Archive for April, 2009
Kentucky tackles MRSA
We tend to tackle MRSA hospital by hospital, but healthcare leaders in Kentucky are thinking differently. Instead of quietly submitting to mandatory reporting of hospital-acquired infections, Kentucky’s hospitals and the University of Louisville School of Public Health and information Sciences have come together to combat MRSA statewide, according to a HealthLeaders piece. They brought the effort both to hospitals, nursing homes, home health, first responders, correctional institutions, school and athletic groups.
Initially, the plan was to focus on rural hospitals, using funding through a rural grant, explains Elizabeth Cobb, MPH, vice president of health policy with the Kentucky Hospital Association. As discussions continued, however, the University of Louisville was brought into the loop, and funding from emergency preparedness grants came into play.
Adverse events may become public in New Jersey
A New Jersey bill currently going through legislature would make some information of “never” events available to the public online, according to an AARP Bulletin. Currently, New Jersey’s 73 acute care hospitals reports these never events under a confidential system. The public would be able to view data concerning 14 serious medical errors, including wrong-site surgery, post-surgical hemorrhage or infection, and blood transfusion problems.
The New Jersey Hospital Association supports this part of the bill, but is concerned about another part which would prevent hospitals and physicians from charging for treatments to repair mistakes-a section of the bill the New Jersey Medical Society, which represents physicians, opposes.
Urgent care centers prove their worth in wake of long ER lines
Lengthy wait times at emergency rooms (ER) around the country have given way to “urgent care centers,” alternatives to the ER for less severe ailments, reports the Los Angeles Times. In 2006, patients waited an average of 3.3 hours to be seen at the ER, according to a Centers for Disease Control and Prevention report. Urgent care centers offer those patients who do not have life threatening problems a chance to escape these long wait times and be treated medically faster than they would be by waiting to see a primary care physician.
The Urgent Care Association of America (UCAOA) reports that 8,000 urgent care centers existed as of 2008. However, these somewhat new options for care are for the most part unregulated. The UCAOA is drafting a list of what patients can expect at urgent care centers (hours, medical professionals who could work there, procedures that can be performed).
Insurers like the idea of urgent care centers because when patients visit urgent care centers, it often means insurers will not have to pay for what most likely would have been more costly ER visits. Many hospitals are scrambling to find ways to lessen ER wait-times for both patient satisfaction and patient safety needs. However, the LA Times article raises an important question—what if patients are unable to appropriately decide on the severity their symptoms?
Do you have any experience with urgent care centers in your community?
Preparedness over panic: Are you ready for the swine flu?
In just a few days, the swine flu outbreak has spread from Mexico to the U.S. and throughout the world. The Centers for Disease Control and Prevention (CDC) is tracking the disease’s path as cases are identified; as of this morning, 64 swine flu cases had been confirmed in the U.S., including 45 in New York City where students who returned from a trip to Mexico have spread it to others. In Mexico, authorities have reported 152 deaths related to swine flu .
The World Health Organization (WHO) has raised its phase of pandemic alert to 4, which indicates human-to-human transmission. The WHO is warning governments worldwide to prepare for a pandemic because cases have been identified in New Zealand and Israel.
So what should hospitals do to prepare? Probably the best thing to do at this point is simply to watch the alerts and follow CDC guidance. The CDC has published new guidelines outlining measures to take to mitigate the swine flu and for infection control when dealing with swine flu cases.
AHRQ looking for a few good hospitals
The Agency for Healthcare Research and Quality is seeking hospitals to take part in phase II of pilot testing for new patient safety indicators, which will run from May2009-September 2009. The indicators being tested include the following:
- Foreign body left in during procedure
- Postoperative Hemorrhage or Hematoma
- Postoperative Respiratory Failure
- Postoperative Physiologic and Metabolic Derangement
- Postoperative Wound Dehiscence
The AHRQ is trying to gather as much evidence as it can to show that these patient safety indicators are good ones, and also identify any potential changes to be made to the list.
If your organization is interested in being a pilot test site, you should be aware that the AHRQ has certain requirements of its pilot sites, which include some IT structure, personnel, and data collection needs.
To find out more about being a part of this pilot test, click here. Those hospitals interested in being a part of the pilot test must fill out a form (available at the above link), and send that filled-out form to the AHRQ by May 15.
Hot topics on the listserv
HCPro has a “Patient Safety Talk” listserv dedicated to all patient safety-related topics. It’s a pretty active listserv and is a great place to bounce ideas and questions off of colleagues.
Some of the most recent topics of discussion have been:
- Medication administration timing
- Therapeutic holds
- Latex safety
- Fall reduction programs
- Critical test results policies
Do these topics line up with concerns at your hospital? Usually there is a wide range of hot topics, and each month different issues are brought up for discussion. It’s a great forum for approaching your peers for their opinions.
If you would like to subscribe to Patient Safety Talk, please send an e-mail with your name, address, and company to owner-patientsafety_talk@hcpro.com.
Have a great weekend!
New study shows fewer patients see primary care doc while in hospital
A study published in today’s Journal of the American Medical Association highlights another interesting point about the continuum of care. I posted twice in the past couple of weeks about reducing rehospitalizations, (last week the CMS announced a pilot project to reduce readmissions) and often one indicator that a patient will avoid rehospitalization is if he or she already has a follow-up appointment booked with a primary care physician (PCP), or specialist after being discharged.
The new study shows that hospitalized Medicare patients age 66 and older are less often being visited by a PCP or other doctor with whom they have been in contact during the past year while during their hospital stays. The study examined enrollment and data claims and found that in 1996, 50.5% of patients in this age group were seen by at least one doctor with whom they’d had some contact with in the last year during a hospital stay. That percentage dropped to 39.8% in 2006. A similar trend occurs when looking specifically at visits by a PCP: in 1996 44.3 % of patients were visited by their PCP during a hospital stay and in 2006, only 31.9% were.
The authors of the study intended to examine the role of the continuum of care plays in keeping patients age 66 and older healthy. One reason for this decrease in visits by a PCP or specialist is the increase in the number of hospitalists that are present in hospitals today. Hospitalists often orchestrate a patient’s care while he or she is inside the hospital and may do some of the tasks that PCPs do when they visit a patient in the hospital.
Senate committee told healthcare must focus on coordination, quality of care
How would you improve the nation’s healthcare system? Focus on the prevention, coordination, and chronically sick patients, a panel of 13 physician, hospital, and insurance executives told the Senate Finance Committee today, according to Modern Healthcare.
The Senate committee was told that the U.S. needs to ensure an efficient healthcare system that prevents readmissions and pays physicians to work with patients before they get sick. The panel of healthcare advisors also stressed that coordination and integration of care was key, noting that the primary care physician plays an important role and would need to see a boost in reimbursement payments to adequately perform this role.
A member of the panel, Glenn Steele Jr., president of Geisinger Health System in Danville, PA, is set to release a study on reducing costs and improving care of the chronically ill, according to Modern Healthcare.
About one-third of surgeons suffer from burnout, study suggests
A new study in the Archives of Surgery has found that 30 – 38% of surgeons across the country suffer from burnouts, according to a piece in Wall Street Journal’s Health Blog.
The study suggests that younger surgeons and female surgeons are at especially high risk for stress and burnout, and found that a number of factors lead to its cause, including:
- Length of training
- Long hours and large workloads
- Imbalance between career and family
- Feeling of isolation
- Grief or guilt over patient death
- Insufficient research time and funding
- High self-imposed expectations
- An inefficient and/or hostile work environment
The study describes an attitude among surgeons that long hours and heavy workloads are expected and emotional responses are not, which researches say feeds stress and burnouts. The study concludes that being overworked is counterproductive and leads to self-destructive behavior that may affect quality of care.
Three patients test HIV positive after exposure to improperly sterilized equipment
Three patients in three separate Veterans Affairs hospitals have tested positive for HIV after being exposed to medical equipment that was not properly sterilized, reports FierceHealthcare.
The three patients were treated in Murfreesboro, TN; Augusta, GA; and Miami. More than 10,000 are being notified to be tested after potential exposure to endoscopic equipment that wasn’t properly sterilized.
The VA instituted a safety training campaign on the subject, and the manufacturers of the equipment said they are working with the VA to ensure healthcare workers are properly using and sterilizing such equipment.
