Patient Safety
Patient safety is a major initiative in health care. Increasing member awareness of patient safety issues and providing neurologists with tools and programs to enhance patient safety can:
- Improve patient care
- Facilitate the creation of more efficient office practices
- Improve practice risk management strategies
New Toolkit Helps Hospitals Use Inpatient, Patient Safety Indicators
The Agency for Healthcare Research and Quality (AHRQ) offers a free toolkit to guide hospitals through the process of using the AHRQ Inpatient Quality Indicators (IQIs) and Patient Safety Indicators (PSIs) to improve care.
FDA Announces a Single REMS for Fentanyl
The U.S. Food and Drug Administration approved a single shared Risk Evaluation and Mitigation Strategy (REMS) for the transmucosal immediate-release fentanyl (TIRF) products. This new shared system will replace the individual REMS and allow prescribers and pharmacies to enroll into just one system, easing the burden on the health care system.
TIRF medicines, which include the brand-name drugs Abstral, Actiq, Fentora, Lazanda, and Onsolis, are narcotic pain medicines called opioids used to manage pain in adults with cancer who routinely take other opioid pain medicines around-the-clock.
The shared system strategy, called the TIRF REMS Access Program, will be used by all sponsors of TIRF products and is expected to ease the burden on the health care system. The program will begin in March, 2012. Until that time, prescribers, patients, and pharmacies should continue to enroll in the individual REMS programs.
The goals of the TIRF REMS Access Program are to ensure patient access to important medications and mitigate the risk of misuse, abuse, addiction, overdose and serious complications due to medication errors by:
- Prescribing and dispensing TIRF medicines only to appropriate patients, including use only in opioid-tolerant patients
- Preventing inappropriate conversion between fentanyl products
- Preventing accidental exposure to children and others for whom TIRF medicines were not prescribed
- Educating prescribers, pharmacists, and patients on the potential for misuse, abuse, addiction, and overdose
Several TIRF products already have an individual REMS in place. Prescribers and pharmacies already enrolled in an individual REMS program for at least one TIRF medicine will automatically be transitioned to the shared TIRF REMS Access program.
Health care professionals who prescribe TIRF medicines that will only be used in an inpatient setting (hospitals, hospices, or long-term care facilities) will not be required to enroll in the TIRF REMS Access program.
Similarly, patients who receive TIRF medicines in an inpatient setting are not required to enroll in the program. Long term care and hospice patients who obtain their medications from outpatient pharmacies must still be enrolled.
For more information:
TIRF REMS Questions and Answers
FDA Issues Advisory on Certain Opioid Analgesics
FDA is advising healthcare professionals and patients of a potential problem with opiate products manufactured and packaged for Endo Pharmaceuticals by Novartis Consumer Health at its Lincoln, Nebraska manufacturing site.
Problems with packaging and labeling have created a risk that some pills may end up in the wrong bottles. The FDA estimates that the risk of this happening is low, but nonetheless advises pharmacists and patients to be on the lookout for any pills that do not match the others in the bottle.
Endo Pharmaceuticals reports that they are aware of only three product mix-ups with respect to these products since 2009. All three of these were detected by pharmacists, and a review of the FDA's adverse events reporting system shows no reports of adverse events related to those mix-ups. The FDA has not issued a recall for the affected medicines at this time.
The manufacturing center in Lincoln, Nebraska has been shut down while investigators determine the source of the problem and put steps in place to prevent it from occurring in the future. This may cause some minor supply disruptions, but they are not expected to be long-term or wide-spread. Further details, along with a list of potentially affected medicines, can be found at the FDA's website.
The same manufacturing problem may also have caused a similar problem with certain over-the-counter medications produced at the same manufacturing center. Novartis has issued a recall of the potentially affected over-the-counter medications; a full recall list can be viewed at Novartis' website.
Patients can get information on affected medications and how to file for a refund at Novartis' OTC Product Updates Website. At this time, it is not anticipated that any opioid products have strayed into over-the-counter product bottles, though the investigation is ongoing.
Diagnostic Errors Online CME Opportunity
Diagnostic errors are the most frequent claim against neurologists. The National Patient Safety Foundation has developed a diagnostic errors CME module, downloadable from the NPSF website, that addresses this important issue. The module features educational PowerPoint presentations, pre-recorded lectures, sample curriculum for teaching medical learners, practice quizzes, and much more. Contributing authors include the leading experts in this burgeoning area of study. To learn more and to purchase the module, visit the NPSF website.
New Patient Safety Award Recognizes Research, Care Improvement Projects
A new AAN Patient Safety Award recognizes innovative and forward-thinking research and/or care improvement projects designed to meet the Joint Commission's National Patient Safety Goals. One recipient will be selected from each of two categories—residents/fellows and practicing neurologists—and be recognized at the 64th AAN Annual Meeting in New Orleans, April 21 through 28, 2012. The deadline to apply for the 2012 award has passed, but you can still view the eligibility requirements to begin planning your project for 2013!
New Report on Transition of Care for Acute Stroke and Myocardial Infarction Patients Is Now Available
The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program is pleased to announce that the following new report is now available. View the final report.
Free FDA Patient Safety Drug Alerts Emailed to AAN Members
More than 700 AAN members have signed up for a free program to receive timely neurology-specific FDA-mandated patient safety drug alerts in their email inboxes.
The AAN and the Health Care Notification Network are offering this program to help Academy members protect their patients and their practices with this quick, convenient way to stay current on FDA alerts.
Registration is free and takes only two minutes to complete. Don't be the last to know about prescription recalls and warnings—sign up today to enroll in this free AAN member benefit.
Patient Safety Online CME
AAN's first online-only CME offering is "Recognizing Abuse in Your Neurology Patients" by Anna DePold Hohler, MD. From this important module, you will learn about the prevalence of abuse, the different types of abuse, methods of screening, and ways to respond to a patient who discloses abuse. One credit of CME is offered.
Patient Safety Colloquia Syllabi
Use this archive of syllabi from past Patient Safety Colloquia to become familiar with recent trends in the area of patient safety:
- Patient Safety Colloquium:Transitions in Care – Who Cares? (2011)
- Patient Safety Colloquium: Diagnostic Errors in Neurology (2010)
- Patient Safety Colloquium: Medication Safety Across Your Practice Settings (2009)
- Patient Safety Colloquium: Essential Patient Safety for the Neurologist - Does Your Practice Measure Up? (2008)
- Patient Safety Colloquium: Patient Safety Is No Accident: Practical Strategies for a Safer Neurology Practice (2007)
ePrescribing
ePrescribing can increase the safety of your practice by reducing the likelihood of medication errors due to incomplete, illegible, or misunderstood prescriptions. Medicare offers incentives for utilization of ePrescribing. Learn more.
Older Driver Safety
Older drivers, particularly those over the age of 85, are at higher risk for traffic fatalities. Additionally, older drivers experience more accidents per mile driven than their younger counterparts. Neurologists play an important role in the safe mobility of their patients, though assessing driving risk and communicating that risk to families can be difficult. The AMA, in collaboration with the National Highway Traffic Safety Administration, has developed a Physician's Guide to Assessing and Counseling Older Drivers.
Access the AAN's guideline for the assessment of driving risk in patient with dementia.