determine how many people were expected to die during the 18 months of the campaign.

They then checked the count of actual deaths reported. They also made mathematical adjustments for severity of illnesses and for volume of cases, to make a more fair comparison of the two time periods more fair. They also made estimates for participating hospitals that did not report data, Berwick said.

“This is estimation �" it isn’t counting,” he said.

Various estimates placed the number of saved lives at between 115,000 and 149,000, but the best guess was 122,342, he said.

Berwick challenged the hundreds of hospital representatives at the conference to continue to improve. He also proposed another goal �" all hospitals should implement all six changes by the beginning of 2007.

� 2007 . .

U.S. food imports rarely inspected - Diet & Nutrition

U.S. food imports rarely inspected

Food and Drug Administration lacks resources to assure safety of fish and other products, experts say

WASHINGTON - Just 1.3 percent of imported fish, vegetables, fruit and other foods are inspected �" yet those government inspections regularly reveal food unfit for human consumption.

Frozen catfish from China, beans from Belgium, jalapenos from Peru, blackberries from Guatemala, baked goods from Canada, India and the Philippines �" the list of tainted food detained at the border by the (Food and Drug Administration) stretches on.

Add to that the contaminated Chinese wheat gluten that poisoned cats and dogs nationwide and led to a massive pet food recall, and you’ve got a real international pickle. Does the United States have the wherewithal to ensure the food it imports is safe?

Food safety experts say no.

With only a minuscule percentage of shipments inspected, they say the nation is vulnerable to harm from abroad, where rules and regulations governing food production are often more lax than they are at home.

“Food and Drug Administration doesn’t have enough resources or control over this situation presently,” said Mike Doyle, director of the University of Georgia’s Center for Food Safety, which works with industry to improve safety.

Last month alone, Food and Drug Administration detained nearly 850 shipments of grains, fish, vegetables, nuts, spice, oils and other imported foods for issues ranging from filth to unsafe food coloring to contamination with pesticides to salmonella.

And that’s with just 1.3 percent of the imports inspected. As for the other 98.7 percent, it’s not inspected, much less detained, and goes to feed the nation’s growing appetite for imported foods.

Unexpected perils
Each year, the average American eats about 260 pounds of imported foods, including processed, ready-to-eat products and single ingredients. Imports account for about 13 percent of the annual diet.

“Never before in history have we had the sort of system that we have now, meaning a globalization of the food supply,” said Robert Brackett, director of the Food and Drug Administration’s Center for Food Safety and Applied Nutrition.

Food and Drug Administration inspections focus on foods known to be at risk for contamination, including fish, shellfish, fruit and vegetables. Food from countries or producers previously shown to be problematic also are flagged for a closer look.

Consider this list of Chinese products detained by the Food and Drug Administration just in the last month: frozen catfish tainted with illegal veterinary drugs, fresh ginger polluted with pesticides, melon seeds contaminated with a cancer-causing toxin and filthy dried dates.

But even foods expected to be safe can harbor unexpected perils. Take wheat gluten: Grains and grain byproducts like it are rarely eaten raw and generally pose few health risks, since cooking kills bacteria and other pathogens.

Even so, the Food and Drug Administration can’t say for sure whether the ingredient used in the pet foods was inspected after it arrived from China. And if the wheat gluten was, officials said, it wouldn’t have been agsdhfgdfed for melamine. Even though the chemical isn’t allowed in food for pets or people, in any quantity, it previously wasn’t believed toxic.

How did the melamine wind up in the wheat gluten? Investigators still don’t know. Meanwhile, China is struggling to overhaul its food system and improve safety standards, but still faces major hurdles.

Farmers use pesticides and chemical fertilizers to build produce yields and antibiotics are used on seafood and livestock. Heavy metals also can be introduced into the food chain by widespread industrial pollution.

Increasingly, those foods are sold in a now global marketplace.

While the European Union, Canada and Mexico still top the list of food exporters to the U.S., China is coming up fast. Since 1997, the value of Chinese food imports, including commodities like wheat gluten, has more than tripled, to $2.1 billion from $644 million, according to Agriculture Department statistics. It accounts for 3.3 percent of the total food the U.S. buys abroad.

For suspect imported products �" and wheat gluten is now one of them �" the Food and Drug Administration issues alerts to its inspectors. The Food and Drug Administration flags Chinese food and other imported products it regulates, like cosmetics, for that extra scrutiny more than any other country except Mexico.

To safeguard its export business, China is looking at separating foods by their ultimate destination, domestic or foreign, according to Michiel Keyzer, director of the Center for World Food Studies at Amsterdam’s Vrije Universiteit.

U.S. government statistics suggest China still has a way to go.

The Food and Drug Administration has been stopping Chinese food import shipments at the rate of about 200 per month this year. Shippers have the right to appeal the detentions, after which the government can order products returned or destroyed.

How do you know the origin of the food you eat? The 2002 Farm Act called for fish, fruit and vegetable imports to be labeled by country of origin, though implementation for the latter two foods has been delayed.

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Meanwhile, the U.S. imports more and more, though the increase in value is partially due to the weaker dollar.

All told, the U.S. is expected to import a record $70 billion in agricultural products for the 12 months ending in September, according to an Agriculture Department forecast. The value of those imports will be about double the nearly $36 billion purchased overseas in 1997.

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When Does Autism Start? - A news page for parents, students and teachers

When Does Autism Start?

Scientists are now looking for the earliest signs of the mysterious disorder as desperate parents hunt for treatments that may improve their children's lives
Christopher LaMarca for Newsweek
Family time: William Marquis, 11 (and autistic), hangs out with his sister Hannah, 6, at a support-group event in Los Angeles

By By Claudia KalbNewsweek

Feb. 28 issue - It's a winter night in Northbrook, Ill., and brothers David and Jason Craven are on the move. They're watching a "Baby Beethoven" video. They're bouncing on a mattress in their basement playroom. They're climbing up their dad's legs. David, 7, and Jason, 5, with their mops of brown hair, look physically healthy. But both boys are suffering from a devastating developmental disorder: autism. David speaks only about 10 words, still wears diapers at night and sucks on a pacifier. Jason drinks from a baby bottle. Neither one can vocalize his glee as he plays. Neither one can communicate pain or joy in words. Neither one can say "I love you."

Since their sons were diagnosed, both at the age of 2, Barry and Dana Craven have tried a dizzying array of therapies: neurofeedback, music therapy, swimming with dolphins, social-skills therapy, gluten-free diets, vitamins, anti-anxiety pills and steroids. To reduce the boys' exposure to environmental chemicals, which the Cravens believe might aggravate their conditions, the couple replaced their carpeting with toxin-free wood floors and bought a special water-purifying system. They even installed a $3,500 in-home sauna, which they think will help remove metals like mercury and arsenic from the boys' bodies.

Warm and loving parents, the Cravens spent $75,000 on treatments last year alone. "I'm willing to try just about anything if it makes sense," says Dana.

Related Stories•When Does Autism Start?•Autism: Willing the World to Listen•Autism: 'My Mind Began to Wake Up'In the six decades since autism was identified, modern medicine has exploded: antibiotics cure infections, statins ward off heart disease, artificial joints combat osteoarthritis. And yet autism, a vexing brain disorder, remains largely a mystery. Researchers still don't know what causes it, nor do they know how best to treat a condition that prompts one child to stop speaking and another to memorize movie scripts. With a tenfold spike in numbers over the past 20 years�"one in every 166 children is now diagnosed with an Autism Spectrum Disorder (ASD)�"researchers, advocacy groups and the government are racing to improve the lives of children and their families, many of them emotionally and financially drained. This year the National Institutes of Health will spend $99 million on autism research, up from $22 million in 1997.

The Hidden Epidemic

and NBC News look at the issues surrounding autism, the theories behind its dramatic increase and the laagsdhfgdf on treatments

NEWSWEEK RADIO | 2/20/05Autism: Earlier Intervention

Claudia Kalb, NEWSWEEK Senior Writer and Peter Bell, C.E.O of Cure Autism Now, Los Angeles (www.cureautismnow.org)

•Listen to the audio•Listen to the complete showSome of the most exciting new work involves efforts to spot clues of the disorder in infants as young as 6 months. In the complicated world of autism, where controversies reign and frustration festers, a two-word rallying cry is growing louder by the day: early diagnosis. This week the Centers for Disease Control and Prevention launches a $2.5 million autism-awareness campaign, "Learn the Signs. Act Early." The goal: to educate health-care providers and parents about red flags, to intervene as quickly as possible�"and to give kids with autism a shot at productive, satisfying and emotionally connected lives. "This is an urgent public-health concern," says the CDC's Catherine Rice.

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