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USA Today Thursday March 22, 2012, ran a Health headlined story: “Hospital Stay May Speed Decline Among Elderly.”

“Hospitalization of older people might place them at higher risk for accelerated cognitive decline a study suggests:”

The study was funded by the National Institutes of Health ad the National Institute on Aging”. The results were published in the journal “Neurology”.

The study involved 1,870 people ages 65 and older enrolled in the Chicago Health and Aging Project. Among this number 71% had been hospitalized at least once during the study. Researchers administered four tests of memory and thinking skills every three years for an overall measure of cognition skill based on the total of the four scores. The findings indicated:

1. The rate of decline after hospitalization would be equivalent to being more than 10 years older!

2. The rate of decline was three times faster on long term memory tests after the first hospitalization and 1.5 times faster on a complex attention test.

3.  More severe illness, longer hospital stay and older age were associated with even faster cognitive decline after hospitalization.

The hospital can be a bad place to go if you’re an older individual”, says physician Marie Bernard, deputy director of the National Institute on Aging. “It should be avoided if possible…”

“Understanding a link to cognitive decline to something as common as a hospital stay is very important,” says Robert Wilson, a neuropsychologist at Rush University Medical Center in Chicago. “Hospitals can be a very risky experience for the elderly, and we think people need to understand that.”

What is the Solution?: Barbara Resnick, President of the American Geriatrics Society and professor of nursing at the University of Maryland School of Medicine says that -

Hospitals need to change how they care for the elderly

(1.)  Patients spend too much time in bed –

(2.)  Alone and attached to monitors.

(3.)  Instead, they should get up -

(4.)  Be encouraged to exercise or sit  in a chair and -

(5.)  Have contact with others, behaviors that motivate patients to stay strong.

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Hospital Failure Rates and Errors for all patients

Hospitals are dangerous places to be…I remember the 1999 report of the Institute of MedicineTo Err is Human” as an explanation of the fact that hospital mistakes were causing 100,000 deaths each year. I remember at the time thinking that the explanation was not very good as most errors were simple mistakes that could have been avoided by double checking…If carpenters could have the rule “Measure twice and cut once”, certainly medical people with far greater responsibilities could double check critical procedures and issues…drug mistakes were very high. An update in USA today in the mid part of the last decade suggested that not much had changed. Today reading the most recent issue of the AARP bulletin (March 2012) “The Worst Place to Be if You’re Sick”, would suggest that medicine continues to plod on with hospital errors that defy understanding. Some of the figures provided will make this clear:

1.  U.S. Surgeons operate on the wrong person or body part as often as 40 times a week..

2.  The number of patients who die each year from hospital errors is equal to 4 jumbo jets crashing each week.

3.  One study of Medicare patients found that 1 in 7 died or were harmed by their hospital care. (44% should have or could have been prevented.)

 4.  A key study published in the Journal of Health Affairs, researchers examine patient charts at three of America’s leading hospitals and found that an astounding one in three admissions included some type of harm to the patient.

5. A report released in January on Medicare patients found that hospital staffs did not report a whopping 86% of harms done to patients. If most errors that harm patients aren’t even reported, they can never be tracked or corrected…This suggests that if the truth were known, the actual results are far worse then the present excessive failures and bad records suggest.

The net result of all of this is the suggestion of massive failures by our hospitals that would never be tolerated anywhere else.

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Commentary by the Alzhiemer's Society, United Kingdom

 
 

21 January 2013

Sir David Nicholson, incoming Chief Executive of the NHS Commissioning Board describes hospitals as 'bad places' for frail older people and specifically for people with dementia in an interview.

In the interview in today's Independent (21 January 2013), Sir David suggests that more emphasis and money needs to be spent on ensuring that care for conditions such as dementia is delivered in the community rather than in primary care.

Alzheimer's Society comment:

'The awful truth is that Sir David is right. People with dementia are going into hospital unnecessarily, staying too long and coming out worse. Supporting people with dementia in the community will prevent them reaching crisis point and needing costly hospital care. This is not only beneficial for the person but makes financial sense for an NHS stretched to breaking point.

'Reducing the time that people with dementia stay in hospital by just one week could save the NHS millions a year. Supporting the 800,000 people with dementia in the UK to live well in the community needs to be established as a top priority for the new NHS Commissioning Board.'

Andrew Chidgey Director of External Affairs Alzheimer's Society, United Kingdom

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Lessons from America’s Safest Hospitals (AARP The Magazine – April –May 2013…article by Beth Howard…this is a good update on Hospital Safety…

“An estimated 6000 “never events” – egregious errors like operations on the wrong limb or instruments left inside a surgical wound – occur every month among Medicare patients alone, according to a report from the U.S. Department of Health and Human Services (HHS). The total number of preventable errors is far higher – some studies suggest that up to a third of all hospital admissions result in harm to a patient. And a 2010 study from HHS estimates that 180,000 Medicare beneficiaries die every year from accidents and errors.

“Preventable hospital errors are a terrible danger to American families and a huge driver of unnecessary health costs.” says Leah Binder, president and CEO of the Leapfrog Group, a Washington, D.C. based nonprofit that assesses hospitals on national standards of safety, quality and efficiency.”

With its “Hospital Safety Score”, Leapfrog rates institutions on 26 measures of safety…The AARP article lists 66 hospitals in the United States that Leapfrog would rate or designate as “Top Hospitals for Safety.”…in addition they have rated all hospitals in the US based on their 26 measures and determined which has the worst record, which has the best record and what the average record or rating would be…this is used to compile a classification and a listing of “A” rated hospitals…you can check you’re your local hospitals against this listing to find the “A” hospitals that are near you. To go to their website just click the below link:

 (Hospital Safety Score)

“About 400,000 drug related injuries occur each year in hospitals, according to an Institute of Medicine study.”

“Five to 10 percent of patients get a preventable infection in the hospital, and nearly 100,000 people die from one each year, reports the Centers for Disease Control and prevention.”

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-Update-

“How Safe is Your Hospital”– Everyday Health – Erinn Connor, Staff Writer – Thursday, 6 March 2014

As many as 440,000 American deaths each year are related to preventable medical errors in a hospital settingaccording to a September study in the Journal of Patient Safety. “Needed changes involve not only doctors and hospitals but increased participation by patients in their health care decisions…(Study author John t. James. PhD).

Diagnostic Errors:  The risk for medical error begins with getting the right diagnosis and getting the wrong one may be more common than you think. According to researchers at Johns Hopkins University School of Medicine, the number of U.S. deaths and injuries related to diagnostic errors could be as high as 160,000 each year….a few extra steps can reduce the risk…”Something like a DNA test along with a biopsy gives a patient a lot of peace of mind…It prevents the horrifying and scary complication of unnecessary chemo or surgery…”

Hospital Acquired Infections: The U.S. Centers for Disease Control and Prevention (CDC) estimates that 1 in 20 patients will pick up an infection during hospital stay.

Common hospital acquired infections include surgical site infections, catheter associated urinary tract infections and ventilator associated pneumonia…even doctors stethoscopes can spread potentially deadly antibiotic resistant MRSA a recent study showed.

Hospitals have infection control protocols in place but patients should see that they’re being followed…

Wrong-Site Surgery:  Surgeries performed on the wrong part of the body or even the wrong patient are still happening with some regularity…Between the years 1995 and 2010, 956 wrong site surgeries were reported to the Joint Commission, an independent organization that accredits health care organizations in the U.S.

It is one of those zero tolerance errors...”It’s earth-shaking for both the doctor and the healthcare system.”

It is recommended that patients do the following prior to surgery:

Make sure the correct body part or area being operated on is marked, and only that part…if one has any questions about the procedure, ask before you get to the operating room..

“All clinicians and hospitals are trying to improve patient safety, but having the patient be a partner in that is just as important…when patients are sharing the decision making with their doctors and having good conversations about risks and benefits and what to expect from procedures, that’s helping improve patient safety too.”

 

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 Reader's Comments

Gill Denman  - Essex, United Kingdom - (17 May 2013): "I thought it was only in the UK that there were problems.  Stanton O. Berg have a look at Cure the nhs pages, the original is Stafford Hospital and now there are others, our local one is Basildon Hospital, in the last 2 weeks I jave been to both the Keogh Enquiry open meeting and the initial Cure the nhs Basildon Hospital meeting.  It was distressing, shocking and listening to the relatives stories with the same factors told over and over again, I wonder how those who run the place can live with themselves.  My mum had several terrible brushes with the place, the last one was when she was seriously injured over several nights.  There seemed to be a general assumption that, if a person has dementia, they will get injured.  So many patients with bruises, broken bones, we were frightened about what we would find each day.  I do wonder if the people who work there think that they will not get old some day, what will happen to them.  A member of staff actually told me not to notice what was happening to other  patients and just consentrate on mum. I told the person that, if there was something wrong, I WOULD see it...Stan, this is not an exageration, what I saw of the relatives in the meetings telling their stories, it could have been people talking about war crimes, I feel very upset as I write this, the last few days have made me realise how lucky we were to get mum out alive.  She went in with constipation, came out with a broken arm, injured leg, I bought our local newspaper only to read that she had been held around the throat by a hospital security guard.  I reported the hospital for abuse, they held a safeguarding enquiry without me and without my full details, I wasn't even told the result."

Beth Ann Doucett- Lino Lakes, Minnesota - (21 March 2014): "It is absolutely horrible. I was more worried about my hospital stay than my surgery...I had infection in my stomach and it was from something I either ate or drank while there...Pretty scary for sure:...My other scare was at the rehab nursiing home after my hip surgery a year ago. The staff didn't realize how delicate my condition was and when they took me from the wheel chair to the bed. The bed was much lower than they thought and they dropped me on the bed. Everything fractured and as a result I was laid up for almost three months. Still have nightmares...So I know what you are talking about...Thanks for sharing."

Cheryl Gagliano  - Pritchard, British Columbia - (22 June 2016): "Stan thanks for sharing this article for all to read. Anesthetic Absolutely advances dementia and Alzheimer's!"