April 2018 Articles
Simple Post

[/vc_column_text][/gem_fullwidth][/vc_column][/vc_row]

Maternal Mortality Rates are on the RIse

In the most recent government data available, there were 17.3 maternal deaths per 100,000 births in the United States. The maternal mortality ratio has been on the rise since 1987, where the ratio was 7.2 deaths per 100,000 births. This number is particularly alarming because there have been many medical advances since the 1980s (CDC). The CDC cites, “The use of computerized data linkages by the states, changes in the way causes of death are coded, and the addition of a pregnancy checkbox to the death certificate in many states have likely improved identification of pregnancy-related deaths over time.” This indicates that the use of incident reporting management software systems, such as the one provided by HealthDox, has contributed to the number of pregnancy related deaths actually being reported.

These statistics raise another important question. How are other developed nations maternal mortality ratios’ as low as 3.8 (Finland) when the United States is reporting a maternal mortality ratio of 26.4 (Lancet 2016)? Furthermore, the United States is the only developed nation with an increasing mortality ratio rather than a decreasing mortality ratio.

In the United States, there is a view that emphasis is not on the mother during child birth. Surveying a general consensus of new mothers, it was noted that the mothers felt more prepared to treat issues that may arise with the child, rather than complications that may arise in themselves. Even during the delivery process, the focus is on the infant, and issues with the mother are simply overlooked. It is part of the culture in hospitals to place their attention on infants therefore not noticing the complications occurring with the mothers (NPR and ProRepublica). But the few occurrences where doctors may not catch a hidden pregnancy complication does not account for the irrationally high number of maternal mortalities for the minority or impoverished mothers. It has been argued that this disparity is attributable to health care access. The United States is one of the only developed nation without some form of universal healthcare. In countries with the lowest reported maternal morality ratios, health services are offered to all mothers equally (Stearmer). Access to healthcare, greater family planning autonomy, and widespread knowledge of reproduction has allowed other nations to keep their maternal morality rates low. Maybe the United States can take note and learn to do the same.

But there is still another question, how are other developed nations maternal mortality ratios’ as low as 3.8 (Finland) when the United States is reporting a maternal mortality ratio of 26.4 (Lancet 2016)? Additionally, the United States is the only developed nation where you find an increasing mortality ratio, as opposed to a decreasing mortality ratio.

In the United States, the emphasis is not on the mother during child birth. Surveying the general consensus of new mothers, it was noted that they felt more prepared to identify issues that may arise with the child, but unaware and unprepared on how to care for issues that may arise in themselves. Even during the delivery process, the focus is on the infant, and issues with the mother are simply overlooked because it is part of the culture in hospitals to place their attention on infants therefore not noticing the complications occurring with the mothers (NPR and ProRepublica). But the few occurrences were doctors may not catch a hidden pregnancy complication does not account for the irrationally high number of deaths for mothers who are minorities or impoverished. This can be attributed to health care access. The United States is one of the only developed nation without some form of universal healthcare. In countries with the lowest reported maternal morality ratios, health services are offered to all mothers equally (Stearmer). This access to healthcare and greater autonomy and knowledge on family planning has allowed other nations to keep their maternal morality rates low. Maybe the United States can take note and learn to do the same.

Medical Records Breached
Information Security Media Group reported that the now defunct company FileFax reached a $100,000 deal with HIPAA over improper disposal of medical records.

​In 2015 it was reported that a dumpster diver in Chicago found the medical records and was selling the files for money. Regulations clearly state that these files were to be shredded or destroyed.

With over 2000 patient’s medical records breached, The Department of Health and Human Services’ Office for Civil Rights clearly had to take firm action. “OCR Director Roger Severino stated ‘Covered entities and business associates need to be aware that OCR is committed to enforcing HIPAA regardless of whether a covered entity is opening its doors or closing them. HIPAA still applies.’” Even though FileFax was on it’s way out, this still represented a breach of HIPAA that needs to be addressed.

 Suburban Lung Associates was the healthcare provider that contracted FileFax to dispose of the medical records, without knowing they would haphazardly get the job done. Joe Gillespie, a security and privacy consultant, has encountered many businesses claiming they properly store and dispose of medical records, but when it came down to it ,“it was obvious in talking with some of them that they did not have the depth of regulatory knowledge that is necessary.” In healthcare is truly takes a commitment to quality to perform at an appropriate level.

The lesson to learn? If healthcare organizations are not careful at all levels with who they contract, they put their patients at risk.

Storage Failure in Fertility Clinic Leads to Huge Loss
University Hospitals Fertility Clinic in Ohio said about 950 families were affected by a freezer tank failing, leading to the loss of over 4,000 eggs and embryos.

CNN reports that the hospital was aware that were were some issues with the freezer. Intermittently, a staff member would check on the tank and refill the liquid nitrogen into the tank to keep the freezer at the optimal temperature. This had been going on for weeks before the ultimate failure of the tank.

Ultimately, the tank had failed when there was a steep change in the temperature and the alarm to alert the staff was not active. The alarm, which was put in place in the event of an emergency, has been turned off for some time, it is not clear why it was turned off or for how long.  There was no staff on hand at the lab on Saturday evening, the suspected time frame the freezer had stopped working. In the end, there was no staff to respond to the emergency and no way for staff to be alerted of the event, which is where the issue lies. Read more here.

In this instance, you see a few key issues with the way the hospital dealt with the problem. There was no outlined procedure solution to the faulty freezer other than filling up the tank when the nitrogen levels were low. With a good policy and procedure plan in place, you consider all the risks and have an outlined action plan to carry forward. It was also clear that there was a communication issue. The tank’s emergency mechanisms were not double checked and fortified in the event that the temperature rose too high, so the tank never transmitted the emergency alarm to the staff. Since no staff was on hand, another red flag, there was no way to resolve the issue. In such an event, it is important to take extra care to have every staff member aware of the issue, communicate the action plan effectively, and consider all risks.

The execution of proper policy management could have mitigated or eliminated this mistake. Do you think our Healthcare Policy Manager could be right for you? Find out here!