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Study: 45% of ICU physicians suffering from severe burnout

Earlier this month, the Critical Care Societies Collaborative published a report simultaneously in the American Journal of Respiratory and Critical Care Medicine, Chest, the American Journal of Critical Care, Critical Care Medicine on the issue of burnout syndrome (BOS) in the ICU. The report defines BOS as when is when excessive and prolonged stress causes a state of emotional, mental, and physical exhaustion. Researchers found that 45% of critical care physicians and 25%-33% critical care nurses working in the U.S. are currently suffering from severe burnout.

“With more than 10,000 critical care physicians and 500,000 critical care nurses practicing in the United States, the effects of burnout syndrome in the ICU cannot be ignored,” says senior author Curt Sessler, MD. “We believe that protecting the mental and physical health of healthcare professionals who are at risk for burnout syndrome is vitally important for not only the professionals but for all stakeholders, including our patients.”

There are three main symptoms of BOS: exhaustion, depersonalization, and reduced personal accomplishment. There’s also a host of nonspecific symptoms such as the inability to feel happiness or contentment, and experiencing feelings of frustration, anger, fear, or anxiety.

To treat and prevent BOS, the study authors recommend: [more]

Joint Commission eliminates life safety Plans for Improvement

As of August 1, The Joint Commission will no longer accept hospital Plans for Improvement for life safety deficiencies identified by surveyors, the accreditor announced today. Hospitals will now have 60 days to fix any and all life safety deficiencies, unless they receive a waiver from a CMS regional office for additional time. The change was announced at the American Society of Healthcare Engineering (ASHE) annual conference by George Mills, director of engineering for The Joint Commission, according to an ASHE advisory alert. The change comes at the request of CMS, which had asked The Joint Commission to revise its Statements of Conditions process. Visit here for more information on the changes.

Joint Commission to test its stroke care performance measures in August

Stroke is the fourth leading cause of death in America, resulting in 133,103 deaths in 2014. In response, The Joint Commission is working a new performance measure set for its Advanced Certification Program for Acute Stroke Ready (ASR) Hospitals. The accreditor is working with both the American Heart Association and American Stroke Association on the development of the measure sets.

So far, the accreditor has developed two new performance measures for ASR hospitals and has updated several other stroke measures. Volunteer facilities will test the measures from August to November 2016, with results to be reviewed and finalized in 2017.

Click here to see the list of draft performance measures. 

Joint Commission releases checklist for new diagnostic imaging standards

Recently, The Joint Commission published an imaging compliance checklist to help healthcare organizations prepare for new standards that go into effect on September 1. The checklist can be used for self-assessment and survey preparation.

In February, the accreditor released prepublication standards for all facilities with diagnostic imaging services. The requirements address the minimum qualifications needed for personnel to conduct diagnostic computed tomography exams:

Click here to download the “The Imaging Compliance Checklist.” 

CMS begins oncology bundles

On July 1, nearly 200 group practices began a five-year demonstration program of CMS’s. The model’s goal is to improve the quality and decrease the costs of cancer care nationwide. Cancer is the second leading cause of death in America, with 22.5% of all deaths in 2014 resulting from some form of it. Meanwhile, the costs of cancer care are expected to rise to $158 billion in 2020, an increase of 27% over 2010.

“The Oncology Care Model encourages greater collaboration and information sharing so that cancer patients get the care they need,” said U.S. Department of Health and Human Services Secretary Sylvia M. Burwell, in an announcement. “This patient-centered care model furthers the goal of the Vice President’s Cancer Moonshot to improve coordination, care, and outcomes while spending dollars more wisely.”CMS Logo

Participating physicians will receive performance-based payments for caring for Medicare cancer patients under a bundled payment model. They’ll also receive a monthly care management payment for each beneficiary. Participating in the Oncology Care Model is 17 health insurance companies, more than 3,200 oncologists, and approximately 155,000 Medicare beneficiaries. The group practices involved will all follow nationally recognized clinical guidelines for chemotherapy, with improved services including: [more]

U.S. House passes mental health bill

On June 6, the House of Representatives passed the “Helping Families in Mental Health Crisis Act” by a 442-2 vote. The bill would allow CMS to reimburse providers for treating Medicaid patients’ mental health and physical health on the same day, increase the number of psychiatric hospital beds, and cut CMS spending by $5 million over 10 years. The bill was created and led by Rep. Tim Murphy, a licensed child psychologist, in response to the Sandy Hook shootings.

“This historic vote closes a tragic chapter in our nation’s treatment of serious mental illness and welcomes a new dawn of help and hope,” he said in a press release. “We are ending the era of stigma. Mental illness is no longer a joke, considered a moral defect and a reason to throw people in jail.”

The Senate is expected to vote on the bill by the end of the year.


Joint Commission updates hospital quality measures Specifications Manual

The Joint Commission recently published its updated Specifications Manual for National Hospital Inpatient Quality Measures.

CMS and The Joint Commission worked on the manual together to create a single set of documentation and create an identity amongst common hospital performance measures. The document includes measure sets for tobacco use, substance abuse, stroke, and venous thromboembolism and its release notes are applicable from July 1 through December 31.

ACS releases new standards for overlapping and concurrent surgeries

The American College of Surgeons (ACS) released a much anticipated update to its “Statements on Principles” addressing both concurrent and overlapping surgeries.
More than six months after a Spotlight Report from the Boston Globe into the concurrent surgeries at Massachusetts General Hospital, the ACS updates stipulate “a primary attending surgeon’s involvement in concurrent or simultaneous surgeries on two different patients in two different rooms is not appropriate.”

ACS also outlined two scenarios in which overlapping operations may occur. In both situations, the organization says patients must be informed of the overlapping surgery.
“The performance of overlapping procedures should not negatively impact the seamless and timely flow of either procedure,” the guidelines state.
Critics told the Boston Globe the changes did little to change unsafe surgical practices associated with double-booking surgeries.

Read the updated guidelines here and for the Boston Globe article, click here.


Joint Commission updates CT technologist prepublication standards

The Joint Commission announced that it was updating two standards involving advanced-level computed tomography (CT) certification. The accreditor had originally announced changes to the CT certification back in February and received several comments from customers concerned over the new minimum qualifications for CT technologists. In response to the feedback, The Joint Commission decided to delete one note and suspend one Element of Performance from the standards.

The prepublication standards for hospitals, critical access hospitals, and ambulatory care centers are now on The Joint Commission website. The standards go into effect on September 1, 2016.


CMS releases list of proposed rules, makes antibiotic stewardship mandatory

Last week, CMS published a list of proposed rule changes for hospitals and laboratories.  One of the more notable proposals would make antibiotic stewardship programs [ASP] mandatory. ASPs are viewed by many as a way to prevent antibiotic misuse and the spread of drug-resistant disease.

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“We propose to change the introductory paragraph [in Infection Control Condition of Participation §482.42] to require that a hospital’s infection prevention and control and antibiotic stewardship programs be active and hospitalwide for the surveillance, prevention, and control of HAIs and other infectious diseases, and for the optimization of antibiotic use through stewardship,” according to the proposed rule.

Only 40% of U.S. hospitals have an antibiotic stewardship program and an estimated 30% to 50% of prescribed antibiotics are unnecessary or inappropriate.  In the U.S., drug-resistant diseases cause 23,000 deaths and 2 million illnesses each year.

The document also changed included changes to patient rights, restraint usage, physician assistants, medical records, diet orders, periodic evaluations, and several more. To see the full list of changes, click here.

Healthcare professionals can comment on the proposed rules until 5 p.m. on August 15, 2016. Comments can be sent by traditional mail to CMS or done online.