Improving hospital safety and other stories . . .BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h3862 (Published 23 July 2015) Cite this as: BMJ 2015;351:h3862
Improving hospital safety has to be a good thing and you can measure it by counting a drop in adverse events (AEs). When investigators compared overall AEs in 2008 and 2011-12 across a sample of Dutch hospitals they found no difference, despite a big safety campaign in the interval (BMJ Quality and Safety 2015, doi:10.1136/bmjqs-2014-003702). Yet, when they looked at preventable AEs, they found a 45% drop. So have Dutch hospitals become safer places? A long accompanying commentary (doi:10.1136/bmjqs-2015-004461) concludes that AEs are the wrong metric altogether.
Minerva is a rather simple kind of goddess and thinks of diagnosis in terms of its consequences. So people diagnosed as having “diabetes” either have symptoms that need treating or they have a risk state that might need treating. But people’s overall risk doesn’t begin with any particular level of fasting blood sugar or glycated haemoglobin (HbA1c), or an abnormal glucose tolerance …
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