October 13th, 2011 by RyanDuBosar in Research
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Hospitals that provide the lowest quality care at the highest cost care for more than twice the proportion of elderly minority and poor patients as the nation’s best performers, researchers found. And patients at the “worst” institutions are more likely than patients elsewhere to die of certain conditions, such as heart attacks and pneumonia.
These hospitals and their patients may be the ones most at risk under new Medicare payment arrangements that could cut payments to hospitals that fail to meet quality metrics, reported researchers from the Harvard School of Public Health.
The researchers examined how quality, costs and patients served correlated among 3,200 hospitals nationwide. They then identified 122 “best” hospitals, those that were in the highest quartile of quality and lowest quartile of risk-adjusted costs, and 178 “worst” hospitals, those in the lowest quartile of quality and the highest quartile of costs.
Hospital quality and performance data were Read more »
*This blog post was originally published at ACP Hospitalist*
September 25th, 2011 by Toni Brayer, M.D. in Health Policy
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I spent the day today with 60 physicians and nurses at a symposium focused on quality improvement and reducing mortality from sepsis. Sepsis (overwhelming infection) is the number 1 cause of hospital deaths and the mortality rate can be as high as 60% if the patient goes into shock from infection. Survival depends upon thousands of independent pieces coming together in an organized way. A patient doesn’t come to the emergency department and say “I have sepsis”. He may arrive by ambulance or be brought in by a relative and simply feel weak, or confused or have a fever.
To make the diagnosis, the doctor or nurse has to be thinking sepsis is a possibility and it is critical to get the right tests and treatments within a very short time frame. There are complicated steps that must be taken quickly and the entire hospital team (lab, pharmacy, transport, doctors and nurses) must act Read more »
*This blog post was originally published at EverythingHealth*
September 12th, 2011 by Monica Kriete in Health Policy
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How do you calibrate care so that it is neither too much nor too little? In this collection of recent posts, health care professionals search for that “just right” level of care.
“I bet celebrities and other VIPs (as they’re known in hospitals) get some of the worst healthcare in America. And, when I mean worst, I mean the most,” says Jay Parkinson in a recent post. Parkinson explores what is publically known about Apple’s CEO Steve Jobs’ care and calls specific attention to “incidentalomas.” Parkinson describes these asymptomatic tumors, sometimes discovered by especially aggressive care, and suggests that they may be over-treated, leading to poor health outcomes.
Mark W. Browne asks, Is the health quality bar set high enough? Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 11th, 2011 by DrWes in Health Policy, Opinion
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It was supposed to be one of a series of “measures to improve safety, reliability, patient experience, staff satisfaction and efficiency of medicine management.” Instead, the wearing of red “tabards” by nurses that read “Do Not Disturb” while they distributed medications has proven to be the straw that broke the camel’s back in England. While the “Do Not Disturb” message on the tabards was replaced with a message that reads “Drug Round in Progress,” isn’t the message the same?
Directive Number 99365.23a: “In the Name of Safety, Do Not Bother Me While I Hand Out Medications.”
It seems almost too incredible to believe and yet, this is how it’s playing out now in England’s National Health Service. Read more »
*This blog post was originally published at Dr. Wes*
July 2nd, 2011 by Happy Hospitalist in Health Policy, Opinion
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Over the last few years, you may have heard a lot about the value of checklists in ICU medicine and their ability to reduce mortality, reduce cost and reduce length of stay. But a recent study took the concept one step further and suggested that checklists by themselves may not be effective unless physicians are prompted to act on the checklist.
As reported in the American Journal of Respiratory and Critical Care Journal, a single site cohort study performed at Northwestern University Feinberg School of Medicine’s medical intensive care unit compared two rounding groups of physicians. One group was prompted to use the checklist. The other group of physicians had access to the checklist but were not prompted to use it.
What they found was shocking. Both groups had access to the checklist. However, patients followed by physicians who were prompted to use the checklist had Read more »
*This blog post was originally published at The Happy Hospitalist*
