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Partnership WITH Patients.

August 28th, 2012 No comments

In 2008, my father John McCleary was infected with MRSA while he rehabilitated from a minor ankle fracture at a tiny hospital in our home state of Maine. After he died, I began a Campaign in Maine to screen all high-risk patients for MRSA. Months later, Governor John Baldacci signed a law requiring all high-risk patients entering Maine Hospitals be screened for MRSA.

Then I shared Dad’s story with others, including the Consumers Union Safe Patient project. The CU gave me opportunities to join the nationwide campaign for Patient Safety. This networking has been helpful in my local and national Patient Safety work. I now work in the Maine Quality Counts consumer advisory council. We are making a difference for patients in primary care settings in Maine. I see attending Partnership With Patients Summit in KC as a way to grow this network of patients working in patient safety.

When I became a cancer patient last fall, I used everything I had learned to improve my chances. I learned all I could about my condition, my surgery, my alternatives, and my care. I improved my diet and exercise habits, and I asked for MRSA screening 2 weeks ahead of surgery. I used Chlorhexidine showers for 2 days before and on the day of surgery. I used online resources to find the best Hospital and doctor for my needs. I am now cancer free and I’ve had a complication free recovery. Knowledge is power, and we are safer with it than without it. I can share my experience of being an engaged patient with others and they can share my story with even more.

I didn’t assume that the hospital would keep me safe; I explained my expectations clearly.

Excerpt from my letter to the hospital:

 

Take the important “time out” before surgery and complete that check list. Give me the appropriate pre op antibiotic and give it at the right time. Keep me warm and clip, don’t shave my hair. Tell me your name and I will tell you mine, on every contact. Please don’t ask my husband to leave my side. He will help keep me safe. Wash your hands every time you touch me or my environment. Pain Control is very important to me. Use the 5 Rights for every medicine you give me. Remove my urinary catheter as soon as possible. Involve me in all discussions about my healthcare plan even if something has gone wrong. Secrecy erodes trust. This list of steps can keep me safe and sustain my trust. Push me hard to walk, cough, deep breath, and take fluids. I want to be out of here as soon as possible because I know it is the best thing for me and my health.

I am giving you my trust, gratitude and sincere admiration for the incredible work that you all do.

You are giving me the safe, clean and expert healthcare, so I can get back to my family for Christmas and begin my recovery.”

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Patient Safety Activists/Advocates Support letter

August 22nd, 2012 3 comments

When I read a letter,  written by a Davita lawyer and submitted as public document to the Maine Certificate of Need officials, I was stunned.  His letter seemed to be an attempt to belittle my work, my reputation and to silence me, and in turn the patients’ voice.

After I consulted with trusted and wise colleagues in Patient Safety, I decided not to write a rebuttal letter.   Instead, my colleagues wrote a strong letter of support to my State officals.  I can’t express how this made me feel.  That virtual group embrace was overwhelming.   We all work very hard to engage and empower patients, to give them a voice, and to help keep them safe.  Each of us has had an impact in our own communities and States, and we also work as a cohesive unit  in a Nationwide network to tackle Patient Safety issues together.  We are unstoppable and our collective  voice will not be silenced. 

The following letter of support was sent yesterday to Maine State officials,  and others.  This letter is a collective effort that brought many of my colleagues together to demonstrate our unified and solid stand for safer patients everywhere.  It was signed by 27 Patient Safety Advocate/Activists.

Without my nationwide Patient Safety network , including Roberta Mikles RN, who put me in touch with Advocate Arlene Mullin, and 5 very brave patients, Maine State Nurses Association, Maine People’s Alliance and Carl Ginsburgh,  this Patient Safety campaign in Bangor, ME,  would never have happened.

 There is power in the truth.

 

Date:    August 17, 2012

 To:       Phyllis Powell

Assistant Director

Planning, Development and Quality

Division of Licensing and Regulatory Services

Department of Health and Human Services

State House Station #11

 41 Anthony Avenue

Augusta, ME 04333-0011

 

Re: Letter in support of patient safety activist Kathy Day, RN concerning proposed

       DaVita acquisition of Eastern Maine Medical Center dialysis services

 

 

The Centers for Medicare and Medicaid Services (CMS) [1] has designated patient safety as a top goal in reforming our healthcare system, reducing costs, and improving public health. Across the nation federal and state agencies, hospital systems and research institutes, auditors, advocates, and activists are working to protect patients and especially vulnerable populations from preventable medical harm.

 

Given this sea change, speaking up and out about patient safety failures is hardly an act of revolution, yet one courageous activist in Maine has drawn fire for doing just that. We write to you today in support of patient safety activist Kathy Day in her quest for serious deliberation of the DaVita acquisition of Eastern Maine Medical Center dialysis services.

 

We know of Kathy Day’s work as an advocate for patient safety in Maine.  Because of her compassion, caring, and advocacy, patients in Maine are receiving better care with less risk from hospital-acquired infections. Her advocacy for dialysis patients is consistent with the growing national concerns reported in the press about the quality and safety of patient care at DaVita dialysis centers.[2] Ms. Day has no personal financial stake in the DaVita matter; her interests lie solely in the outcome of Maine’s dialysis patients.

 

We urge Maine to reject the proposed DaVita acquisition pending a more thorough review of patient quality and safety concerns. This action has precedent. The State of Vermont recently rejected the out-of-state-for-profit acquisition of dialysis centers by Fresenius Medical Care because it reportedly failed to pass their patient quality and safety muster.[3]



[1] Medicare and Medicaid programs cover the costs of 96% of dialysis patients. See: http://www.medpac.gov/chapters/Mar12_Ch06.pdf

[2] DaVita patients historically have had the highest hemoglobin levels of any company, according to congressional testimony and the U.S. Renal Data System. See: http://www.denverpost.com/news/ci_18613171

[3] State of Vermont Banking, Insurance, Securities, and Health Care Administration. Docket No. 11-004-H. See: http://7d.blogs.com/files/proposed-decision-12-1-2011.pdf

Additionally, it appears to be statutorily prudent[1] to require regulatory investigations[2] and whistle-blower lawsuits[3] regarding DaVita operations be concluded and prescribed corrective action taken before giving further consideration to a business transaction that may negatively impact the quality of care for Maine’s dialysis patients.

 

While healthcare is delivered one patient and one community at a time, national coalitions support the grassroots work of state advocates and activists like Kathy Day to promote policy action that recognizes patient safety as not only a moral highground, but also as a financial necessity for program sustainability.

 

 

Sincerely,

 

*** Please note that all supporters are non-conflicted individuals and organizations. ***

Signed by 27 Patient Advocates and Activists



[1]Maine statutory requirements for certificate of need: Title 22: HEALTH AND WELFARE

Subtitle 2: HEALTH Part 1: ADMINISTRATION Chapter 103-A: CERTIFICATE OF NEED HEADING: PL 2001, C. 664, §2 (NEW) §335. Approval; record. C. Ensures high-quality outcomes and does not negatively affect the quality of care delivered by existing service providers; [2003, c. 469, Pt. C, §8 (NEW).] 7. A. The applicant is fit, willing and able to provide the proposed services at the proper standard of care as demonstrated by, among other factors, whether the quality of any health care provided in the past by the applicant or a related party under the applicant’s control meets industry standards; [2001, c. 664, §2 (NEW).]

4 It is reported that DaVita has been under review/investigation by the U.S. Office of the Inspector General for The Department of Health and Human Services, the U.S. Attorney’s Office in Colorado, and the U.S. Attorney’s Office in Missouri. See: http://www.denverpost.com/news/ci_18613171

[3] It is reported that DaVita settled one whistleblower lawsuit in Texas 07/2012, agreeing to pay $55 million over allegations of drug overuse. See: http://www.denverpost.com/news/ci_21002816/denver-based-davita-settles-case-overuse-kidney-care Another whistle-blower lawsuit was reported to have been filed in Georgia. See: http://www.nytimes.com/2011/07/26/health/26dialysis.html?_r=1&pagewanted=1&sq=davita&st=cse&scp=2

 

cc:

 

Mr Larry Carbonneau , DHHS Manager Healthcare Oversight

Karynlee Harrington,  Director, Maine Quality Forum

Mary Mayhew, Commissioner DHHS

Janine Raquet, AAG

Rep. Adam Goode, Bangor

Rep. Joe Brannigan, Portland

Rep. Herbert Clark, Millinocket

Rep. Michael Michaud

Office of the Inspector General for Department of HHS

Larry Ramuno, QIO