pubic health


Commentary: Mayor Menino, Out-Front Leader On Public Health

By John Auerbach
Guest Contributor

In the early 1990’s, at the height of the AIDS epidemic, there was a shortage of courage among many political leaders. That was why I was surprised when I heard that a little-known city councilor from Hyde Park was taking a public stance that needle exchange should be considered as a way to slow the spread of HIV. Needle exchange was (and still is in many circles) too controversial for most elected officials to support, in spite of the substantial body of evidence that it was effective. When I heard he was from Hyde Park, not a neighborhood that had felt the full impact of the epidemic, I wondered, “Who is this guy?”

John Auerbach

John Auerbach

That guy, it turned out, was Tom Menino. And in classic Menino style, he wasn’t taking the position he took because it was politically popular to do so. It wasn’t. He was taking the position because he thought it was the right thing to do.

It was several more years before I actually met him. I heard he was looking for someone to head up the newly created Boston Public Health Commission. I wasn’t interested in the job. I thought that the task was too overwhelming – pulling together 50 or more relatively small programs into a single department at a time when resources were limited and most of the attention was focused on supporting the success of the nascent Boston Medical Center. But I remembered the story of his courage in the AIDS epidemic, and I wanted to thank him. Continue reading

Rep. Jeffrey Sanchez: Make Massachusetts Patients Safer

Rep. Jeffrey Sanchez

This Tuesday, the Massachusetts legislature’s Joint Committee on Public Health is slated to hold a hearing on 33 — count ’em, 33 — proposed bills on patient safety and quality of care. (The agenda is here.) Here, Rep. Jeffrey Sánchez, the joint committee’s House chair, writes a guest post about his own legislative offering, to be heard at the hearing along with the others.

(CommonHealth welcomes guest posts on health care topics of broad public interest. To inquire about submitting one, please click on the “Get in Touch” button below.)

In Massachusetts, we’re surrounded by some of the best health care institutions and practitioners in the world and don’t typically think patient safety is an area that needs to be addressed. But unfortunately, accidents happen.

Back in 1999, the Institute of Medicine released an eye-opening study, “To Err is Human,” which found that nearly 100,000 people die every year in the United States due to medical errors. As the report’s title suggests, these errors aren’t malicious or intentional; they are often a result of systems or a culture that make it too easy for mistakes to occur. We need to encourage systems that make it difficult, if not impossible, to make an error.

Another area that must be addressed in order to improve patient safety is the rate of health-care-associated infections. Each year in the Commonwealth, there are about 34,000 such infections. In addition to delaying recoveries and affecting quality of life, these infections have a significant financial impact, costing the Commonwealth between $200 and $400 million annually.

There are shining examples right here in Massachusetts of the type of systemic changes that are necessary to address these patient safety issues. Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital, was part of a team that developed a simple two-minute checklist for use in surgery that has seen a drop in deaths and complications of an astounding 36%. New England Baptist Hospital instituted a program to screen and treat patients for MRSA (methicillin-resistant staph) and ended up reducing all surgical site infections by almost 60%. The Massachusetts Hospital Association and the Massachusetts Coalition for the Prevention of Medical Errors are also working together to reduce the number of central line-associated blood stream infections.

These types of initiatives should be implemented across the Commonwealth. To do so, I have filed House Bill 1519, An Act reducing medical errors and improving patient safety. This bill, which is among those to be heard on Tuesday, includes: Continue reading