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2019 National Health Care Governance Survey Report

A new AHA report provides a wealth of benchmarking data for hospital boards, answering questions about typical size of the hospital board, board diversity, term limits, board selection, orientation/education, evaluation, time commitment, and more.

The report includes data and commentary organized by these categories:

  • Board composition
  • Board structure and support
  • Board practices
  • Performance oversight
  • Board culture

Source: National health care governance survey report. American Hospital Association, 2019. https://trustees.aha.org/system/files/media/file/2019/06/aha-2019-governance-survey-report_v8-final.pdf

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

 

AMA Updated Data on Physician Practice Arrangements

Data from the American Medical Association’s Physician Practice Benchmark Surveys indicates for the first time ever that more physicians are employees rather than owners of medical practices. Physician employment has been an ongoing trend in recent years, but the AMA report indicates the pace of growth has slowed.

This latest report provides data and discussion of medical practices, covering their number, type, size, specialty, and ownership structure.

Source: Kane CK. Policy research perspectives. Updated data on physician practice arrangements: for the first time, fewer physicians are owners than employees. American Medical Association, 2019. https://www.ama-assn.org/system/files/2019-07/prp-fewer-owners-benchmark-survey-2018.pdf 

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

 

2017 National Nursing Workforce Survey

The National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers have published their latest joint biennial survey results on the nation’s nursing workforce. The report provides a statistical overview and discussion of both registered nurses [RN] and licensed practical/vocational nurses [LPN/LVN]. Survey findings cover these topics:

  • Size of the RN and LPN/LVN workforce nationally and by state
  • Aging of the workforce
  • Gender, race, and ethnic diversity
  • Education
  • Employment and salary
  • Telehealth use

Source: Smiley RA and others. The 2017 national nursing workforce survey. Journal of Nursing Regulation 9(3):S1-S88, Oct. 2018, updated Jan. 2019. https://www.journalofnursingregulation.com/article/S2155-8256(18)30131-5/fulltext

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

PATIENT FALLS: Canadian study evaluates rubber flooring in long-term care setting

Falls are a major health concern for older adults world-wide, particularly in long-term care (LTC), where approximately 60% of residents fall at least once per year, and 30% of falls cause injury…”

The value of installing a synthetic rubber flooring (compliant flooring) over a concrete floor was compared to plywood over concrete in this randomized trial conducted at one long term care facility in British Columbia.  There were 74 private rooms in the intervention group and 76 in the control group in this 4-year study.  The researchers concluded that the rubber flooring was “not effective for preventing serious fall-related injuries in LTC.”  This article includes interesting tables showing details about the nearly 2,000 patient falls recorded over a 4-year period in this one Canadian facility.  The vast majority of falls occurred in the patient room (excluding the bathroom).  Falls were most likely to occur in the evening and least likely to occur in the afternoon.  There were 85 falls resulting in serious injury,

Source: Mackey, D.C., and others. (2019, June 24). The Flooring for Injury Prevention (FLIP) study of compliant flooring for the prevention of fall-related injuries in long-term care: A randomized trial. PLoS Medicine, 16(6).  Click here for free full text:  https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1002843&type=printable  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

READMISSIONS: Diabetics with low blood sugar on last day of inpatient hospital stay are more likely to be readmitted

Potential approaches that may reduce the risk for readmission or death after discharge [for diabetes patients] include delaying patient release from the hospital until normoglycemia is achieved, modifying outpatient [diabetes] medications or advise patients to perform frequent glucose monitoring or use continuous glucose-monitoring devices.”

The relationship between low blood glucose levels and hospital readmission was studied in this large-scale analysis of over 800,000 admissions to Veteran Affairs hospitals over a period of 14 years. An inverse relationship was found – diabetic patients with low blood glucose levels (hypoglycemia) on the last day of a hospital inpatient stay were more likely to be readmitted to the hospital or to die within 180 days after discharge.

Source: Spanakis, E.K., and others. (2019, September). Association of glucose concentrations at hospital discharge with readmissions and mortality: A nationwide cohort study. JCEM. The Journal of Clinical Endocrinology & Metabolism, 104(9), 3679-3691. Click here for free full text:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642668/?report=printable  Posted by AHA Resource Center, (312) 422-2003, rc@aha.org

 

 

 

READMISSIONS: Hospital revisits data trends including emergency department visits and observation visits

Although readmissions for target conditions decreased from 2012 to 2015 in the US, total hospital revisits within 30 days of discharge steadily increased over that same period.”

Changes in total 30-day hospital revisits (including emergency department treat-and-discharge visits and observation stays as well as hospital readmissions) were studied for Medicare patients hospitalized with pneumonia, heart failure or acute myocardial infarction from January 2012 to September 2015.  A total of over 3 million original hospitalizations were studied.  Hospital readmissions decreased over the study period, but treat-and-discharge visits and observation stays increased.

Source: Wadhera, R.K., and others. (2019). Hospital revisits within 30 days after discharge for medical conditions targeted by the Hospital Readmissions Reduction Program in the United States: National retrospective analysis. BMJ. 366.  Click here for free full text:https://www.bmj.com/content/bmj/366/bmj.l4563.full.pdf  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

EMERGENCY: Which patients are likely to benefit the most from emergency care?

…we identified 51 condition groups most sensitive to emergency care, conditions where timely, high-quality emergency care is expected to make an impact on mortality and morbidity.”

A comprehensive list of emergency care sensitive conditions (ECSC) developed by an expert panel to represent adult patient conditions that are most appropriate for emergency care is the focus of this research article.  The conditions were then paired with national ED utilization data.  There were about 16 million (14 percent) of the roughly 114 million total ED visits in 2016 that were considered to be ECSC.  Here are the utilization data for the top 5 most frequent of these ECSC visits:

  • 10.7 percent of all ECSC visits were related to sepsis and SIRS
  •   7.9 percent were related to pneumonia
  •   7.9 percent were related to chronic obstructive pulmonary disease
  •   6.1 percent were related to asthma
  •   5.7 percent were related to heart failure

You can also determine those conditions that are most likely to be admitted after presenting in the ED.  Here are the 5 highest:

  • 94.8 percent of patients with sepsis and SIRS were admitted
  • 88.1 percent with respiratory failure
  • 83.9 percent with femur fractures
  • 80.0 percent with cerebral infarction
  • 79.7 percent with meningitis

Other patient disposition data and median emergency department charges are also included.

Source: Vashi, A.A., and others. (2019, August 7). Identification of emergency care-sensitive conditions and characteristics of emergency department utilization. JAMA Network Open, 2(8).  Click here for free full text:  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2747479 Posted by AHA Resource Center (312) 422-2003 rc@aha.org