Coalition Report Focuses on Care at the End of Life

A new report from the National Coalition on Health Care released on October 12 emphasizes that the quality of care provided to dying patients can be improved dramatically. The coalition report notes that many Americans who die of terminal illness suffer pain and other distress that could be relieved through existing knowledge, programs and therapies. Nine institutions and organizations are profiled in the report as examples of what has been done in the health care system to provide quality care to dying patients. These best practices can, and should, be replicated throughout the country so that similar programs are available to all dying patients, according to Donald M. Berwick, M.D., M.P.P., president and chief executive officer of the Institute for Healthcare Improvement. The report is available by calling 202-638-7151 and will be posted on the coalition's Web site at http://www.nchc.org.

AHRQ Urges Research on Bioterrorism Threat

The Agency for Healthcare Research and Quality (AHRQ) has announced new support for assessing and improving the U.S. health care system's capacity to respond to potential bioterrorism. The $5 million initiative is part of a broad effort by the U.S. Department of Health and Human Services and other federal agencies against bioterrorism. The initiative will focus on clinical preparedness of health care professionals and health care systems. Clinical training and the ability of front-line medical staff, including primary care physicians, emergency departments and hospitals, to detect and respond to possible threats will be examined. “This research will help clinicians, hospitals and other parts of the health care system detect and respond more quickly in the event of a bioterrorist incident,” said AHRQ Director John M. Eisenberg, M.D. “We need to think about how we would handle the unthinkable.”

AAFP Members Deliver Care Packages to Azerbaijan

A delegation consisting of 11 family physicians and 14 other volunteers recently returned from the former Soviet republic of Azerbaijan, where it delivered $1.9 million worth of medicine and medical supplies. The country of 8 million people in southwest Asia, located on the Caspian Sea, includes 1 million refugees who will benefit from the supplies. The aid came from Physicians With Heart, a collaborative effort of the AAFP, AAFP Foundation and Heart to Heart International, a humanitarian aid organization based in Olathe, Kan. The partnership's mission is to mobilize resources to improve health, to provide medical education and to foster the development of family practice worldwide. The Azerbaijan project was the eighth annual airlift by Physicians With Heart. “Each Physicians With Heart trip brings help to people much of the world doesn't know about,” said Mary Lynass, M.D., Scottsdale, Ariz., who made the journey with Physicians With Heart for the second time. “The people hear from us that there is someone out there who knows their situation, who remembers them. They are not invisible. We come to shake their hands and say we care. It's not just about the medicine.” For more information on the airlift, visit the AAFP Web site at https://www.aafp.org/airlift/2000.

HHS Creates Organ Transplant Advisory Panel

Department of Health and Human Services (HHS) Secretary Donna E. Shalala has announced the creation of an advisory committee on organ transplant to increase involvement in the department's oversight of transplant policy. The new committee will independently review revised organ allocation policies being developed by the U.S. transplant network. Creation of the committee was recommended by the Institute of Medicine (IOM) in a 1998 congressional report. Current regulations require that transplant policies ensure the best interest of patients. Performance standards to facilitate this are included in the HHS regulation. In particular, the IOM called for sharing livers for transplant across broader population areas to ensure that livers are provided to patients with greatest medical need, as determined by transplant physicians. In addition to reviewing policy, the advisory committee will examine transplant data needs, ethical issues and coverage and finance issues. For more information, visit the HHS Web site at http://www.hhs.gov.

Healthy People Encouraged to Wait for Influenza Vaccine

Because of a delay in the manufacture of the influenza vaccine this year, physicians are being instructed by Surgeon General David Satcher, M.D., to advise young, healthy people to wait until December to receive influenza vaccine. According to Dr. Satcher, physicians should focus first on immunizing high-risk patients. Influenza kills, on average, 20,000 people a year in the United States and puts 100,000 in the hospital. According to the report, high-risk groups include anyone over the age of 65; anyone suffering immune suppression associated with cancer treatments, human immunodeficiency virus infection or some other cause; any woman who will be past the first trimester of pregnancy during influenza season; and health care workers and others in regular contact with people at high risk. Influenza season normally peaks in January and lasts through March, so postponing vaccination until December will leave plenty of time for immunity to take effect, according to the Centers for Disease Control and Prevention.