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OPERATING ROOMS: Staff turnover rates, U.S. 2017

Staff turnover rates in U.S. hospitals have remained about the same for the past few years, according to this survey conducted in the spring of 2017.  A total of 338 responses were received from OR managers.  Here are the findings for turnover:

  • 9.7 percent (average turnover rate for RNs in the OR)
  • 8.2 percent (average turnover rate for surgical technologists)

Staff turnover in this survey was defined as “the percentage of staff who have left and been replaced in the past 12 months).

Source: Saver, C. (2017, September). Survey: Surgical volume creeps up amid scramble for new staff. OR Manager, 33(9), 1, 9-11, 13.  Click here for publisher’s website: http://www.ormanager.com/survey-surgical-volume-creeps-up-amid-scramble-for-new-staff/  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

BENCHMARKS: Physicians per major gift officer

…each one-year increment of greater experience was associated with an additional $69,000 in donations per year…”

Finding quantitative data on major gift officers – and their workload – in the literature is unusual.  This study is based on a 2015 survey of seven academic medical centers.  The researchers had hoped to arrive at an optimal workload ratio, but although they found an average of just under 48 faculty physicians per major gift officer, they do NOT consider this average to be an optimal figure.  They did find a statistically significant relationship between a major gift officer’s experience and the amount of donations – as noted in the quote above – highlighting the not surprising importance of retaining staff who are experienced in fundraising.

Source: Wheeler, J.L., et al. (2017, Spring). How many physicians per gift officer? Healthcare Philanthropy Journal, 46(1), 26-32.  Click here for publisher’s website: https://www.ahp.org/Home/Resources_and_Tools/Journal/Home/Resources_and_Tools/Healthcare_Philanthropy_Journal.aspx?hkey=9d23727d-f194-43c6-85e2-cd1e6888419b   Posted by AHA Resource Center (312) 422-2050 rc@aha.org

 

CARDIOLOGY: Higher volume linked to better outcomes

We demonstrate through a large regional database a positive relationship between volume and outcomes in interventional cardiovascular care.”

The volume-outcome relationship in health care has been studied quite a bit over the years – particularly related to various surgical specialties.  It is intuitively pleasing to think that if a surgeon, if a surgical team, if a hospital has a higher volume of … whatever… there will be better outcomes than providers who only see patients of this type now and then.  This study confirms this relationship for heart attack patients who were treated in the interventional cath lab.

The study analyzed outcomes data for 9,360 patients in the Dallas metro area who received care from 2010 to 2015.  Interestingly, for these patients who were diagnosed as having the most severe type of heart attack, 59 percent of patients arrived at the hospital either by themselves or transported by a family member; 39 percent arrived by ambulance.

Mortality in the facilities classified as low volume (less than 200 percutaneous coronary intervention procedures per year) was 9.55 percent.  Mortality in the intermediate and high volume facilities was almost identical – at 6.25 and 6.22 percent, respectively.

Source: Langabeer, J.R., Kim, J., and Helton, J. (2017, July-September). Exploring the relationship between volume and outcomes in hospital cardiovascular care. Quality Management in Health Care, 26(3), 160-164.  Click here for publisher’s website http://journals.lww.com/qmhcjournal/pages/articleviewer.aspx?year=2017&issue=07000&article=00006&type=Abstract    Posted by AHA Resource Center (312) 422-2050, rc@aha.org

BENCHMARKING: Housekeeping cost per square foot

The relationship between patient satisfaction with care received in the hospital, as measured by the Medicare star ratings, and housekeeping cost was studied based on data from nearly 3,500 hospitals.  The authors of this very brief report note that the findings are intuitive – spend more money on housekeeping and patients will be more satisfied –  except for the oddly low cost per square foot for the 5-star rated hospitals.  Here are some of the reported findings:

Housekeeping Cost per Patient Day: 5-star is the best rating

  • $174.98 for 5-star rated hospitals
  • $103.82 for 4-star rated hospitals
  • $  85.16 for 3-star rated hospitals
  • $  75.98 for 2-star rated hospitals
  • $  75.93 for 1-star rated hospitals

Housekeeping Cost per Square Foot: 5-star is the best rating

  • $2.80 for 5-star rated hospitals
  • $6.73 for 4-star rated hospitals
  • $4.96 for 3-star rated hospitals
  • $3.83 for 2-star rated hospitals
  • $4.34 for 1-star rated hospitals

Source: The importance of a clean hospital room, according to patients. (2017, April). Healthcare Financial Management, 71(4), 78-79.  Click here for publisher’s website: https://www.hfma.org/Content.aspx?id=53567    Posted by AHA Resource Center (312) 422-2050, rc@aha.org

EMERGENCY DEPARTMENTS: New capacity metric finds 6 ED beds per 10,000 ED visits in California hospitals

Our novel metrics capturing both supply of beds and visit demand demonstrate that recent trends of hospital supply may be insufficient to keep pace with growing ED patient demand and evolving, complex medical conditions.”

The change in supply of emergency department facilities and in demand for emergency care in California hospitals from 2005 to 2014 was studied using data from the California Office of Statewide Health Planning and Development (OSHPD).  The total number of ED visits in California increased by about one-third over this ten-year period, reaching a total of over 13 million visits in 2015, or 342 ED visits/1,000 population.  The number of emergency departments in California remained about the same – 339 facilities in 2014 – but the number of ED beds increased about 30 percent to 7663 in 2014.

The researchers developed a new metric – ED bed supply per ED visit.  Over the ten-year study period, there was a small decrease of about 4 percent in this metric.  It was roughly 6 ED beds per 10,000 ED visits in both 2005 and 2014.

Sources:

Chow, J.L., Niedzwiecki, M.J., and Hsia, R.Y. (2017, May 11). Trends in the supply of California’s emergency departments and inpatient services, 2005-2014: A retrospective analysis. BMJ Open, 7(5).  Click here for free full text: http://bmjopen.bmj.com/content/bmjopen/7/5/e014721.full.pdf

For more information on OSHPD data, click here: https://www.oshpd.ca.gov/HID/

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

BENCHMARKS: Space planning in labor and delivery

This is a rule-of-thumb provided by Hayward & Associates, a health care facility planning firm, that may be used to plan for a labor and delivery area.  In the following ratios, LDR means labor-delivery-recovery.  LDRP means the same except adds a postpartum stay in the same room – this is also known as single-room maternity care.

Space planning based on annual births

  • 100 to 200 births / LDRP room if the LDRP concept is used exclusively
  • 300 to 400 births / LDR or LDRP room if some patients are moved to a separate postpartum room after discharge

Recommended departmental gross square feet (DGSF) and departmental gross square meters (DGSM) are also given in this brief article.

Source: Hayward, C. (2017, Spring-Summer). Obstetrical services capacity and preliminary space need. SpaceMed Newsletter. Click here: https://www.spacemed.com/newsletter/rule-102-ob.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

SURGICAL SUITES: Guidelines on best practices to prevent surgical site infections

The number of unresolved issues in this guideline reveals substantial gaps that warrant future research.” (page E6)

Best practices in avoiding surgical site infections were studied by the Centers for Disease Control and Prevention with the assistance of the Healthcare Infection Control Practices Advisory Committee.  This guideline is based on the full text review of nearly 900 journal articles and studies.  The guideline is organized according to specific surgical practices – for example the efficacy of wearing a space suit during orthopedic surgery – and assigns each practice a rating on a continuum as to whether the practice is highly recommended, unresolved, or somewhere in between.  The rating on the space suits, for instance, is that it is unresolved.

Source: Berrios-Torres, S.I., and others. (2017, May 3). Centers for Disease Control and Prevention guideline for the prevention of surgical site infection 2017. JAMA Surgery. Click here: http://jamanetwork.com/journals/jamasurgery/fullarticle/2623725  Posted by AHA Resource Center (312) 422-2050, rc@aha.org