Shaw's Eco-Logic

This HND piece examines the leading organization for accreditation of healthcare facilities in the US—the Joint Commission on Accreditation of Healthcare Organizations. We trace its history all the way back to surgeon and pioneer in patient outcomes measurement Ernest Amory Codman, MD. Unfortunately, Codman is sort of a secular Joan of Arc figure in medicine: Greatly admired now, but figuratively burned at the stake by his contemporaries. (cf. Mark 6:4)

We focus on some recent critiques of this group, including a blistering article that appeared in the Wall Street Journal, and a new study, coming out of Harvard. Let's just say that the Joint Commission's gold seal of approval may not be warranted in certain cases.

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This HND piece digs into the matter of calibrating environmental air monitoring instruments. We detail why it's needed, along with the common calibration modalities. After that, we segue into the faulty notion of surrogate calibration.

Unfortunately, surrogate calibration has gained some popularity because it is...expedient. When it's used, it is inevitably because doing the calibration properly is a bit more difficult than the practitioners would like. Trouble is, surrogate calibration can introduce significant error into these measurements.

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This HND piece examines the problem of bloodstream infections—especially those affecting pediatric leukemia patients. Generally regarded as the most dangerous type of healthcare-associated infection, bloodstream infections are far too common, and have a disturbingly high fatality rate.

Pediatric leukemia patients, already immunocompromised by virtue of chemotherapy and their youth in many cases, are unfortunately prone to serious bloodstream infections. If only these could be diagnosed earlier.

We report on a pilot study that shows the efficacy of a new diagnostic approach, using next-generation DNA sequencing. The test can identify the DNA of more than 1000 pathogens, long before their infections would become symptomatic. Prophylactic antibiotics can then be administered, and this can save lives. Great stuff.

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This HND article takes up where we left off, around five years ago. In this offering, we get into the chemistry and mechanism of how PAA kills those microbes, along with the many advantages of this germicide.

After that, we segue into safety and regulatory issues, and conclude with a look at available monitoring systems for this compound.

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This HND piece revisits a topic last covered by us in February, 2016. In this piece, we go beyond the basics, and highlight an interesting new finding (hence the title).

We feature comments made by popular physician Julie Vu, and also question her reference to the tired "watch your sodium" platitude. Not only are most people not too affected by sodium in the diet, the more important parameter is the sodium/potassium ratio—and there are plenty of foods rich in potassium.

The good news involves the simple matter of taking your blood pressure at home. There are benefits!

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This HND piece is a guest column from Steve Schuster, CEO of Innovative Anesthesia, with decades of experience in healthcare.

My friend Schuster gets right to the point: What do the people want? Most surveys indicate overwhelmingly that people want health care services when they need it, at minimal out-of-pocket costs. He also destroys the myth of a "market" for healthcare:

There is no "market" for health care. People get sick, go the doctor and expect a way to get better, without worrying about prices or costs. All they want is to get better, and they have neither the time nor the ability to shop for the lowest cost or price. Couple this with the fact that most get health insurance from their employer and do not think they are spending their own money, one can readily see that a "market" does not exist.

But, the best part is his wonderful plan to fix health insurance.

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