Good Medical Care – It Depends on a Lot

I read this brief on-line article today.

http://healthyliving.msn.com/health-wellness/many-hospitals-ineffectively-treat-bloodstream-infections-study-suggests

The title suggested it would be about the ineffective treatment of bloodstream born infections by hospitals.  Bloodstream born infections can cause serious medical complications and death.  They require early recognition and treatment.

In its short space, however, for me it raised the subtle, but more important point that good medical care often depends on an awful lot of moving parts working efficiently and effectively.  In medicine there is so much more to a good outcome than simply making a timely diagnosis or performing a successful surgery.

The article reports on a study which suggests that bloodstream born infections are more commonly mistreated in community care hospitals than in large multifaceted care facilities. It may seem intuitive that better medical care is generally provided in a setting with more resources and more physicians in more diverse practice areas, but there’s more to the study and the story.

One, bigger may be better, but it ain’t perfect.  Size matters, but you can receive poor care virtually anywhere.  Additionally, some medical conditions, like bloodstream infections, can be challenging to treat even in best of circumstances with the best of care.  Inappropriate treatment and ineffective treatment are two different things

Two, there has been an alarming increase in antibiotic resistant bacteria in recent years. This makes it difficult to treat infections even when properly diagnosed.  Often, it is not a matter of prescribing appropriate antibiotic therapy, but instead a matter of there being an effective treatment at all.  This problem will only get worse and continue to complicate timely and effective diagnosis and treatment for more an more infections as the become antibiotic resistant.

Three, there are a variety of risk factors associated with bloodstream infections.  These are often included in prior medical records.  The study suggests that medical records systems which identify such risk factors could assist health care providers when making decisions about appropriate antibiotic therapy.  Unfortunately, despite the tremendous advantages such systems would provide in virtually all areas of patient care, the medical records systems in the United States are not well integrated and are not likely to be anytime soon.

So, ineffective treatment of bloodstream born infections – there’s more to it (and the treatment of all medical conditions) than meets the eye.

 

 

 

 

Posted in antibiotic resistant bacteria, blood infections, electronic medical records, Sepsis | Tagged , , , , |