By ThinkReliability Staff

Think you (or a family member) might have the swine flu? Conventional wisdom might say to get to the doctor, stat. However, that may not be the recommended action. Public health officials and other medical experts are concerned that if the swine flu reaches epidemic proportions, the health system may be overwhelmed. Additionally, there is a concern that a person who has seasonal flu or a cold might go to the doctor believing it’s swine flu . . . and catch swine flu in the doctor’s office from the ill people there.

So, here we have two potential impacts to the goals. First, the public safety goal is impacted because of the potential that the public won’t be able to be effectively treated. This might occur if medical facilities are overwhelmed, by both patients who require treatment and patients who do not require treatment coming to the facilities. Patients who do not require treatment may come to the facilities because they are not certain if they require care.

The patient safety goal is impacted because patients might contract the swine flu. This could occur when patients go to a medical facility and there are patients there who have swine flu. The patients might go to the medical facility if they believe they have swine flu and are uncertain if they require medical care.

These causes are shown in the Cause Map above. Any cause on the cause map can have a solution; however, in this case there is one cause common to both impacts to the goals. Thus, mitigating this cause reduces the impacts to both goals. But how do we help patients determine whether or not they need medical care? Microsoft Corporation, along with doctors from Emory University, have developed a swine flu on-line questionnaire that can help you determine whether you require medical treatment. Hopefully this tool can help keep some patients who don’t require treatment out of medical facilities, and from contracting swine flu if they didn’t already have it.

By Kim Smiley

According to the CDC, drug poisoning is now the second leading cause of unintentional death, after car crashes.  Most of the drug poisoning deaths result from the abuse of illegal and prescription drugs.  If we look at an extremely basic cause-and-effect for overdose of prescription drugs, we note that a patient overdoses (takes too many pills) for some situationally-dependent reason (such as increasing the amount of medication to provide additional benefit, as can occur with painkiller addiction) AND access to an increased amount of the medication.  Many times the access to the medication is provided by “doctor-shopping”, where a patient sees multiple doctors for painkiller prescriptions. 

Databases that track these sorts of prescriptions have been implemented in most states to curb access to large amounts of the most frequently abused drugs.  However, since the programs are state-run, patients could still get multiple prescriptions by crossing state lines.  Also, in some states it may take as long as two weeks before a new prescription shows up in a database, creating extra time for addicts to collect prescriptions.

This is an example of a case where a solution has been implemented, but it  hasn’t reduced the risk to an acceptable level (as evidenced by the thousands of people still dying from prescription drug overdoses).  So, the solution is being tweaked.  The federal government has provided funding to states to upgrade their databases.  It’s hoped that this will start to decrease the number of deaths from prescription drug abuse.  If it doesn’t, even more drastic action will be needed.