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UNINSURED: 48.3 million in 2010 dropped to 28.7 million in 2015 (U.S. national data for non-elderly population)

In 1972, the earliest year shown in this source, there were 30.7 million Americans under age 65 who did not have health insurance.  This number has varied somewhat from year to year – sometimes dropping, sometimes rising – but reached the highest number (48.3 million) in 2010.  In 2015, the number of uninsured Americans under 65 who were uninsured dropped to 28.7 million.  Here are some of the years shown in this source:

Number of Persons Uninsured (under 65 years old)

  • 30.7 million  1972 (the earliest year)
  • 23.0 million  1978 (the lowest year)
  • 48.3 million  2010 (the highest year)
  • 28.7 million  2015 (the most recent year)

Source: U.S. National Center for Health Statistics. (2017, February). National Health Interview Survey: Long-term trends in health insurance coverage. Click here: https://www.cdc.gov/nchs/data/nhis/earlyrelease/trendshealthinsurance1968_2015.pdf   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

POPULATION HEALTH: Are these battles winnable?

An estimated 400,000 people quit smoking between 2012 and 2016 – one of the successful initiatives of the “Winnable Battles” campaign begun by the Centers for Disease Control and Prevention in 2010.  The outcomes of this program five years later are reviewed in this report and summarized in the JAMA article.  The idea was to target a carefully-chosen set of public health issues and then devote federal, state and local resources to improving them.

Here is a summary of what happened five years on:

  1. Clear success in decreasing adult and teen smoking
  2. Likewise, exceeded the target in decreasing teen pregnancies
  3. Making good progress on most measures of reducing healthcare-associated infections – except catheter-associated urinary tract infections
  4. Slow progress on measures related to nutrition, exercise, obesity
  5. Slow progress on reducing foodborne illness
  6. Slow progress on reducing motor vehicle deaths
  7. Mixed results on measures related to HIV

Sources:

Winnable battles: Final report. (2016, November). Atlanta: U.S. Centers for Disease Control and Prevention. Click here: https://www.cdc.gov/winnablebattles/report/docs/winnable-battles-final-report.pdf; and, Frieden, T.R., Ethier, K., ad Schuchat, A. (2017, February 2). Improving the health of the United States with a “winnable battles’ initiative. JAMA. Click here: http://jamanetwork.com/journals/jama/fullarticle/2601246  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

STROKE: Cleveland Clinic pioneers deep brain stimulation

On December 19, 2016, Dr. Andre Machado, chair of the Neurological Institute at the Cleveland Clinic, performed the first deep brain stimulation procedure on a stroke patient.  This lengthy surgery, part of an ongoing clinical trial, involved implantation of electrodes in the brain that are connected to a pacemaker-like device.  As the patient recovers from the brain surgery, physical therapy will be combined with stimulation of areas of the brain to overcome damage done by the stroke.  A key objective of this groundbreaking surgery is to help stroke patients recover from stroke-induced paralysis.  An estimated 400,000 Americans a year – or half the number of patients who have a stroke each year – end up disabled.

Sources:

Cleveland Clinic performs nation’s first deep brain stimulation for stroke recovery. (2017, January 4). News release. Click here: https://newsroom.clevelandclinic.org/2017/01/04/cleveland-clinic-performs-nations-first-deep-brain-stimulation-stroke-recovery/; and, Sifferlin, A. (2017, January 4). Doctors perform groundbreaking surgery for stroke. Time. Click here: http://time.com/4620618/doctors-perform-groundbreaking-surgery-for-stroke/  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

SUPPLY CHAIN: What is a consolidated service center?

Health systems with sufficient scale and volume may benefit by establishing a consolidated service center (CSC) model as part of their supply chain strategy, according to consultant Jamie Kowalski .  These facilities are significantly larger than the typical hospital storeroom.

  • Large hospital storeroom: 10,000 sf stocking as many as 3,000 items
  • CSC: 60,000 to 250,000 sf stocking as many as 100,000 items

According to survey data, the number of CSCs in the U.S. has increased from 20 in 2012 to over 60 today.  Reasons why CSCs might not work out are also discussed in this brief article.

Source: Consolidated service center? If the shoe fits… (2016, December). The Journal of Healthcare Contracting. 13(6), 40, 42.

HOSPITAL BUDGETS: Hospital spending by category 2015

The following data are based on an analysis of the Centers for Medicare and Medicaid Services (CMS) 2015 inpatient market basket update projections.  A base year of 2010 weights were used.

Hospital Spending (by percent)

  • 59.1  Wages and benefits
  • 14.1  Other products (for example, food, medical instruments)
  •   9.1  Professional fees
  •   6.9  Prescription drugs
  •   3.7  All other: labor intensive
  •   3.7  All other: non-labor intensive
  •   2.1  Utilities
  •   1.2  Professional liability insurance

Source: American Hospital Association. (2017, February). The cost of caring. Click here: http://www.aha.org/content/17/costofcaringfactsheet.pdf  Posted by AHA Resource Center (312) 422.2050 rc@aha.org

ED: How to onboard and train staff at a new freestanding emergency department in a large city

Lenox Health-Greenwich Village, a division of Lenox Hill Hospital, was the first freestanding emergency department in New York City.  The facility, which opened July 17, 2014, was designed with 24 fully-equipped patient rooms and 2 more rooms with minimal furnishings for the safe care of behavioral health patients.  These rooms are all large enough to accommodate two patients each if needed.  The utilization for the first 6 months was 12,700 patients and by the end of the first year, over 30,000 were treated.  This article describes in some detail the simulation process and topics used to train staff prior to the opening of the new facility.  The video describes the construction projects that were underway to add ambulatory surgery space on the fourth floor, imaging upgrades to the fifth floor, and physician offices on the sixth.

Sources:

Kerner, R.L., and others. (2016, October). Simulation for operational readiness in a new freestanding emergency department. Simulation in Healthcare, 11(5), 345-356.  Click here for free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5172849/pdf/sih-11-345.pdf

Here is a video about the facility: https://www.northwell.edu/about/news/video/lenox-health-greenwich-village-what-emergency-care-should-be

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

HOSPITAL CLOSURES: What is nurse executive’s role?

Five nurse executives who were employed at rural hospitals were interviewed about their experiences when their hospitals closed.  The researchers categorized key themes brought out in these interviews, which are discussed in this brief article.  They cover topics related to a flattening of the organizational structure of the hospitals, a strong sense of family among staff, development of crisis conditions concerning supplies and workforce and feelings of betrayal by the hospital owners.  They also mention the challenges of finding qualified board members and top administrators in small communities.  Another difficulty was the disposition of medical records after the closure.

Source: Warden, D.H., and Probst, J.C. (2017, January). The role of the nurse executive in rural hospital closure. JONA. Journal of Nursing Administration, 47(1), 5-7. Click here for publisher’s website: http://journals.lww.com/jonajournal/Abstract/2017/01000/The_Role_of_the_Nurse_Executive_in_Rural_Hospital.3.aspx   Posted by AHA Resource Center (312) 422-2050, rc@aha.org