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Top Patient Safety Concerns for Healthcare Organizations, 2014

To help healthcare organizations determine where to focus their patient safety efforts, the ECRI Institute has released a list of top 10 patient safety concerns. The current concerns identified and discussed are:

  1. Data integrity failures with health information technology systems
  2. Poor care coordination with patient’s next level of care
  3. Test results reporting errors
  4. Drug shortages
  5. Failure to adequately manage behavioral health patients in acute care settings
  6. Mislabeled specimens
  7. Retained devices and unretrieved fragments
  8. Patient falls while toileting
  9. Inadequate monitoring for respiratory depression in patients taking opioids
  10. Inadequate reprocessing of endoscopes and surgical instruments

The list is based on ECRI’s analysis of patient safety events and root cause analyses submitted to its federally designated patient safety organization, ECRI Institute PSO.

Source: ECRI Institute’s top 10 patient safety concerns for healthcare organizations 2014. ECRI Institute, April 2014. https://www.ecri.org/Forms/Pages/PSRQ_Top10.aspx [Free registration required for download]

Related resources:

2014 top 10 hospital C-suite watch list. ECRI Institute, 2014. https://www.ecri.org/Forms/Pages/2014-C-Suite-Watch-List.aspx

Top 10 health technology hazards for 2014. ECRI Institute, 2014. https://www.ecri.org/2014hazards

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

Number of Physician Offices by Size and State

How many physician offices are there in each state? What size are these medical offices? A new release by SK&A answers these questions.

The report lists the total number of physician offices in each state and breaks them down by size range based on the number of physicians located in the offices. The size ranges used are 1 physician; 2 physicians; 3-5 physicians; 6-9 physicians; 10-19 physicians; and 20 or more physicians.

The states are also ranked by the total number of physician offices. Not surprisingly, California, New York, Florida, Texas, and Pennsylvania top the list, while North Dakota is the state with the fewest medical office locations.

Source: U.S. physician office density report. SK&A, July 2013. http://www.skainfo.com/health_care_market_reports/physician_office_density.pdf

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

30 Largest Accountable Care Organizations

The marketing contacts firm SK&A has released a new ranking of the nation’s 30 largest ACOs based on the total number of physicians. Topping the list are:

  1. Partners Healthcare
  2. Valley Preferred Aetna
  3. Hill Phys/Dignity Health/UCSF Health Net.

Included in the list are the ACO headquarters city and state, the total number of facilities as well as physicians involved, and the type of ACO. The five ACO types used by SK&A are Medicare Shared Savings Program, commercial, look-alike [similar to Medicare ACOs but not Medicare-contracted], Medicaid, and Pioneer.

Source: Top 30 accountable care organizations. SK&A, Apr. 2014. http://www.skainfo.com/health_care_market_reports/ACO_Top30.pdf

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

EMERGENCY DEPARTMENTS: Is utilization declining? Why?

Some analysts predicted that implementation of the Affordable Care Act (ACA) would bring more patients to hospital emergency rooms, but there are recent reports from some hospitals that ED demand is falling off.  Please note that this article is a news report and NOT a scientific study or a survey.  But the thrust of the article is that there are reports that some ED administrators have experienced unexpected decreases in demand.  Why would this be?  Speculation is that patients who are not severely ill are making greater use of urgent care centers and other alternatives to the hospital emergency department.  Evidence to support this would be that some ED administrators note that admissions from the ED have been increasing.  In other words, patients who come to the ED are sicker as evidenced by a greater proportion who are admitted directly to inpatient care.  Another idea is that patients are still feeling the effects of the recession.  Of course, also, it is still very early in the ACA implementation process, so previously-uninsured patients may yet turn up at hospital EDs in number.

Source: Unexpected drop-offs in demand in some regions worry ED administrators.  ED Management;26(4):37-38, Apr. 2014.  Click here to access publisher’s website: http://www.ahcmedia.com/public/products/ED-Management.html  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

POPULATION HEALTH: Academic medical center’s role?

Ways in which academic medical centers (AMCs) can incorporate population health concepts into their more traditional mission are explored by the Chair of the Department of Population Health at NYU Langone Medical Center.  After defining the concept of “population health” and differentiating it from “public health,” Dr. Gourevitch discusses these areas of opportunities for AMCs:

  • Improving capacity for assuming population risk
  • Optimizing community benefit
  • Emerging models of care
  • Harnessing health information technology
  • Making employees into “health ambassadors” to their communities
  • Relating performance measures to population health
  • Broadening the scope of medical student education to include nonmedical influences on health
  • Integrating primary care and population health
  • Emphasizing downstream translational research
  • Fostering partnership with community
  • Building team science
  • Defining population health metrics
  • Measuring AMC impact on population health

Source:  Gourevitch, M.N. Population health and the academic medical center: the time is right. Academic Medicine;89(4):544-549, Apr. 2014.  Click here to access the publisher’s website:  http://journals.lww.com/academicmedicine/Abstract/2014/04000/Population_Health_and_the_Academic_Medical_Center_.13.aspx   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

OPERATING ROOMS: Flip room utilization can be 30 to 40 percent lower BUT there are reasons to implement them

If setting up an operating room schedule that permits surgeons to move immediately from one procedure to the next results in lower surgical suite utilization, why do it?  This pragmatic article suggests that, if managed carefully, flip rooms can be a powerful incentive to reward productive and loyal surgeons.  How to decide which surgeons qualify to be offered the flip room schedule is discussed.  Orthopedic surgeons tend to be good candidates due to the nature and duration of orthopedic cases.  The political ramifications of offering flip rooms to only certain surgeons need to be considered.

How to Identify Surgeons Who Would Be Good Flip Room Candidates

  • Are they using their current block time at 75 to 80 percent?
  • Are they bringing in 250+ cases per year?
  • Do they have a lot of cases with an operative time of 60 minutes or less?

Source: Firm policies and the right procedures tip the cost-benefit balance toward flip rooms.  OR Manager;30(4):19-21, Apr. 2014.  Click here to access the publisher’s website:   http://www.ormanager.com/2014/03/13/firm-policies-and-the-right-procedures-tip-the-cost-benefit-balance-toward-flip-rooms/  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

Top 10 injuries treated in trauma centers, by cause, US 2012

These are 2012 data from the National Trauma Data Bank 2013 annual report, which contains records from 805 US and Canadian trauma centers, and is compiled by the American College of Surgeons.  Here are the top ten most frequent types of injuries according to what caused the injury.  Note that I left out the general categories “other” and “unspecified,” which each were at about 1 percent.  Also note that I rounded the percentages, which were reported as 2-decimal places in the original source.

  • 41 percent FALLS
  • 28 percent MOTOR VEHICLE TRAFFIC
  •   7 percent STRUCK BY, AGAINST
  •   5 percent TRANSPORT, OTHER
  •   5 percent CUT/PIERCE
  •   4 percent FIREARM
  •   2 percent PEDAL CYCLIST, OTHER
  •   1 percent HOT OBJECT/SUBSTANCE
  •   1 percent FIRE/FLAME
  •   1 percent MACHINERY

Of these, the most likely to result in death is FIREARM (16 percent).

Source: National Trauma Data Bank 2013: Annual Report, [2013], Table 18, and Figure 18B.  Click here for access to the full text:  http://www.facs.org/trauma/ntdb/pdf/ntdb-annual-report-2013.pdf    Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

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