By Yanling Yu and Rex Johnson, Washington Advocates for Patient Safety
On September 30th, 2013, the Safe Patient Project of Consumers Union and Washington Advocates for Patient Safety (WAPS) hosted a joint meeting at the Seattle Public Library to share ideas on how to become smart consumers and protect themselves and family members from medical harm, hospital infections as well as failed hip and knee implants. It was a well attended event with many presentations and lively discussions.
Lisa McGiffert, Suzanne Henry, and Daniela Nunez from Consumers Union first presented their new campaign to get the top six hip and knee implant makers to provide 20-year warranties on their products. When implants are defective, patients or their insurance including Medicare and Medicaid normally end up paying for additional surgery to replace failed devices. Such a revision can be more costly than original surgery and result in longer hospital stays and complications. Patients who receive hip implants should be guaranteed a new hip at no cost if their current one fails or is recalled. In addition, the pain and suffering has emotional and financial costs for patients and their family members.
Thus, it seems to be common sense that patients with implants deserve a form of warranty. Such a warranty would have helped Mary Schrag (WAPS), who shared a video that documented a recalled metal-on-metal hip that left a devastating impact on her life. These Metal-on-Metal (M-O-M) hip replacements have an unusually high failure rate, based on data from Australia, England, and Wales where devices are tracked through national registries. Mary’s example clearly shows why manufacturers should live up to their claims and provide warranties on their products.
Following a lively discussion, members of WAPS presented their work to improve transparency and accountability in medical care to save more lives and avoid preventable harm. Like many patient safety advocates around the country, a number of WAPS members have been personally impacted by medical harm which led to our advocacy for patient safety. By sharing painful personal stories about the harms to our loved ones and our families, we emphasized the importance of patient-centered care, shared-decision making, quality of care, transparency, and accountability. As the third leading cause of death in our country, preventable medical harm is currently killing an estimated 440,000 people in the US each year, as shown by a recent study published in Journal of Patient Safety. Our stories highlighted the human toll of medical harm and reminded everyone that behind the statistics of each medical harm, there was a beautiful, precious human life and their family. You can access these presentations here.
To save more lives and to be a voice for patients, we have been collaborating with Consumers Union’s Safe Patient Project for several years. More recently, we worked together to protect the WA hospital infection reporting law that retains reporting of infections involved hip and knee replacements and cardiac surgeries. With more people undergoing hip and knee replacements, patients need to be able to see their local hospitals’ infection rates for these procedures, which can help people make informed medical decisions.
At the meeting, Dr. Robert Mecklenburg at Virginia Mason also gave an introduction on the Robert Bree Collaborative, a statewide public/private consortium established in 2011 by the Washington State Legislature “to provide a mechanism through which public and private health care stakeholders can work together to improve quality, health outcomes, and cost effectiveness of care in Washington State.”. The Collaborative is in the process of creating a warranty for the surgery itself involved with hip and knee replacements. By bundling packages of care, they can offer a warranty for specific procedures that go wrong and provide additional care at no cost.
Another informative talk was given by David Ansley with Consumer Reports. He presented on the Consumer Report’s Choosing Wisely campaign and how it’s helping to change the culture of excessive medical care. Through this campaign, Consumer Reports is working with doctors to help patients avoid unnecessary and potentially harmful medical care. Doctors often order tests and recommend treatments when they are not needed—sometimes even when they know they shouldn’t. In fact, nearly half of primary-care physicians say their own patients get too much medical care, according to a survey conducted by researchers at Dartmouth College. And the Congressional Budget Office says that up to 30 percent of the health care in the U.S. is unnecessary. David Ansley pointed out that patient need to ask if every treatment is necessary and to say “No” to unnecessary ones.
All in all, to choice wisely and eliminate preventable medical harm, we must engage patients and their families in patient-centered care and shared decision making process. Partnering with patients through out the journey of care is absolutely essential to quality of care.
The opinions in this blog reflect that of the authors and not the University of Washington.