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Physician Employment Trends in Health Systems

Trends in physician employment by health systems are illustrated by SK&A in 2 comparative maps — one for November 2011 and another for March 2014 — showing the changes in physician employment rates state by state over the past 3 years.

Generally, the upper midwest and New England regions of the country have the highest physician employment rates for health systems. Employment rates for 2014 ranged from 22% in Nevada to 73% in North Dakota.

Source: Physician employment trends in health systems. SK&A, March 2014. http://www.skainfo.com/integrated_health_systems/Physician_Employment_Map.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

EBOLA: How can hospitals prepare?

Epidemiologists are watching the outbreak of the Ebola virus in West Africa with concern.  There is no treatment for this disease, which results in the death of about three-quarters of those who contract it.  In the U.S., the Centers for Disease Control and Prevention (CDC) has worked up some resources.

From a CDC Informational Call — you can listen for free or read the transcript (see link below, under “Sources”)

CDC recommends some common-sense precautions in this call:

  1. Put the patient in isolation in private room with a private bathroom and keep the door closed — an airborne infection isolation room would be ideal
  2. Keep a log of who goes in the room
  3. Use disposable or dedicated medical equipment
  4. Everyone entering the room should were personal protective equipment–double gloving, disposable shoe covers, leg covers
  5. Everyone should take the personnel protective equipment off carefully

CDC Specific Guidelines for Hospitals

The above guidelines are summarized in chart form here: http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html#modalIdString_CDCTable_0

Emory has a special unit

Emory University Hospital (Atlanta, Ga.) has a Level 1 infectious diseases containment unit because of proximity to the CDC headquarters.  This is where the two health care workers who contracted Ebola in Africa are receiving care.

What happened at Carolinas Medical Center (Charlotte, N.C.)?

In late July 2014, Carolinas Medical Center closed a corridor in the emergency department until hospital officials were sure that a patient presenting with Ebola-like symptoms and a travel history of having been in Africa did not in fact have the disease.

RELATED: How Community Hospital (Munster, IN) successfully handled MERS case

Middle East Respiratory Syndrome (MERS) was identified in Saudi Arabia in 2012 and has been expected to make an appearance in the U.S. ever since.  The first case here is said to have been identified in April 2014 at Community Hospital in Munster, Ind., near Chicago.  A key to the successful treatment and containment in this case was alertness of staff in getting a travel history and then application of the hospital’s tracer-tag system (tags are worn by employees) to see who had been in contact with the patient.  The hospital also worked closely with the CDC in the handling of this patient.


[The CDC informational call].  What U.S. Hospitals Need to Know to Prepare for Ebola Virus Disease.  Centers for Disease Control and Prevention, Aug. 5, 2014.  Click here for access to these materials: http://emergency.cdc.gov/coca/transcripts/2014/call-transcript-080514.asp

[The Emory story].  How U.S. hospitals are preparing for Ebola: another ED goes into lockdown over an Ebola scare.  Daily Briefing, Aug. 4, 2014.  Click here for access to this story: http://www.advisory.com/daily-briefing/2014/08/04/how-us-hospitals-are-preparing-for-ebola

[The Carolinas Medical Center story].  An Ebola scare shut down a North Carolina ED: should the U.S. be worried?  Daily Briefing.  July 31, 2014.  Click here for access to this item: http://www.advisory.com/Daily-Briefing/2014/07/31/An-Ebola-scare-shut-down-a-North-Carolina-ED

[MERS at Community Hospital].  Rice, S.  Preparation, technology pay off  when Middle East virus arrives in the heartland.  Modern Healthcare.  44(19):8-9, May, 12, 2014.  Click here for access to publisher’s website: www.modernhealthcare.com  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

2014 Healthcare Supply Chain Management Salary Survey

According to an annual survey from the magazine Healthcare Purchasing News, the  overall average salary in healthcare supply chain management was of $87,365 in 2014,  a small dip from the 2013 average of $88,342. However, the salary is still a 25% increase over five years ago. The survey also reports average salaries for these supply chain positions:

  • Corporate/executive/senior VP, materials/supply chain management/support services
  • Administrator/CEO/COO
  • Director of materials management/materials manager
  • Contracts management
  • Value analysis coordinator
  • Contract/service line manager
  • MMIS/materials IT systems manager
  • Purchasing director/manager
  • OR materials/business manager
  • Assistant/other materials management
  • Purchasing agent
  • Senior buyer/buyer
  • Other

Compensation is also reported by years of experience, tenure at current facility, gender, education, type of facility, facility bed size, and geographic region. The direct reporting relationships and the type of professional certifications are indicated for survey respondents. The most common professional certification cited was a CMRP [certified materials & resources professional], and 41% of the supply chain professionals reported to the CFO.

Source: Barlow RD. 2014 SCM salary survey: Salary slip may be a reset button hit – mild dip may be no cause for alarm. Healthcare Purchasing News, Aug. 2014. http://www.hpnonline.com/inside/2014-08/1408-SCMSalarySurvey.pdf

Click here for 2013 survey post.

Posted by AHA Resource Center (312) 422-2003, rc@aha.org

DISASTER PREPAREDNESS: How to get the hospital ready for bad weather

This white paper presents a model for thinking about the components of a comprehensive strategy to get hospitals ready for destructive weather.  There are four layers of resilience outlined in this model:

  • Usable information for decision-making
  • Ensure continuity of health services
  • Create durable/resilient facilities (hardening structures, incremental adaptations, innovative practices)
  • Risk management (Joint Commission accreditation standards, insurance)

Each of these components, as well as the broader concept of community resilience, is discussed in this report.

Source: American Meteorological Society.  A Prescription for the 21st Century: Improving Resilience to High-Impact Weather for Healthcare Facilities and Services, Apr. 2014.  Click here for access to this white paper:  http://www2.ametsoc.org/ams/assets/File/health_workshop_report.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org


Physician-owned practices outperformed IDS-owned practices in Midwest study

This study, which I’m going to guess might have been conducted in the Twin Cities–although the location is identified only as a “large upper Midwest community”–surprised the authors.  But, it’s important to note that this study was not based on national data.  The authors examined data from 2008 and 2009 for a total of 273,000 enrollees covered by self-insured health plans.  The point was to compare the performance of medical group practices that were owned by an integrated delivery system (32 practices) versus those that were physician-owned (20 practices).

The findings were that the quality of care was pretty much the same regardless of whether the practices were part of an integrated delivery system or not.  However, the physician-owned practices often outperformed the IDS-owned practices as far as cost savings.  The authors comment that:

  • “This unexpected finding might result from difficulties encountered in creating a uniform culture in the large, complex health care delivery systems and the technology-intense culture of the hospital-based IDS practices.”

Source: Kralewski, J., Dowd, B., and others.  Do integrated health care systems provide lower-cost, high-quality care?  PEJ. Physician Executive.  40(2):14-18, Mar.-Apr. 2014.  Click here for access to this article:  http://www.acpe.org/docs/default-source/survey/do-integrated-health-care-systems-provide-lower-cost-higher-quality-care.pdf?sfvrsn=4  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Top 25 Integrated Health Systems – 2014

SK&A has updated its annual ranking of the largest 25 integrated health systems based on the total number of affiliated health facilities. Topping the list are Ascension Health, VA [Veterans Affairs] Health Systems, and Community Health System Inc. However, Kaiser Permanente has the most affiliated physicians, while HCA Inc. includes the most hospitals.

For each system listed, the headquarters state location is given along with the count of associated hospitals, medical offices/groups, nursing homes, physicians, and total facilities.

Source: Top 25 integrated health systems – SK&A market insight report. SK&A, 2014. http://www.skainfo.com/registration_OneKey.php [free registration required to view/download the report]

Related link: Top 25 integrated health systems – 2013

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Reduce air changes overnight in OR and save energy costs

This article describes changes in operating room design guidelines based on the new edition of the Facilities Guidelines Institute (FGI) 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities.  In this blog post, I’m highlighting just one factoid — mentioned by the Chair of the Revision Committee that prepared these new guidelines.  He mentions that SETBACKs are now allowed in the operation of the surgical suite.  This means that the number of AIR CHANGES can be reduced at times when the operating room is not in use — such as overnight.

I like it that the expert quantifies the potential savings — “You can set back the number of air changes per hour, maintain temperature and humidity, and save $10,000 to $15,000 per year per operating room in energy costs.”  He notes that there may be upfront costs in order to install the appropriate dampers or controls, but that the facility would recoup these installation costs quickly.


For optimal OR design, play by the rules and get expert advice.  OR Manager.  30(7):1, 7-9, 11, July 2014.  Click here for access to publisher’s website: http://www.ormanager.com/2014/06/16/for-optimal-or-design-play-by-the-rules-and-get-expert-advice/#.U_YP66PviSo

Here’s a link to the FGI Guidelines site: http://www.fgiguidelines.org/    Posted by AHA Resource Center (312) 422-2050 rc@aha.org



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