“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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Fee-for-Service Thwarts Value-Based Care’s Intention

A Modern Healthcare article noted: ”Society wants the healthcare system to improve the population’s overall health while caring for the sick at a lower overall cost. The term of art is providing value-based care. Yet system leaders are stuck with a reimbursement system that still rewards volume through fee-for-service medicine.”

“Those differing approaches to providing healthcare—actually, only value-based care can truly be called healthcare since fee-for-service medicine is more properly called sick care—present providers with two diametrically opposed incentive schemes.” Read more

Hospitals’ Purchase of Doctors Leads to Higher Prices, Spending, Study Finds

A Kaiser Health News article noted: “A new study gives ammunition to what health economists and health insurers have argued for years: When hospitals buy physician practices, the result is usually higher hospital prices and increased spending by privately insured patients.”

“The study, published … in the journal Health Affairs, was based on an analysis of 2.1 million hospital claims from workers of self-insured employers between 2001 and 2007.  The analysis by Stanford University researchers found prices were most likely to increase when hospitals bought physician practices, as opposed to hospitals forming looser contractual relationships with physicians.” Read more

The Costs of 10 Top Commercially Insured Readmission Conditions

A Becker Hospital Review article noted: “Of the 10 most common readmissions conditions for patients with private insurance, chemotherapy resulted in the highest costs for hospitals, according to an Agency for Healthcare Research and Quality statistical brief.”

“Here are the costs of the 10 most common readmissions among the commercially insured, according to the AHRQ brief. Note: Costs were defined as the actual expenses incurred in the production of hospital services (such as wages, supplies and utility costs). A readmission was defined as a patient who was hospitalized within 30 days of a previous hospital admission. Read more

Hospitals Boost Patient Safety, but More Work Is Needed

A Kaiser Health News article noted: “Two major safety shortcomings in America’s hospitals—the frequency with which patients get hurt during their stays and the large number who are readmitted—have decreased as government penalties and other programs targeting them kick in.”

“The Obama administration credited the new quality initiatives created by the federal health law. But some of the improvements in patient safety preceded that law. Even with the improvements, one out of eight patients is injured during their time in the hospital.” Read more

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