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Only 251 Hospitals Score Five Stars In Medicare’s New Ratings

May 29, 2015 Comments off

Only 251 Hospitals Score Five Stars In Medicare’s New Ratings
Source: Kaiser Family Foundation

In an effort to make comparing hospitals more like shopping for refrigerators and restaurants, the federal government has awarded its first star ratings to hospitals based on patients’ appraisals.

Many of the nation’s leading hospitals received middling ratings, while comparatively obscure local hospitals and others that specialized in lucrative surgeries frequently received the most stars.

Evaluating hospitals is becoming increasingly important as more insurance plans offer patients limited choices. Medicare already uses stars to rate nursing homes, dialysis centers and private Medicare Advantage insurance plans. While Medicare publishes more than 100 quality measures about hospitals on its Hospital Compare website, many are hard to decipher, and there is little evidence consumers use the site very much.

Many in the hospital industry fear Medicare’s five-star scale won’t accurately reflect quality and may place too much weight on patient reviews, which are just one measurement of hospital quality. Medicare also reports the results of hospital care, such as how many died or got infections during their stay, but those are not yet assigned stars.

Hospitals — Economic Contribution Often Overlooked (2015 Update)

May 19, 2015 Comments off

Economic Contribution Often Overlooked (2015 Update) (PDF)
Source: American Hospital Association

In 2013, America’s hospitals treated 134 million people in their emergency departments, provided care for 544 million other outpatients, performed almost 27 million surgeries, and delivered nearly 4 million babies. Every year, hospitals provide vital health care services like these to millions of people in thousands of communities. However, the importance of hospitals to their communities extends far beyond health care.

Progress With Electronic Health Record Adoption Among Emergency and Outpatient Departments: United States, 2006–2011

April 18, 2015 Comments off

Progress With Electronic Health Record Adoption Among Emergency and Outpatient Departments: United States, 2006–2011
Source: National Center for Health Statistics

Key findings

Data from the 2006–2011 National Hospital Ambulatory Medical Care Survey

  • In 2011, 84% of hospital emergency departments (EDs) used an electronic health record (EHR) system.
  • Adoption of a basic EHR system with a specific set of functionalities by EDs increased from 19% in 2007 to 54% in 2011.
  • In 2011, 73% of hospital outpatient departments (OPDs) used an EHR system, up from 29% in 2006.
  • Adoption of a basic EHR system with a specific set of functionalities by OPDs increased from 9% in 2007 to 57% in 2011.
  • From 2007 through 2011, adoption of Stage 1 Meaningful Use objectives by EDs and OPDs increased.In 2011, 14% of EDs and 16% of OPDs had EHR technology able to support nine Stage 1 Meaningful Use objectives.

Emergency Department Visits for Drug Poisoning: United States, 2008–2011

April 14, 2015 Comments off

Emergency Department Visits for Drug Poisoning: United States, 2008–2011
Source: Centers for Disease Control and Prevention

Key findings
Data from the National Hospital Ambulatory Medical Care Survey, 2008–2011

  • During 2008–2011, an average of 1.1 million emergency department (ED) visits were made each year for drug poisoning, with a visit rate of 35.4 per 10,000 persons.
  • The ED visit rate for drug poisoning was highest among persons aged 20–34. The rate declined with age after 20–34, and rates for those aged 0–19 were similar to those aged 50 and over.
  • Drug-poisoning ED visit rates did not differ by sex and age, with the exception of persons aged 35–49, where females had a higher visit rate than males. The ED visit rate for unintentional drug poisoning was higher than self-inflicted drug poisoning overall and for males, but did not differ for females.
  • About one-quarter (24.5%) of drug-poisoning ED visits resulted in hospital admission.

Alarms, Health IT, and Patient Violence Lead ECRI Institute’s 2015 List of Top 10 Patient Safety Concerns

April 8, 2015 Comments off

Alarms, Health IT, and Patient Violence Lead ECRI Institute’s 2015 List of Top 10 Patient Safety Concerns
Source: ECRI Institute

Patient safety is a top priority for every healthcare organization, but knowing where to direct initiatives can be daunting. To help organizations decide where to focus their efforts, ECRI Institute has compiled its second annual list of the Top 10 Patient Safety Concerns for Healthcare Organizations.

This year’s list includes:

  1. Alarm hazards: inadequate alarm configuration policies and practices
  2. Data integrity: incorrect or missing data in EHRs and other health IT systems
  3. Managing patient violence
  4. Mix-up of IV lines leading to misadministration of drugs and solutions
  5. Care coordination events related to medication reconciliation
  6. Failure to conduct independent double checks independently
  7. Opioid-related events
  8. Inadequate reprocessing of endoscopes and surgical instruments
  9. Inadequate patient handoffs related to patient transport
  10. Medication errors related to pounds and kilograms

free registration required2

Hat tip: PW

The Efficiency of Slacking Off: Evidence from the Emergency Department

April 2, 2015 Comments off

The Efficiency of Slacking Off: Evidence from the Emergency Department (PDF)
Source: National Bureau of Economic Research (via Stanford)

Work schedules play an important role in time-sensitive production utilizing workers interchangeably. Studying emergency department physicians in shift work, I find two types of strategic behavior induced by schedules. First, on an extensive margin, physicians “slack off” by accepting fewer patients near end of shift (EOS). Second, on an intensive margin, physicians distort patient care, incurring higher costs as they spend less time on patients accepted near EOS. I demonstrate a tradeoff between these two strategic behaviors, by examining how they change with shift overlap. Accounting for both costs of physician time and patient care, I find that physicians slack off at approximately second-best optimal levels.

UK — National Confidential Inquiry into Suicide and Homicide by People with Mental Illness

March 27, 2015 Comments off

National Confidential Inquiry into Suicide and Homicide by People with Mental Illness
Source: University of Manchester

We found 18 deaths by suicide per year in in-patients under observation across the UK during 2006-12. We found that half of deaths examined occurred when checks were carried out by less experienced staff or agency staff who were unfamiliar with the patient. A common feature was that staff did not follow the observation plan because the ward was busy or poorly designed. We found that the current observation approach is not working safely enough. New models need to be developed and evaluated.

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