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GOVERNANCE: How many members on governing board?

The average size of a health care governing board is 13 to 16 members, according to a 2015 survey conducted by The Governance Institute.  This article, written by a governance consultant, describes the traditional model for a hospital board – the community board model.  Reasons why health systems are exploring other models are discussed.  These other models include:

  • Mirror boards
  • Community board at the parent company level only
  • Board of experts
  • Committees only at the system board level
  • CEOs of subsidiary hospitals report directly to system CEO

Source: Stout, L.R. (2017, March-April). Breaking free from traditional models. Healthcare Executive, 32(2), 72-75.  Click here for publisher’s website: http://ache.org/HEOnline/digital/heonline_index.cfm  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

 

MAGNET HOSPITALS: How did the idea come about?

During the nursing shortage of the early 1980s, there were an estimated 100,000 vacancies nationwide and inadequate staffing in over three-quarters of U.S. hospitals.  In an effort to alleviate the shortage, the American Academy of Nursing engaged four AAN fellows to choose a topic and conduct research on nurses employed at hospitals.  The author of this brief article – Muriel Poulin – and her colleagues Margaret McClure, Margaret Sovie and Mabel Wandelt, decided to study the characteristics of hospitals that were doing a good job of retaining nursing staff.  They surveyed 41 hospitals and prepared a report that served as the basis of the later Magnet Recognition Program.

When I stop to consider how much the program has progressed, I cannot get over it.  It has been a remarkable evolution that now includes hundreds of healthcare organizations around the world…” (Dr. Poulin, page 73).

Sources:

Poulin, M. (2017, February). A remarkable journey: Why the Magnet Recognition Program continues to resonate today. JONA. The Journal of Nursing Administration, 47(2), 72-73. Click here for publisher’s website: http://journals.lww.com/jonajournal/Abstract/2017/02000/A_Remarkable_Journey__Why_the_Magnet_Recognition.2.aspx

American Nurses Credentialing Center. (2017). ANCC Magnet Recognition Program. Click here: http://www.nursecredentialing.org/Magnet  Posted by AHA Resource Center (312) 422-2003 rc@aha.org

TRANSPARENCY: Should you let patients read their notes?

Advantages and disadvantages of allowing patients to read the notes that physicians and other providers write about their office visits and hospital care are explored in this short Modern Healthcare article.  The movement towards greater transparency of care is explored further on the website OpenNotes.  Here are some of the providers that are exploring this concept.

Who is doing this?

  • Geisinger Health System (Danville, PA)
  • Beth Israel Deaconess Medical Center (Boston)
  • Sutter Medical Foundation (Sacramento, CA)
  • MUSC Health (Charleston, SC)
  • Harborview Medical Center (Seattle)
  • Mayo Clinic
  • Kaiser Permanente Northwest
  • Department of Veterans Affairs
  • UCHealth (Denver)

Sources:  Livingston, S. (2017, Jan. 2). Growing number of doctors allowing patients to read their notes. Modern Healthcare, 47(1), 14-15.  Click here for publisher’s website: http://www.modernhealthcare.com/article/20161231/MAGAZINE/312319982; and, OpenNoteswww.opennotes.org   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

VIOLENCE: Top 5 reasons why guns are fired in hospitals

These data were compiled based on reports of firearm discharges in hospitals over a 10-year period ending in December 2016.  During this time, a total of 416 firearm discharges occurred, killing 279 people.  A tendency for larger hospitals to have more frequent firearm discharges was observed.

Top 5 Motives for Firearm Discharge

  • 30 percent (suicide)
  • 15 percent (while violating another law)
  • 10 percent (domestic – family dispute)
  • 10 percent (related to care of patient who is a prisoner)
  •   6 percent (accidental)

Elderly people (over 70 years old) are disproportionately likely to be in this offender group.

Source: Aumack, T., York, T., and Eyestone, K. (2017). Firearm discharges in hospitals: An examination of data from 2006-2016. Journal of Healthcare Protection Management, 33(1), 1-8.  Click here for publisher’s website: http://www.iahss.org/?page=Journal  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

PATIENT SAFETY: What are top 10 concerns in 2017?

Here is the annual list compiled by ECRI Institute of the top 10 patient safety concerns based on a review of event reports and survey data.

Most organizations already know what their high-frequency, high-severity challenges are.  Rather, this list identifies concerns that might be high priorities for other reasons, such as new risks, existing concerns that are changing because of new technology or care delivery models, and persistent issues that need focused attention or pose new opportunities for intervention.” (page 2)

The Top 10 (these topic headings are quoted directly from the white paper):

  1. Information management in EHRs
  2. Unrecognized patient deterioration
  3. Implementation and use of clinical decision support
  4. Test result reporting and follow-up
  5. Antimicrobial stewardship
  6. Patient identification
  7. Opioid administration and monitoring in acute care
  8. Behavioral health issues in non-behavioral-health settings
  9. Management of new oral anticoagulants
  10. Inadequate organization systems or processes to improve safety and quality

A nice feature of this white paper is that it contains links to ECRI Institute resources that provide advice and guidance on each of these topics.

Source: ECRI Institute. (2017, March). Top 10 patient safety concerns for healthcare organizations 2017: Executive brief. Plymouth Meeting, PA: ECRI Institute. Click here for free full text (but you may be asked to fill out a registration form): https://www.ecri.org/EmailResources/PSRQ/Top10/2017_PSTop10_ExecutiveBrief.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

ISOLATION ROOMS: How many air changes per hour?

Design considerations for negative isolation and positive isolation rooms are discussed in this brief article by an engineering consultant.  Negative-pressure isolation rooms are intended to keep an infectious patient from infecting others in the hospital.  Positive isolation rooms are the opposite – intended to keep germs away from an immunocompromised patient in the room.  The recommendation for both types of isolation rooms is reported to be at least 12 air changes per hour.  Some hospitals use isolation rooms for general patients when they are available.  Although allowed in the past, it is no longer possible to operate isolation rooms that can be switched back and forth from negative to positive pressure.

Source: Herrick, M. (2017, February). Pressure points: Planning and maintaining air isolation rooms. Health Facilities Management, 30(2), 29-32.  Click here: http://www.hfmmagazine.com/articles/2671-planning-and-maintaining-hospital-air-isolation-rooms  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

SPACE PLANNING: How to determine number of ORs needed

Tips for the planning process for a new surgical suite are given in this brief newsletter article by an experienced health care architect.  There are some interesting facts that are otherwise difficult to find in the literature:

  • What is the difference between an operating room and a procedure room?
  • What is a hybrid operating room?
  • How are some of the metrics used defined – room time, room turnaround time, throughput?
  • What is a target room turnaround time? (“…usually 15 to 20 minutes”)
  • How many hours are procedure rooms open? (“Most procedure rooms are available eight hours per day for a total of 480 minutes per day”)

Scheduling efficiency: A scheduling efficiency factor is multiplied by the annual minutes available per procedure room to account for periods of time that a case cannot be scheduled.  This factor may range from 70 percent for ORs or procedure rooms used for complex (and sometimes unscheduled) procedures — such as cardiothoracic, neurosurgery, and trauma/orthopedics — to 90 percent for an outpatient suite where all procedures are scheduled.”  (page 3)

Source:  Hayward, C. (2017, Winter). How many operating rooms? It’s complicated. Click here for newsletter: https://www.spacemed.com/newsletter/news101.html  Posted by AHA Resource Center (312) 422-2050 rc@aha.org