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C2-AI reports on progress in identifying positive outcomes in the hospital setting vs. problem areas and how to identify these issues. This represents a very real breakthrough in quantitating best practices and searching out problem areas:

Using our established systems which risk-adjust for the case-mix of patients and their comorbidities, C2-Ai’s regular detailed analysis across multiple hospitals in our global network (inc. in the UK) has identified:

Major variations in Covid-19 care between hospitals
The factors that most influence patient outcomes Cambridge-based C2-Ai, one of ‘10 Essential Digital Health Ideas for COVID-19’ - Healthcare UK, has award- winning systems that benchmark individual and Trust performance, built around 140m records from 46 countries. We are approaching you prior to publication of our findings to drive your region forward and help position the NHS and British innovation at the forefront of effective COVID-19 management internationally. We propose:
- An immediate wider deployment of this validated system that is already providing accurate analysis of hospital COVID-19 performance, outcomes and issues - with deliverable solutions and the benefit of supporting a comprehensive plan to have the NHS insulated from the worst of ‘Wave 2’. No integration required.
- Immediate tactical deployment of approved, rapid triage tools that free up to 20% of CCU capacity, can reduce deaths by 500 and save £7m per hospital (‘phenomenal and works incredibly fast’ – NHS Consultant).

DISCUSSION

Raw hospital mortality rates for Covid-19 (which may vary from 20% to 40%+) do not reflect the underlying case-mix of patients treated, how seriously ill they are on admission and other conditions they may have. This makes it impossible to understand variations in performance between hospitals, identify those that are managing Covid-19 most effectively (and why), and drive down mortality and harm.
C2-Ai award-winning systems resolve this challenge - uniquely reporting patient-level, risk-adjusted outcomes in hospital care, identifying best practice, problems, root causes and solutions. Today’s standard hospital reporting has been shown to provide visibility on as little as 10% of the issues we track.
Detailed findings across our NHS and other partner hospitals to date have confirmed specific areas of concern linked to mortality while also dispelling some myths.
This is not a new idea or a request for data. The systems have been delivering in 11 countries for 10 years, including the US and NHS. They have been used for detailed analysis and surveillance nationally e.g. by Sir Bruce Keogh and Sir Mike Richards.
We have the largest patient dataset in the World (140m records from 46 countries), have the highest access to NHS Digital Data already and have spent years developing and validating these unique solutions with hospitals like Imperial and Karolinska.

Scalpel Blade Safety remains a problem in O.R.’s around the world.

Operating theatres are the second most common site for Sharps injuries[1] and the second most common injury reported in this environment are scalpel cuts, accounting for 7% of the total number of reported injuries [2]. The risks to the surgical staff and downstream workers are well documented and can be grouped under the following headings:

Infection – HIV / AIDS, Hepatitis B, Hepatitis C, etc.
Physical Trauma – in particular to a digital artery or nerve or a tendon (of either a hand or a foot)
Psychological trauma.
Cost – 15 years ago, the cost of an uncomplicated injury was estimated to range from US$500 [3] to US$2,000 and US$50,000 to US$100,000 for an injury requiring microsurgery and up to 3 months of rehabilitation (This is probably a gross underestimate when loss of salary for a private surgeon is considered.) To date the highest reported litigation is US$12.2 million[4], paid to a doctor who contracted HIV from a sharps injury.
Syringes are the most common type of injury, however, the incidence of scalpel injuries is much higher [5].

A NEW WAY OF THINKING

Surgeons are continuing to refuse to use safety scalpels - citing patient safety as their reason - lack of correct balance and feel, obstructed vision, limited range of choice
- Staff continuing to be at risk of potentially preventable injuries.
- Nursing staff and OSHA compliance staff are left with the impossible job of trying to make hospitals comply with safety regulations [6]
Safety scalpels are unproven. There is no evidence that they prevent injuries.
- A huge systematic literature review conducted by the Australian College of Surgeons found absolutely no evidence that safety scalpels prevented injuries [7]
Safety scalpels may be more dangerous than traditional reusable metal handles.
- The original data used to support safety scalpels was mis-interpreted. On review it actually shows the injury incidence was two to four times higher for safety scalpels than the incidence for the standard metal handle [8]
- In a recent publication pushing for greater uptake of safety scalpels it was noted that the number of injures was the same for both safety scalpels and traditional scalpels - again the incidence of injury with a safety scalpel must be much higher because traditional reusable metal handles are still the most common in use in US operating theatres. [9]
Single-handed scalpel blade removers and traditional handles remain the safer alternative in many situations.
- They are OSHA compliant
- CDC studies show that up to 87% of active medical devices are not activated. Safety scalpels are active devices and therefore the risk of not activating is still significant. [10]
- Based on the above CDC research, Fuentes et al. show that combining a single-handed scalpel blade remover and a hands-free-technique (such as a passing tray or neutral zone) is up to five times safer than a safety scalpel. (This is best explained by knowledge of "active" vs. "passive" safety devices.) [11]
- Use of a single-handed scalpel blade remover & a hands-free-technique will ensure optimal staff safety AND optimal patient safety.