“Top Performer” Hospitals

The Joint Commission, the leading accreditor of health care organizations in the United States, has designated Mount Sinai Beth Israel, Mount Sinai St. Luke’s, and Mount Sinai Roosevelt as “Top Performers on Key Quality Measures,” based on data from 2013.

The “Top Performer” program recognizes institutions for improving performance on evidence-based interventions that increase the likelihood of good medical outcomes for patients with certain conditions. As “Top Performers,” the hospitals will be included in The Joint Commission’s America’s Hospitals: Improving Quality and Safety, an online annual report found at http://bit.ly/1xMz5qM and also on The Joint Commission’s Quality Check® website.

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Doctors Hesitate to Ask Heart Patients about End-of-Life Plans

An NPR story noted: “Of the 5 million Americans with failing hearts, about half of them will die within five years of getting diagnosed. Given the odds, it seems that people with heart failure should start thinking about how they want to die. But doctors don’t routinely talk to those patients about end-of-life planning.”

“When researchers asked 50 doctors and 45 nurse practitioners and physician assistants how often they discuss preparing for death with their heart failure patients. A third of the providers said they lacked confidence in talking about end-of-life care. Only 12 percent said they have routine yearly discussions about the end of life.” Read more

The Path of Least [Antibiotic] Resistance

The Brookings Institution article noted: “While antibiotics are necessary and crucial for treating bacterial infections, their misuse over time has contributed to a rather alarming rate of antibiotic resistance, including the development of multidrug-resistance bacteria or ‘super bugs.’ Misuse manifests throughout all corners of public and private life; from the doctor’s office when prescribed to treat viruses; to industrial agriculture, where they are used in abundance to prevent disease in livestock.” Read more

Hospitals Put Pharmacists in the ER to Cut Medication Errors

The NPR story noted: “In the emergency department at Children’s Medical Center in Dallas, pharmacists who specialize in emergency medicine review each medication to make sure it’s the right one in the right dose. It’s part of the hospital’s efforts to cut down on medication errors and dangerous drug interactions, which contribute to more than 7,000 deaths across the country each year.”

“Medication errors can be caused by something as simple as bad handwriting, confusion between drugs with similar names, poor packaging design or confusion between metric or other dosing units, according to the Food and Drug Administration. But they’re often due to a combination of factors, which makes them harder to prevent.” Read more

Health-Care Providers Want Patients to Read Medical Records, Spot Errors 

The Wall Street Journal article noted: “The aim is to move patients and doctors into a relationship of shared accountability. Health-care providers are giving patients more access to their medical records so they can help spot and correct errors and omissions.”

“Studies show errors can occur on as many as 95% of the medication lists found in patient medical records. Errors include outdated data and omissions that many patients could readily identify, including prescription drugs that are no longer taken and incorrect data about frequency or dosage. Patients also are being asked to fill in the blanks about pain relievers and other over-the-counter medications, as well as supplements and vitamins, all of which can interact with prescription drugs.” Read more

“Post-Hospital Syndrome.”

The New York Times article noted “In a 2013 paper, Dr. Harlan Krumholz, a professor of medicine and public health at Yale School of Medicine, described a syndrome that emerges in the days and weeks after a hospital stay: ‘Physiologic systems are impaired, reserves are depleted, and the body cannot effectively avoid or mitigate health threats.’ He called this period of vulnerability ‘post-hospital syndrome.’”

“The syndrome was identified as a result of new Medicare rules that hold hospitals responsible for re-admissions within 30 days after discharge. When health systems began studying patients who returned to the hospital soon after discharge, two critical facts emerged. First, the problem is common and widespread, occurring after nearly one in five hospitalizations of patients on Medicare. Second, and even more surprising, the majority of cases represent an illness distinct from the initial hospitalization.” Read more

7 Things You Should Absolutely Know before Going to the Hospital

The Huffington Post article noted : “Let’s be honest: No one goes to the hospital to relax. Getting there, whether for a medical emergency or a scheduled appointment, is overwhelming — especially when you’re worried about a loved one. And once you arrive, the situation only seems to feel more tense.”

“If you happen to end up in the hospital (either with a loved one or for yourself), these tips will help you feel calm and in control. Below are seven things you should know before making a hospital visit. Read more

The Foreign Language of Health Insurance

The Kaiser Health News article noted “As soon as Deb Emerson, a former high school teacher from Oroville, Calif., bought a health plan in January through the state’s insurance exchange, she felt overwhelmed.”

“She couldn’t figure out what was covered and what wasn’t. Why weren’t her anti-depressant medications included? Why did she have to pay $60 to see a doctor? The insurance jargon – deductible, co-pay, premium, co-insurance – was like a foreign language. What did it mean?”

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Shift from Fee-for-Service Medical Care to Fee-for-Quality

The Forbes article noted “If you didn’t know it, the key intent of Affordable Care Act is to shift medical care from fee-for-service to fee-for-quality.”

“For too long, hospitals have gorged on referrals into their systems and walk-ins to their emergency rooms. But besides electronic medical records—a low hanging fruit–hospitals are hailed widely as being inefficient and sloppy. But the game changes when hospitals start getting paid for how many people they heal, not how many people they process. Think: outcomes not transactions.”

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