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COMPENSATION: Nurse leader salary survey with 2015 data

Data from the second compensation survey conducted by the American Organization of Nurse Executives (AONE) – based on 2015 data – are summarized in this article.  The data are reported as the percentage that fall within ranges for different positions.  For example, the most frequently reported range for chief nursing officers in nonsystem hospitals is $250,000 or more (17 percent reported this).  CNOs in system hospitals were much more likely to be in this top salary band – 52 percent reported earning $250,000+.  Not surprisingly, nurse executives working for health systems in the corporate office, those in academic medical centers, and those in consulting firms were more likely to draw higher compensation.

Source: Kittner, A., and Thrall, T.H. (2016, October). AONE 2016 salary survey: Wide ranging compensation, strong satisfaction. Nurse Leader, 14(5), 311-316.  Click here for full text: http://www.nurseleader.com/article/S1541-4612(16)30112-4/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

BURNOUT: How managers can prevent it

Yes, another article on burnout, but I like the inclusion (in the magazine version of this article) of pithy bullet-point advice on how a manager can prevent burnout on his or her team.  Example: “Advocate for the resources your team needs to perform.”  Or, “Share what you’re learning and how you’re doing it.”  This is a quick read by a management coach.

Source: Valcour, M. (2016, Nov.). Managing yourself: Beating burnout. Harvard Business Review, 94(11), 98-101.  Click here: https://hbr.org/2016/11/beating-burnout  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

READMISSIONS: Community health workers help reduce

A readmission reduction program established by the University of Maryland St. Joseph Medical Center (Towson, Md.) in partnership with Maxim Healthcare is described in this brief article.  Prior to establishment of this home-based service, the hospital had 30-day readmission rates of 25 percent for high risk patients – which dropped to 10 percent about a year or so later.  It is staffed by nurse practitioners, RNs, and community health workers – who are considered key to the success of the program.

Planning Statistics: Program Experience (based on first 17 months)

  • 1600 assessments of high risk patients
  • 1200 of those patients agreed to participate in the program
  • 5 percent of hospital’s total discharges opt into the program
  • 15 community health workers were employed to care for the 1200 patients

Source: Whitman, E. (2016, Oct. 24). Deploying community health workers to reduce readmission rates. Modern Healthcare, 46(43), 32.  Click here for article published in slightly different version: http://www.modernhealthcare.com/article/20161022/magazine/310229996   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

EMERGENCY DEPARTMENT: Front door to hospital brings in 65 percent of admissions through the ED (US 2014 data)

These data are from the Emergency Department Benchmarking Alliance (EDBA) which in 2014 included responses from over 1,100 emergency departments in the United States.

The EDBA data survey over the last five years finds that between 65 and 68 percent of hospital inpatients are processed through the ED.  This reflects the role of the ED as the ‘front door’ of the hospital.

Percent of Patients Processed Through the ED

  • 58 percent (2004)
  • 61 percent (2005)
  • 61 percent (2006)
  • 62 percent (2007)
  • 64 percent (2008)
  • 65 percent (2009)
  • 66 percent (2010)
  • 67 percent (2011)
  • 68 percent (2012)
  • 68 percent (2013)
  • 65 percent (2014)

Source: Augustine, J.J. (2016, Apr. 13). National surveys on emergency department trends bring future improvements into focus. ACEP Now.  Click here:  http://www.acepnow.com/article/national-surveys-emergency-department-trends-bring-future-improvements-focus/?singlepage=1  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

CANCER: Merits of active surveillance – watchful waiting

The approach of active surveillance, which is increasingly common with prostate cancer patients, is becoming more frequently discussed as an option for selected patients with other types of slow-growing, early-stage cancers also.  The author, who himself opted for active surveillance, reviews reasons why watchful waiting may be becoming more often chosen – primarily due to therapy side effects and cost.  Considerations for insurers in framing their positions about active surveillance are covered.

Source: Kirkner, R.M. (2016, Oct.). Don’t just do something, stand there: How more types of cancer are lending themselves to active surveillance. Managed Care, 25(10), 25-28.  Click here: http://www.managedcaremag.com/archives/2016/10/don-t-just-do-something-stand-there-how-more-types-cancer-are-lending-themselves   Posted by AHA Resource Center (312) 422.2050, rc@aha.org

MORTALITY: US hospital mortality rate 1.89 percent in 2013

Data from the Healthcare Cost and Utilization Project (HCUP) are available on a great free online site that you can use to run state and national statistics on hospital utilization and cost by patient diagnosis or procedures.  It’s a collection of databases, which separately address the hospital inpatient setting, children in the hospital inpatient setting, the emergency department, readmissions, and state-specific data.

Recently, a caller to the AHA Resource Center asked for a national average for HOSPITAL MORTALITY RATE.  I decided to see what could be found on this in HCUPnet.  The following data are from the National Inpatient Sample (NIS) on HCUPnet.  Another nice feature of this database is that it contains all-payer data – not limited to Medicare data.

  • 1.89 percent (672,510 inhospital deaths based on records for 35.6 million discharges) in 2013

It is easy to re-do the same query on earlier years, so I did.  The results are consistent for the five most recent years (see below).  Likewise, the number of total discharges contained in each year of the data are consistent – at about 36 to 37 million.

U.S. Hospital Mortality Rate Trends: Most recent 5 years

  • 1.89 percent (2013)
  • 1.84 percent (2012)
  • 1.87 percent (2011)
  • 1.86 percent (2010)
  • 1.89 percent (2009)

Going back to the earliest available year – 1997 – the mortality rate was 2.45 percent.

Source: U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality.  HCUP national (nationwide) inpatient sample.  Click here: http://hcupnet.ahrq.gov  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

 

EMERGENCY DEPARTMENT: What is a warm handoff?

Reading Hospital (West Reading, PA) implemented a program in early 2016 referred to as a “warm handoff” intended to help patients who present in the emergency department with heroin or other opioid addiction.  The idea is to first care for whatever caused the patient to come to the ED and then connect the patient with a substance abuse treatment program.  If the patient is interested in accepting the warm handoff, the ED staff makes a connection to appropriate mental health staff.

The hospital website indicates that the Reading Hospital is one of the busiest EDs in Pennsylvania, with over 107,000 ED visits per year.  The warm handoff program is currently operating at about one patient every two days … so 182 warm handoff patients per year, by my calculation.  Or, 182 patients/107,000 visits = 170 warm handoff patients/100,000 ED visits, again by my calculation.

Sources:

Sandel, K. (2016, May 18). What is the ‘warm hand-off’ and how can it help Pennsylvania’s opioid abuse crisis? Pennsylvania Medical Society Quality and Value Blog. https://www.pamedsoc.org/tools-you-can-use/topics/quality-and-value-blog/BlogMay1816

Warm handoffs connect substance abuse patients to vital services. (2016, Oct.). ED Management, 28(10), 118-119. Click here for publisher website: https://www.ahcmedia.com/articles/138640  Posted by AHA Resource Center (312) 422-2050, rc@aha.org