Today's Top Stories Also Noted: Spotlight On... Consumer's take on surgeon ratings; USC transplant program in trouble; HealthSouth CFO's punishment too mild?; and much more...
1. Conn. tackles hospital-acquired infections A new Connecticut law requires that all hospitals report infection rates by 2008. In the United States, hospital-acquired infections and other medical mistakes account for 98,000 deaths annually and increases healthcare costs by $4.5 billion. It's an important step, because hospitals rarely report infection rates on their own. Last year the Connecticut Hospital Association revealed only three infections statewide, yet the CDC estimates that at least 21,000 of the state's patients pick up an illness while at the hospital. Currently several states require reporting, including New York, Florida and Pennsylvania, but most still do not. Lowell Levin, an emeritus professor who works for the World Health Organization, was an early proponent of such measures. His 1985 book Medicine on Trial raised public awareness of hospital infections. "If we're going to attack these complications effectively we have to work on several fronts--management of personnel, including doctors and nurses, but first, the public has to be aware there's a problem. There's a need for public oversight, like this new law," Levin remarked to HealthCare Connecticut Online. He's in favor of infection reporting because it allows patients to choose the safest hospital, but it also drives overall infections down as hospitals compete to keep their facilities safe in the public eye. Under the new legislation, state infection rates will be reported annually, though Levin would like to eventually see them reported monthly. - to learn more about Connecticut's new law, check out this article 2. Less ambulance diversion means more profit Adding additional hospital beds to the ICU improves emergency care, reduces patient risks and increases hospital revenue. This is according to a study published in the Annals of Emergency Medicine, in which researchers spent two years monitoring the Oregon Health and Science University in Portland. The study reports that every hour of ambulance diversion time cost the hospital a hefty $1,100 dollars. But when more beds were added, the hospital earned an additional $175,000 monthly from ambulance patients. The study did not assess how much revenue the hospital lost by taking beds from other departments to add them to the ER. This seems to be a rare win-win situation for everyone involved. Patients that aren't diverted to another hospital benefit by receiving faster treatment and hospitals can increase their revenue by providing more access to emergency care. - see this Modern Healthcare report 3. End-of-life care drains healthcare spending A new study from the Mayo Clinic reports that intensive care accounts for 30 to 40 percent of hospital spending, with the majority of care given to elderly patients with chronic conditions. In Olmsted County, NY, where the Mayo Clinic is based, patients in the last year of life accounted for one of every four days spent in the ICU. Treatment in this expensive setting contributes to the overall rise in healthcare costs. In another recent conducted study by the Center for the Evaluative Clinical Sciences (CECS), the authors concluded that "a fundamental problem, and one that contributes to both overspending and worse outcomes, is that most acute care hospitals have become first-line providers of services to chronically-ill elderly people, whose care would be better managed, safer and less expensive outside the hospital setting." These studies call into question the best method for handling end-of-life care. Clearly, taking care of chronically ill patients in a hospital setting doesn't carry a substantial benefit for anyone involved. For one thing, it's a substantial drain on the Medicaid program, which is projected to run out of money by 2018. But this isn't simply a question of saving money to preserve federal funding. While elderly and chronically ill patients deserve the best care possible, often that doesn't mean more tests, more medications and longer hospitalizations. Instead, hospice care, nursing homes and palliative care could be more effective and financially responsible alternatives to expensive end-of-life ICU care. - read this Minneapolis/St. Paul Business Journal report for details on the Mayo Clinic study 4. Study assesses nurse satisfaction A new study aims to assess nurse satisfaction in a number of areas, including nutrition, housekeeping, facilities management, patient transport, patient lift teams, security, supply management and clinical equipment maintenance staff. The purpose of the project is standardize metrics that chief nursing officers can use to evaluate nurse satisfaction and, in turn, retention. The American Organization of Nurse Executives (AONE) hopes that the standards will "build a collaborative culture that will promote employee satisfaction and foster higher quality care delivery." The project commenced last month and will be completed by April 2007. Aramark Healthcare, the AONE Institute for Patient Care Research & Education and the Studer Group will all collaborate on the study. With many hospitals struggling to retain nurses--and states threatening to establish mandated nurse-to-patient ratios--expect the outcome of this study to draw a lot of attention. - take a look at the joint press release from the three groups participating in the study 5. Fitch reports high not-for-profit margins Fitch Ratings reports that not-for-profit hospitals are enjoying their highest margins since 1998. Operating margins improved 33.3 percent to 2.8 percent in 2005 from 2.1 percent in 2004. This is both good and bad news for the not-for-profit sector, which could face backlash from the IRS if it appears as though the hospitals aren't providing enough charity care to maintain their tax-exempt status. The issue is clearly front-of-mind for the IRS: Last month the tax agency launched an investigation into whether 550 hospitals deserved to keep their tax-exempt status. - see Fitch Rating's press release about the profit margins ALSO NOTED TODAY'S SPOTLIGHT... A consumer's take on surgeon rating > The Los Angeles Times reports that yet another transplant program--this time at USC University Hospital--is in trouble. Analysis of hospital statistics reveals that the USC liver transplant program's mortality rates are twice the national average. As FierceHealthcare readers already know, USC is just one of a growing number of hospitals facing transplant program problems. Report > A federal appeals court in Atlanta has thrown the sentence for former HealthSouth CFO Michael Martin. The court found the recommended seven-day sentence too short. Article (WSJ sub. req.) > Chutes & Ladders: HCA has named VA undersecretary of health Jonathan Perlin to the spot of senior vice president of quality and chief medical officer. Perlin has resigned from his position at the VA. Report > According to one report, 79 percent of physicians encourage patients to use the Internet for medical information. Most often, they recommend WebMD as a reputable online source. Release > Regulators in South Carolina have denied Presbyterian Healthcare's attempt to block Tenet's Piedmont Medical Center of Rock Hill to build a 100-bed hospital. Report > Behrman Capital has sold Tandem Healthcare to JER Partners and Formation Capital for $620 million. Florida-based Tandem owns or manages 77 facilities in 12 states. Report > North Carolina's Medicaid program actually spent $350 million from 2005 to 2006, less than originally anticipated. The state credits Medicare Part D for the savings. Article > The American Society for Healthcare Engineering is educating members on methods to reduce energy waste. The project is expected to save $65 million in energy costs in the first year alone. Report And Finally... How can a three-year-old tell a doctor how much pain he's in on a scale from one to five? Children have difficulty describing their pain levels, but a Phoenix Children's Hospital program has found a way around that problem. Report
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