Have a happy, safe Thanksgiving!

November 17, 2014

Evelyn McKnight and Lauren Lollini

Happy Thanksgiving!

Happy Thanksgiving!

Thanksgiving time is family time. We delight in family gatherings with lots of good food and great conversations. We at HONOReform wish you a wonderful Thanksgiving!

Sometimes life’s events mar even Thanksgiving, usually one of the happiest family times of the year. And when those life events are completely preventable, the disappointment is even greater.

Vicky is the daughter-in-law of one of the victims of the Nebraska Hepatitis C Outbreak of 2002. She explained the unrest that the outbreak caused in her family that Thanksgiving. Here is their story in Vicky’s words:

“Shortly after we learned that Dad tested positive for Hepatitis C, Mom called to say that they would not be coming to Thanksgiving at our house. I was shocked. Although Dad was fighting cancer, he was fairly active for an 80+ year old; he got out of the house regularly for errands and coffee with his friends. And above all, Mom and Dad loved spending time with the family, and the precious grandchildren were to be at the dinner.

When I pressed Mom for a reason, she was evasive, but finally she gave their reason: they didn’t want to risk transmitting the virus to any of the family. They were worried that by taking food off the same platters, perhaps an accidental reuse of forks or spoons would transmit the virus. Maybe even by being in the same room, the virus would be transmitted.”

Their concern was not uncommon among the community that autumn. The Nebraska Hepatitis C outbreak of 2002 was uncovered shortly before Thanksgiving. Public health officials determined that nurses at the Fremont Cancer Clinic reused syringes to access a large saline bag that was used for port flushes on many patients throughout the day. Because a patient with known Hepatitis C was treated at the clinic, the saline bag was contaminated with his blood, and therefore with Hepatitis C. Nebraska Health and Human Services notified the exposed patients, urging them to be tested for Hepatitis C, Hepatitis B and HIV. Of all the people who were tested, 99 were diagnosed with Hepatitis C, composing the largest outbreak of Hepatitis C from a single source in US history.

Because so many people in the community was affected by the outbreak, and because fear and ignorance about the disease was so rampant, it is likely that the conversation between Vicky and her in-laws was repeated in many households that Thanksgiving. Of course, viral hepatitis can ONLY be spread through blood-to-blood transmission, such as through unsafe injections. But at that time the community needed much education about this fact; the need for education about viral hepatitis continues to this day throughout the country.

Vicky went on to share:
“When I strongly assured Mom that the virus was not transmitted through the air or through saliva and that it could only be transmitted through blood, she was still reluctant. She said that even though that may be true, they didn’t want anyone to be uncomfortable by their presence. She thought it would be a jollier time for everyone else if they stayed home.

I told her no, it would not be a jolly time without you; all the family would all miss you too much. Iasked her to call her family physician and talk to him about the situation. After more argument, she finally agreed and said she would call back.

She did call back a week later and said that her family physician assured them it was safe for Dad to attend the family gathering and that they would be coming to Thanksgiving. But she was still worried for the others – worried that they would be uncomfortable with their presence. I offered to call each adult family member and assure them that they would not be at risk for contracting Hepatitis C from Dad at Thanksgiving dinner. She was very relieved by this and thanked me profusely.

We had a wonderful Thanksgiving gathering that year, perhaps made even more dear by our heightened concern and love for our dear Dad. We sat at the table a long time, reminiscing and telling family stories. It was a wonderful day, and my only regret was Mom and Dad’s worry, that nearly kept them from sharing that warm, loving family time with us.”

Vicky’s family had a lovely Thanksgiving that year, but not everyone who contracts disease through unsafe injections is so fortunate. Some will be too sick from their illness, others will let fear and worry keep them away from holiday gatherings. And all because of an illness which is completely preventable!

At your family gathering this year, do yourself and everyone else a favor. Share with your loved ones this advice from the One and Only Campaign:

In order to ensure that you are receiving safe injections, ask your healthcare providers the following questions before you receive an injection:

1.    Will there be a new needle, new syringe, and a new vial for this procedure or injection?
2.    Can you tell me how you prevent the spread of infections in your facility?
3.    What steps are you taking to keep me safe?

It’s very important to keep your eyes open because this could happen anywhere”

November 10, 2014

Evelyn McKnight and Lauren Lollini

Healthcare providers can be 'survivors' of unsafe injections

Healthcare providers can be ‘survivors’ of unsafe injections

 

Usually in this space we share stories from patients who have survived an unsafe injection. Today we are sharing the survival story of a physician who stopped colleagues from performing unsafe injections during her residency.

Here is Susan’s story

My story of improper injections is from my residency. I was in my third year of family practice residency in Minnesota and I was starting a procedures rotation. The attending physician and nurses were preparing for procedures that day – mainly mole removals and simple skin techniques. I noticed that after the first procedure the nurses took the needle off of the syringe and put a new needle on it in order to use the same syringe of anesthetic for the second patient.

I told them, “You can’t do that.”
They explained that because the attending physician was not drawing back it was actually safe to use the same syringe with a different needle.

I told them that it was NOT the case and then we put the needle and syringe into the sharps container. After class that day I spoke with the program director and several others at the residency. By the next week when I was back on that rotation the procedure had changed. I noticed that there was some conversation between the attending physician and the nurses about how that change had come about.

I was just shocked and appalled at the time. Residency is very stressful. In addition to the stress of learning so many things, I didn’t think I would have to be stressed about watching healthcare providers to make sure they were using proper injection technique. Its just very important to always keep your eyes open because this could happen anywhere.

HONOReform applauds the ongoing work of the Viral Hepatitis Implementation Group

November 3, 2014

Evelyn McKnight and Lauren Lollini

Viral Hepatitis Implementation Group met recently in Washington, DC

Viral Hepatitis Implementation Group met recently in Washington, DC

Kudos to our colleagues, including leadership of National Viral Hepatitis Roundtable (NVHR), for dedicated work on advancing the Viral Hepatitis Action Plan. An update from the recent meeting is included below.

On Tuesday, 10/14/14, the cross-government working group supporting and monitoring the implementation of the updated Viral Hepatitis Action Plan—the Viral Hepatitis Implementation Group or “VHIG”—met in Washington, DC to share updates on 2014 accomplishments and plans for the coming year. Some of the highlights included:
• Promising preliminary data from HRSA’s Bureau of Primary Health Care showing a significant increase in the number of hepatitis C tests conducted in health centers across the U.S. in 2013 and similar promising increases in HCV testing numbers from the Indian Health Service (IHS). read more »

Antibiotics and Injection Safety

October 27, 2014

Evelyn McKnight and Lauren Lollini

Lexington Insurance recently invited Tom and Evelyn McKnight to speak to Risk Management on injection safety

Lexington Insurance recently invited Tom and Evelyn McKnight to speak to Risk Management on injection safety

Tom and Evelyn McKnight were recently sponsored by Lexington Insurance to speak to hospital risk management on injection safety in Honolulu. While there, they learned about public health threats to the native Hawaiians through disease before antibiotics. Here are some of Tom’s thoughts about the importance of injection safety when delivering antibiotics.
Antibiotics and Injection Safety

Following is a written transcription of the video:

Aloha!
And welcome to the beautiful state of HI.
I’m tom mcknight and i’m a family physician. With my wife Evelyn, I am a co-founder of the organization HONOReform.

We have been invited to the state of Hawaii by AIG to speak to risk managers about injection safety.

As you might remember, the early days of the Hawaii were fraught with many diseases, many of which were brought by western civilization. Chicken pox, measles and even Hansen’s disease had a devastating effect on society. With the advent of antibiotics and injections in 1940’s and 1950’s, their health has become much safer.

But every injection needs to be a safe one. So our organization is promoting safe injection practices, because every injection needs to be handled and distributed properly.

So join with us and all of our co-sponsors in promoting needle injection safety.

Mahalo!

Same Problems, Different Virus

October 20, 2014

Evelyn McKnight and Lauren Lollini

Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.

Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.

If you are like many Americans out there with access to electricity or cell reception, you have been bombarded by the media attention to this ebola situation. I phrase it as a situation because I do not quite know how else to categorize it, yet. Typically, I am not one to catastrophize. And like my fellow patient safety advocates across the country, we are not surprised by the same things which might mortify the rest of our fellow Americans.

Why not, you ask? Because we have seen this all before, over and over again.
read more »

Tom McKnight reflects on 33 years of family practice

October 13, 2014

Evelyn McKnight and Lauren Lollini

Tom McKnight recently was named the Nebraska Family Physician of the Year at the Nebraska State Capitol

Tom McKnight recently was named the Nebraska Family Physician of the Year at the Nebraska State Capitol

It is a pleasure to announce that Dr. Thomas A. McKnight—Tom—a founding member of HONOReform and our medical director, was honored by Governor Dave Heineman on October 8, 2014. In a special proclamation, Tom was named “2014 Family Physician of the Year” in Nebraska. We are grateful for Tom’s ongoing leadership and guidance.
He is pictured with Representative Jeff Fortenberry and Governor Dave Heineman. The text of his talk is included here.

Thank you Gov Heineman, Representative Heineman, and the NE Academy of Family Physicians. I am humbled and honored by this award. I know that there are many deserving family physicians in our state that provide outstanding, compassionate care on a daily basis to Nebraska families.

I chose to go into family medicine because it provides the opportunity to be involved in peoples’ lives from birth to death. I’ve enjoyed family medicine because of the broad range of challenges emotionally and intellectually that each patient encounter brings. In my daily routine I often celebrate with new parents when they bring their baby to the doctor for the first time and then go to the next exam room to break the news to a married couple that the husband has terminal lung cancer and has only a few months to live. I have to say family medicine is as challenging and exciting now as it was 33 years ago when I started my practice.

After finishing medical school at UNMC i did my residency in Cedar Rapids, IA. I took a temporary position in the ER while we were waiting the birth of Luke. This gave me a chance to see a different side of medicine. It taught me that i wanted to develop long term relationships with patients and that i would only be fulfilled in having my own practice.

We volunteered for 6 months in various Native American Health Centers in NM, MT and AK before we settled in our new home in Fremont. This time period also allowed me to get licensure and staffing in place to open my solo practice in July, 1981. I still remember how happy but anxious i was to see my very first patient with brand new staff. Evelyn and I wonder if it was bravery or foolishness to have a new baby, buy a house, start a brand new practice with no patient base, all with no other income. It worked out. Fremont has been very supportive of us and it has been a marvelous place to practice medicine and raise a family.

The loyalty of my staff is unmatched. In the 33 years of practice 2 employees have been with me from the beginning, 6 have been with me 25 years or more and 9 have been with me for more than 10 years. We have 5 families who have two generations that serve patients with me. With all the stresses and changes in medicine, I think this is remarkable. It shows their dedication to caring for their friends and neighbors in Fremont. Their dedication goes beyond the time they spend at the office. They attend patients’ weddings and funerals, give baby showers for needy patients and organize fundraisers to help with patient’s medical bills. Most importantly they hold patients’ hands when they need a compassionate listener, share in the joy of a new baby and shed tears in the loss of a loved one. Patients know their dedication and i think that often they would rather see their favorite staff member than me. The same devotion the staff shows to our patients they extend to me and my family. They do their best to make my day run as smoothly as possible and that is not easy, given how many emergencies come up in one day. In the years of illness within my own family, they sent supper home with me every day for a year. They took our kids to their activities and hugged me through the time of my mother’s death. We will never forget your kindness and compassion.

The most important part of this journey is my family. They were patient and understanding when i was called from family life to attend to others’ needs. I was privileged to mentor all three sons during their medical education. It was marvelous to see their compassion and care of patients during their family medicine rotations. It gave them an understanding of my career. I’m honored that they have chosen medicine for their own career paths. Its rewarding and sometimes humorous to talk to them about their own patients. I got a phone call from Curtis the psychiatrist recently, asking me how to treat constipation!

The most important person here is Evelyn. She has stood by my side, been the most trusted confidante and understanding partner that i could have. She was the mother, often the father when i wasn’t able to be part of family life. She waited patiently for me many late nights to share the joys and sorrows of my day. I know how difficult it is and she continues to offer her support and love. I am eternally grateful.

Being involved with medical students throughout my career has been extremely rewarding. It is a source of continued stimulation and keeping up with the advancements of medicine. Sharing the joy of their first delivery or the satisfaction of suturing their first laceration gives me a warm feeling. Its interesting to show them private practice medicine and what it is like to be involved in a community. I love following their educational and career advancement and then have them as specialty consultants.

The patient doctor relationship is special. I am privileged to care for 4 generations of families. I am so humbled that they have placed their trust in me, many for 3 decades. We’ve gotten to know each other well and i feel like a part of their lives. They are a part of mine as well; they ask about my family and send me gifts and articles that they know i would like. This is really what family practice is about – caring for families through generations. It is a blessed coincidence that the first baby I delivered in Fremont in 1981 was JoAnne’s baby girl named Christine. I delivered Christine’s baby girl Caitlyn in 2011, the last baby I delivered.

Many things have changed in medicine in the years of my career. Immunizations now prevent many diseases that were devastating to families when i first started practice. I remember many nights interrupted by trips to the ER where i did spinal taps on children, looking for meningitis, which is now very uncommon with meningococus vaccine. We now have genomics to assist with cancer care and cardiovascular disease. We used to have to get hard copy medical journals to research new developments but now i can consult Medscape on my smartphone. Computerized medical records are replacing cumbersome paper charts and will allow patients to have their medical records anywhere in the world. Patients have changed also, for the better. They are more involved and knowledgeable about treatment options. They are full partners in their healthcare, which is better for them and healthcare providers. Patients know their bodies better than anyone and bringing this knowledge to the partnership makes for better health. We need to embrace these changes in technology and patient partnership.

I’ve enjoyed opportunities to serve in ways other than office medicine. Service trips to third world countries, membership on nonprofit boards, medical staff offices and our own patient safety foundation HONOReform has promoted my own personal growth. We have met so many wonderful, committed people in these endeavors. Their dedication inspires me.

Our own experience with medical error and the work of HONOReform has made me a better doctor because i understand both the doctor and the patient side of the relationship. I’m less defensive, more compassionate, and more grateful than i used to be. I’ve learned how to accept responsibility and do the right thing, even when that is a very difficult thing to do. To say “I’m sorry, this is not what i wanted for you” when my care of a patient did not turn out as planned is the right thing to do.

HONOReform is a national organization, and we stay very active here in Nebraska. If I could wish one thing for our state, it would be the adoption of a bill that emphasizes safe injection practices. We have seen many lives here in Nebraska (and throughout the country) altered or ended because of lack of adherence to injection safety. HONOReform is willing to roll up our sleeves and work with Nebraska lawmakers to put an injection safety bill in place. We believe this legislation is overdue.

For all of this, I thank you from the bottom of my heart. Our work is not done, we are eager to see what the next 33 years will bring.

How my 6 year old found the CDC website

October 6, 2014

Evelyn McKnight and Lauren Lollini

Lauren Lollini and her 6 year old daughter Lucy

Lauren and her 6 year old daughter Lucy

When I was infected with Hepatitis C, my daughter had just turned one. The devastation of such a horrendous diagnosis coupled with the new person who was now in my life was almost stranger than fiction. Now more than five years later, after a wild ride and a journey still in process, I have started to open up to my daughter and talk a bit about the drug diversion which caused my disease.

I know, I know, Lucy is only six and the idea of drug diversion seems a pretty intense subject for a first grader. But every so often she asks me to tell the story and I know which one she means. And as it is a very long story with many twists and turns, I always ask, which part?
read more »

It Takes Courage to Speak the Truth

September 29, 2014

Evelyn McKnight and Lauren Lollini

Lauren is the survivor of the 2009 Hepatitis C Outbreak in Colorado who chose to take a first step to passing legislation to make patients safer.

Lauren is the survivor of the 2009 Hepatitis C Outbreak in Colorado who chose to take a first step to passing legislation to make patients safer.

As a therapist, I often find myself congratulating clients for taking the first step as that is usually the most difficult. That first step might be making a phone call and asking about what resources are available for help or quite literally taking that first step into my office. So, too, do I congratulate the past contributors to our blog who have gone above and beyond to take that first step to share their stories. By speaking their truth, they have risked much, but were still undeterred.

You simply need to scroll back through the last few months and you will find many heroes who could no longer stay silent. Most recently, Anita Betrand shared her journey from addiction as a CRNA to that of an advocate speaking out so others can learn from her. Her struggle in and of itself was an arduous one, yet Anita chose to take that one next step to help educate so other healthcare workers finding themselves in a similar circumstance know there is a light at the end of the tunnel.
read more »

Sharing stories, transforming ourselves

September 22, 2014

Evelyn McKnight and Lauren Lollini

Evelyn McKnight, president of HONOReform

Evelyn McKnight, president of HONOReform

In my work as a patient safety advocate, I have had the great good fortune of meeting many people who share with others their tragic story of how they were affected by unsafe healthcare. Like my family, their families were hit with a Mack truck on the road of life when they went to the doctor seeking better health, but came away with a worse medical condition because of unsafe healthcare. Telling the story may be gut-wrenching – it can be like living a nightmare all over. But through sharing their stories, these brave men and women are able to transform their experience into something useful, rather than simply a horrible personal trauma. read more »

Sharing stories, transforming healthcare

September 15, 2014

Evelyn McKnight and Lauren Lollini

“If I look at the mass I will never act. If I look at the one, I will.”
- Mother Theresa

Evelyn McKnight, president of HONOReform

Evelyn McKnight, president of HONOReform

Tomorrow marks the one year anniversary of “Survivor’s Stories” blog. We thank you for your loyal readership, and we ask you to share with all your associates.

Today we want to thank the many people who have so graciously shared their personal stories with us. Thank you Barbara, Johnny, Mary, Amanda, Ron, Tom, Kim, Tom, Chuck, Melisa, Patty, Tam, Jan, Sharon, Joe, Karen, Rich and Anita for sharing your own story of how your life has been affected by unsafe injections. We know how difficult it can be to share such deeply personal stories with others, especially total strangers. We also know how vitally important it is.

The number of Americans that have been affected by unsafe injections in the past decade is staggering, reaching into the hundreds of thousands. Yet these numbers, although alarming, do not bring about change as readily as the story of the one. These numbers are dry statistics, “human beings with the tears dried off,” and fail to spark emotion or feeling and thus fail to motivate action. Social psychologists argue that this reflects the way our consciences and ethical systems are based on individual stories and are distinct from the parts of our brains concerned with logic and rationality. See “Psychic Numbing and Genocide” for more fascinating information on the numbing effect of impersonal data.

It is the personal stories that change hearts. And when hearts are changed, behaviors are changed. Healthcare becomes safer for all Americans.

I will never forget my first visit to Capitol Hill to visit my congressional delegation’s offices. Congressmen are busy people, and the staff that supports them is equally busy. When I first sat down with staffers, I could read distraction and disinterest in their faces. But as I told my story, they became transformed. They peered at me closely. They asked questions. They took notes. And by the end of the interview, they asked me what their boss could do to help and even made offers of what he would do that day.

Personal stories are powerful. When there is a face on an issue, it becomes real. It moves people to action.

I was very nervous the first time I told my story publicly, which was to a nursing class at Johns Hopkins School of Nursing. After the class, the professor said to me, “Today you have spoken to a hundred new nurses. After hearing you speak, they will never compromise patient safety. Through your story, you have made healthcare safer for all the patients that they will serve, which will be thousands upon thousands over the course of their careers.” The butterflies in my stomach flew away immediately, and after looking at it in this way, I have never been reluctant to share my story ever since.

Do you have a story to tell?
How would hearing your story motivate providers, policymakers and manufacturers to commit to safe injections?

Again, we thank all the many people who have shared with others how their lives have been affected by unsafe injections. And we ask those of you who have a story, but have not shared it, to let us help you tell your story. Contact me anytime at evelyn@honoreform.org. Thank you.

Next week we will discuss how sharing stories help the people who have been affected by unsafe injections.