Pressing for better quality across healthcare

By Noam N. Levey

Dr. Donald Berwick On Better Health Care SystemReporting from Atlanta—

The cardiac intensive care unit at Egleston Children’s Hospital in Atlanta gleams and hums with a dazzling array of scientific wonders that breathe for tiny lungs and monitor every beat of an infant heart.

But on a recent visit, Dr. Donald Berwick was especially pleased by something decidedly low-tech: a quiet zone where nurses can place medication orders without being interrupted, even during emergencies.

Hospital leaders created the zone — little more than a computer terminal in a corner of the room behind an orange sign on the floor that reads “Shh … We’re in the MedZone” — two years ago after noticing that distracted staff members were making dangerous mistakes when ordering medicine.

The deceptively simple system, built on a principle used in aviation, cut medication errors by two-thirds, saving money and lives.

Full story at Los Angeles Times

Teen Use of ADHD Meds Up Sharply

By Nancy Walsh

ADHD-drugsThe use of stimulant medications among children with attention deficit hyperactivity disorder (ADHD) continues to rise, particularly among adolescents, a nationally representative survey showed.

In 2008, these medications were used by 3.5% (95% CI 3.0 to 4.1) of children ages 18 and younger compared with 2.4% (95% CI 1.8 to 2.9) in 1996, according to Samuel H. Zuvekas, PhD, of the Agency for Healthcare Research and Quality in Rockville, Md., and Benedetto Vitiello, MD, of the National Institute of Mental Health in Bethesda, Md.

But among those ages 13 to 18, the rate of use increased by 6.5% annually, rising from 2.3% (95% CI 1.5 to 3.1) in 1996 and reaching 5% (95% CI 3.9 to 6.1) by 2008 (P<0.001), the researchers reported online in the American Journal of Psychiatry.

Full story at Med Page Today

D.C.’s mental health system isn’t worthy of celebration

By Letter to the Editor

D.C. Mental Health SystemRegarding the Sept. 14 editorial “A long-overdue recovery”:

While St. Elizabeths Hospital has modestly improved through its new building and the efforts of Stephen T. Baron, its director, the District’s approach to residents with the most severe mental illnesses is no cause for congratulation.

When men and women can be found, on almost any block, muttering to voices nobody else can hear, wearing urine-drenched clothing they’re not even aware of, sleeping in doorways or on steaming Metro grates and eating out of trash cans, we are not seeing evidence of “a flourishing system of community health care.”

Full story at Washington Post

Should We Be Watching Traumatic Images on TV?

By Stephanie Sarkis, Ph.D.

Watching TV TraumaOn the 10th anniversary of 9/11, countless television channels will be airing replays of the traumatic events of that day. It is in your best interest, psychologically, not to watch that coverage.

When you watch disturbing events, such as 9/11, on television, you can experience feelings of anxiety, despair and panic, all while sitting in the comfort of your living room. You feel a sense of helplessness because you are witnessing events that you are not able to control or help resolve. Watching repeated television coverage of the planes hitting the towers, people falling from buildings and seeing endless human suffering can trigger the same feelings of helplessness you experienced 10 years ago. In fact, in some cases, watching replays of the events of 9/11 can make you feel even worse than you did back then. Ten years ago, you most likely experienced shock, which is a way our mind protects us from additional psychological trauma. Ten years later, you will be watching the replays of 9/11 without that psychological buffer. It may feel like time has healed some of those wounds, but as you watch television, you may find that healing being dismantled.

Full story at Huffington Post

Writing the Book on Military Mental Health

By Mark Thompson

Soldier StressThe literature of war can be literature — think Stephen Crane’s The Red Badge of Courage (Civil War), Erich Maria Remarque’s All Quiet on the Western Front (World War I), or Neil Sheehan’s A Bright Shining Lie: John Paul Vann and America in Vietnam. And sometimes it’s less lit and more textbook. That’s surely the case with the publication of Combat and Operational Behavioral Health. Catchy title it’s not.

It’s edited (and contributed to) by Battleland’s own Dr. Elspeth “Cam” Ritchie, and because she’s too modest to toot her own horn, we’ve decided to blow it for her. The Army’s former top psychiatrist, she and 152 of her colleagues, largely from the field of military mental health, have just released the latest medical science on the mental challenges associated with combat. They spent six years writing (and rewriting) chapters dealing with everything from post-traumatic stress disorder, suicide, drug dependency, and all of the pathologies we’ve come to associate with a decade of non-stop war. But they also write about good things: the important role played by chaplains in keeping military minds healthy, for example, and the need to develop ways of improving troops mental resilience.

Ful story at Time