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January 27, 2010 -- Hospital Impact has been ranked one of the top 50 healthcare blogs by Wikio.
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by Christopher Cornue
Most likely, everyone is familiar with the Premier Demonstration Project of the past 4+ years. For those who are not … in summary, it was an opportunity for hospitals to voluntarily report their quality data to CMS through Premier, which would then be benchmarked against other hospitals. Each hospital would then be compared and would be eligible for additional payments if they achieved results in the top two deciles (20%) to baselines scores identified in Year 1 of the project. There was also an opportunity for hospitals to lose money if they fell in the bottom two deciles (bottom 20%) to baselines scores from Year 1. This project has continued beyond the original three years and will be expanding beyond the original areas of AMI, HF, Hip/Knees and Community Acquired Pneumonia.
by Tony Chen
Have 90 seconds to spare? Here are a few links on healthcare, hospitals, and innovation:
WSJ Health Blog: Overcrowded ER? Put patients in the hallway. Apparently, the data says it doesn't adversely impact quality. Nurses hate it, though some say that's exactly the point.
by Nick Jacobs
RAC is the magic bullet that CMS (Centers for Medicare and Medicaid Services) is using to describe the new federal Medicare Recovery Audit Contractor program that was officially started last week. RAC was started by the Medicare Modernization Act of 2003 to identify and correct improper payments. Third-party auditors get to keep a piece of the payments they identify and collect as inappropriate.
Not unlike the health care environment created during the Clinton Administration, there seems to be a natural assumption that hospitals are basically working day and night to game the system.
by Tony Chen
Many of you know Paul Levy, CEO of Boston's Beth Israel Deaconess Medical Center and Running a Hospital Blogger. He has long pushed for more transparency in healthcare and has led by example. He posts comments from staff, quality scores, and previously even asked if he makes too much money.
Well, this is a good moment to revisit transparency. Earlier today, there was an article in the Boston Globe about the various problems that this transparency has surfaced: firings, wrong-side surgeries, and this past week, a maternal death. WSJ piped in on the article this morning as well.
by Tony Chen
Apparently a lot more than we thought. Read this op-ed in the WSJ on an op-ed piece in the NYT. Here's the money quote from the article written by Newt Gingrinch, John Kerry, and the data-driven-decision-making GM of the Oakland A's:
America’s health care system behaves like a hidebound, tradition-based ball club that chases after aging sluggers and plays by the old rules: we pay too much and get too little in return. To deliver better health care, we should learn from the successful teams that have adopted baseball’s new evidence-based methods. The best way to start improving quality and lowering costs is to study the stats.
by Tony Chen
As I mentioned previously, I've been reading Management Lessons from Mayo Clinic and today was struck by Mayo's laser sharp focus on patient-centric care.
Now, of course, we've all heard about patient-centric care, but what is it really? Is it focusing on what the patient needs? or wants? And defined by who? (real example from the book) A physician who says "I can't take the time to answer your questions because then I won't be able to answer the questions of all my other patients" can actually believe that she is giving the patient what she needs, right? She is making herself available to a larger number of patients - isn't that what patients want? Patients don't think so. Isn't "patients first" always defined by the patient?
5 thoughts struck me after reading chapter 2:
1. Walk the talk, or just don't talk? If we "say" we are patient-centric with wearing lapel pins and in our marketing, and we don't deliver, isn't it that much more disappointing and disheartening for patients? Is it almost better not to put it out there publicly as a value until we can achieve it to a certain degree? The story of the non-patient-centric physician wearing the "patients first" lapel pin says it all.
by Nick Jacobs
The issue of how much to fund scientific and medical research continues to raise it's ugly head, and it has become painfully clear to me that the research system in this country is broken as well. Science needs desperately to study the disease mechanisms that represent underlying causation. Researchers and physicians must develop unique methodologies that can appropriately and seamlessly explore environmental causation's as well as primary genetics.
by Tony Chen
I've always heard people say that we in the hospital industry tend to have a "product-centric orientation, instead of a customer-centric one." Often times, that comment references the fact that we are typically structured organizationally by service line or by specialty, not by customer segment. For example, typical hospitals don't have a "Director of Services for Men in Their 30s and 40s." Sure, we offer screenings for prostate cancer, heart disease, and can deal with tennis elbow. We have primary care physicians, and we might even have fitness coaches. But a guy would literally have to bend the rules of the universe to get access to all of these services on the same day, in the same place. Yes, we have "women's services", but aren't these services primarily about OB/GYN services?
by Nick Jacobs
AOL ran a piece by Ashley Neglia entitled, “What Happens When We Die?” This article asks the question, “Is the mind an extension of the brain or its own entity?” This article was based on the work of Dr. Sam Parnia, a critical care physician who wrote the book of the same title. Through his work Dr. Parnia attempts to clarify what patients are experiencing during near death experiences.
According to the experts, it is absolutely clear that when the heart stops beating, the brain shuts down in about 10 seconds. Although the expectation is that brain activity would come to a complete stop as well, but anywhere from 10 to 20 percent of people who have actually gone through what is described as a clinical death still report some type of brain activity.
by Nick Jacobs
With the financial meltdown, a ground war in two countries, the oil crisis, and global warming all coming at us at once, it seems abundantly clear that the next president of the United States could very well be so wrapped up in this one of a kind Perfect Storm that, even if the Congress goes completely his way, it may not make much real difference to any of us. Of course we need to find a way to take care of the millions of uninsured in our own country, to help those of us who are about to lose our homes, to bring back our young fathers and husbands who are in harm's way in Afghanistan and Iraq, but with limited resources, entitlements are sure to suffer as the wars continue to drain the coffers.
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