The Daily Briefing

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How Capitol Hill will impact your imaging business

June 7, 2012

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ANA recognizes six hospitals for nursing excellence

Award highlights improvements in patient outcomes, RN job satisfaction

January 30, 2012

The American Nurses Association (ANA) last week awarded six hospitals the 2011 National Database of Nursing Quality Indicators (NDNQI) Award for Outstanding Nursing Quality, which recognizes hospitals that improve patient outcomes and maintain high nurse job satisfaction.

ANA identified top hospitals using performance measures reported to ANA's NDNQI by more than 1,800 facilities. According to ANA, award winners "demonstrated superior results" on a broad range of nursing-sensitive performance indicators, including patient falls with injury, hospital-acquired infections, and pressure ulcers.

The 2011 NDNQI Award for Outstanding Nursing Quality winners are:

  • Robert Wood Johnson University Hospital (New Brunswick, N.J.);
  • Parkview Whitley Hospital (Columbia City, Ind.);
  • Poudre Valley Hospital (Fort Collins, Colo.);
  • Shriners Hospital for Children-Chicago;
  • The Burke Rehabilitation Hospital (White Plains, N.Y.); and
  • Linden Oaks Hospital (Naperville, Ill.).

The Advisory Board congratulates member organizations Robert Wood Johnson University Hospital, Parkview Whitley Hospital, and Poudre Valley Hospital for being recognized by the ANA for achieving outstanding nursing quality.

"The award-winning hospitals recognize the importance of basing their nursing care strategies on data showing what produces the best results for patients," said ANA President Karen Daley. "They are committed to continuous improvement, outstanding teamwork, effective leadership, and evidence-based practices."

Poudre Valley CNO Donna Poduska called the honor "a remarkable accomplishment directly resulting from the carefully exacting work that our nurses do to maintain high-quality care." For example, Poudre Valley has reported no cases of ventilator-associated pneumonia in ICU patients for more than 900 days.

Similarly, Burke Rehabilitation Hospital CNO Marie Spencer said the award "demonstrates Burke's commitment to patient care and process improvement" (ANA release, 1/26; Northern Colorado Business Report, 1/27; Burke release, 1/26).

A fresh start: Joplin hospital torn down to be built anew

Crews demolish old hospital, break ground on new facility

January 30, 2012

Eight months after a deadly tornado hit Joplin, Mo., officials have started to demolish the ravaged St. John's Regional Medical Center and launched construction on a new facility.

On May 22, a tornado cut a six-mile-long path through Joplin and directly hit St. John's, one of the region's largest hospitals and a level II trauma center. The deadly twister killed 161 people, including five St. John's patients and one visitor, and destroyed more than 7,000 homes.

Within one week of the tornado, Sisters of Mercy Health System, St. John's parent system, built a 60-bed field hospital equipped with surgical suites and MRI and CT scan capabilities. Since then, a modular hospital has served Joplin patients while the health system continues to work on a component hospital expected to open this spring.

Sisters of Mercy last summer also pledged to build a new hospital in the Missouri town. The facility, which is slated to open in 2015, will include 327 inpatient beds and there are plans to expand that number to 424.

Demolition, construction begin
Construction workers over the weekend began demolishing and clearing the original 750,000-square-foot St. John's hospital building. In all, crews will flatten five buildings across the 47-acre hospital site, including three medical offices and a rehabilitation facility.

Before starting on the project, crews searched the facilities for objects that remained in good condition, such as artwork, Bibles, and memorial plaques. In the process they found three time capsules, which were buried in 1968, the 1980s, and 1996.

After the demolition ceremony, officials held a groundbreaking ceremony on the new hospital site. "Though the tornado took our hospital, it did not destroy our spirit," according to Sisters of Mercy's website. "Mercy is rising again in Joplin" (Hayes, CNN, 1/28; Letner, Joplin Globe, 1/29).

DOJ: No individual mandate? No problem

Agency says most of reform law can stand without the mandate

January 30, 2012

The Obama administration on Friday said that if the Supreme Court strikes down the federal health reform law's individual mandate, the rest of the law should remain intact.

In a brief filed with the court, Department of Justice (DOJ) lawyers noted that just two provisions would need to be eliminated if justices deem the mandate unconstitutional: one requiring health insurers to accept individuals regardless of their health status and the other prohibiting insurers from charging higher premiums based on an individual's medical history.

Plaintiffs in the case have argued that the entire law must be voided if the mandate is struck down.

The brief states, "Other provisions can operate independently and would still advance Congress' core goals of expanding coverage, improving public health, and controlling costs even if the minimum coverage provision were held unconstitutional."

DOJ lawyers also said plaintiffs in the case have not cited an example of when the Supreme Court in recent years has struck down a comprehensive law based on if it found a single provision unconstitutional.

Karen Harned of the National Federation of Independent Business, a plaintiff in the case, said the mandate holds the reform law together. She added, "To argue otherwise would be like arguing a house can stand after its foundation has crumbled" (Haberkorn, Politico, 1/27; Vicini, Reuters, 1/27; National Journal, 1/27 [subscription required]).

Health IT champion steps down as nation's CTO

Administration did not announce replacement plans

January 30, 2012

The Obama administration on Friday announced that Aneesh Chopra has stepped down from his post as the country's first chief technology officer.

Chopra, who once served as Virginia's technology secretary and as managing director at the Advisory Board Company, became the nation's CTO in 2009. He once called health IT "a labor of love" and said that he spent his career in state government working to advance IT use to improve patient outcomes and reduce costs.

As CTO, Chopra advocated for greater use of technology in health care and improving government transparency by making more data available online. He helped oversee the $19 billion in federal stimulus package funding aimed at encouraging electronic health record adoption.

In a statement, President Obama thanked Chopra for his service. He said, "Aneesh found countless ways to engage the American people using technology, from electronic health records for veterans, to expanding access to broadband for rural communities, to modernizing government records." The president added that Chopra's "legacy of leadership and innovation will benefit Americans for years to come."

Commenting on Chopra's departure, White House Office of Science and Technology Policy Director John Holdren noted Chopra's efforts to implement "the President's open government strategy focused on unlocking the innovative potential of the federal government to solve problems and seed the jobs and industries of the future."

The White House did not offer information about Chopra's reasons for stepping down or his future plans. The administration also did not provide information on plans for replacing Chopra (Quinn, Politico, 1/27; Lee, Modern Healthcare, 1/27 [subscription required]; Sasso, "Hillicon Valley," The Hill, 1/27; White House Office of Science and Technology Policy release, 1/27; Smith, "Tech Daily Dose," National Journal, 1/27).

Boston group builds state-of-the-art hospital in Haiti

Facility will boost country's public health system two years after devastating earthquake

January 30, 2012

Haiti's public health care system—long considered one of the worst in the Western Hemisphere—will get a boost this summer when Boston-based Partners in Health opens a 320-bed teaching hospital in the country.

In 2010, the country was devastated by an earthquake that killed hundreds of thousands of Haitians. The 7.0-magnitude quake knocked down medical clinics, killed scores of medical workers, and caused severe damage to the General Hospital in Port-au-Prince, the nation's capital.

The new $16 million National Teaching Hospital is one of the few examples of reconstruction after the disaster. It will be located in a small city called Mirebalais, about 35 miles outside of the country's capital. "It's really this type of assistance that we need," says Haiti Health Minister Florence Guillaume.

Once open, the National Teaching Hospital will be the largest hospital in the country, with six ORs, an ED, and a neonatal ICU. In addition, the facility will be wired with a fiber-optic data connection and be the only public facility in the country to offer CT scans. The hospital's roof will be covered with solar panels, allowing the facility to operate entirely with solar power on sunny days.

Guillaume says the new hospital will be a boon to the country's public health system in two ways. First, it will provide other Haitian health facilities with a place to send patients for complicated procedures and tests. Second, the new hospital will help train health care providers and could create a better working environment that encourages them to remain in the country.

David Walton, a Brigham and Women's Hospital physician who is overseeing construction of the facility, says Partners in Health has received about $4 million of in-kind donations for the new hospital, including gifted medical and construction supplies (Beaubien, NPR, 1/27).

For nursing home patients, surgery itself can present 'a danger'

Study finds higher surgical mortality risks among nursing home patients

January 30, 2012

Undergoing even routine surgery increases mortality risk for patients in nursing homes compared with patients of similar age who are not in long-term care facilities, according to a recent study in the Annals of Surgery.

For the study, researchers compared post-surgery mortality risks and interventions between nursing home residents and adults of similar age suffering the same number of illnesses but who were not in nursing homes. Using Medicare claims and nursing home surveys, the researchers identified about 71,000 nursing home residents and one million other seniors who had one of four types of abdominal surgery between 1999 and 2006.

The researchers found that:

  • After an appendectomy, 12% of nursing home residents died, compared with 2% of Medicare beneficiaries not in a nursing home;
  • After gallbladder surgery, 11% of nursing home residents died, compared with 3% of others;
  • After colon surgery, about one-third of nursing home residents died, compared with 13% of others; and
  • After ulcer surgery, 42% of nursing home patients died compared with 26% of others.

In addition, the researchers found that nursing home patients who survived surgery were more likely to undergo "invasive interventions" after the procedure.

According to lead study author Emily Finlayson, a colorectal surgeon at the University of California-San Francisco, "[s]omething about undergoing anesthesia, the surgery's physiological assault on the body, impacts older people much more than we think." She says family members should discuss alternatives to surgery for nursing home patients.

However, Finlayson notes that some surgeons may be resistant to non-surgical alternatives. "[W]ith older patients there's less length of life to protect, so the other variables become way more important: maintaining cognitive status, living independently, caring for yourself," she says (Span, "The New Old Age," New York Times, 1/25).

Weekly review

Key articles from Jan. 23-Jan. 27

January 30, 2012

Missed a day of the Daily Briefing? Here's a quick round-up of top stories and research highlights from last week’s issues.

HealthGrades names 'Top 50 Cities for Hospital Care' (Jan. 24)

HealthGrades last week released its list of "America's Top 50 Cities for Hospital Care" based on an analysis of risk-adjusted patient mortality and complication rates at almost 5,000 hospitals nationwide.

Obama breezes over health care in State of the Union address (Jan. 25)

President Obama in his State of the Union address last week spent little time discussing health care and the federal health reform law.

Analysis: Why the president skipped over health care—and whether it matters (Jan. 25)

President Obama used just 44 words to discuss health reform in last week's State of the Union address—the most limited discussion of health care by a president in two decades—but there were still some takeaways for providers.

Five things to watch in the State of the Union (Jan. 24)

One night before the State of the Union address, the Daily Briefing's Dan Diamond previewed the presidential speech.

Catholic system parts ways with church as it eyes expansion (Jan. 23)

Catholic Healthcare West has announced that it is ending its governing board's affiliation with the Catholic Church and changing its name, highlighting the unique challenges facing religious hospitals as they seek to expand.

Moody's: The top revenue pressures facing hospitals (Jan. 26)

In its 2012 outlook, Moody's Investors Service reviews the top margin pressures facing not-for-profit hospitals and warns that revenue growth may be slow across the next 18 months.

Using analytics to understand ICD-10 exposure

January 30, 2012

There are less than two years left until the ICD-10 transition. Are you prepared?  To support your transition plan, we are sharing best practices from the most progressive institutions on how they are using advanced analytic tools to understand ICD-10’s impact. More.

Daily roundup: Jan. 30, 2012

Bite-sized hospital and health industry news

January 30, 2012

  • California: A bill that would create a universal health care system in California stalled in the state Senate last week. The bill fell three votes short of the 21 required to pass in the Senate. Although lawmakers have until Tuesday to act on the legislation, Senate President Pro Tempore Darrell Steinberg (D) says he does not think the bill would pass this year (Van Oot/Sanders, Sacramento Bee, 1/27).
  • California: University of California-Davis medical students over the weekend opened a new clinic in Knights Landing that provides no-cost care to rural Yolo County residents. Open every third Sunday of the month, the clinic will be staffed by medical school and undergraduate students, as well as volunteer physicians, RNs, and public health graduate students. It will be the first medical clinic to serve Knights Landing since 2008, when CommuniCare Health Centers closed (Robertson, Sacramento Business Journal, 1/26).
  • Pennsylvania: Temple University Hospital in Philadelphia last week announced that it had reactivated its heart and lung transplant programs. The hospital closed down the lung program in May 2011 following the departure of its primary lung transplant surgeon and shut down the heart program in July 2011 due to low patient volumes. It has recruited two physicians to lead the programs (Burling, Philadelphia Inquirer, 1/27).

AMA chief urges Boehner to stop ICD-10 rollout

American Medical Association (AMA) CEO James Madara recently sent a letter to House Speaker John Boehner (R-Ohio) asking him to stop the federally mandated implementation of the ICD-10 insurance coding system for physicians.

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 new codes by Oct. 1, 2013.

  • Learn more about the IT Strategy Council's research on preparing for the ICD-10 transition, from confronting popular myths to overcoming common hurdles. The Advisory Board also is offering formal assistance to hospitals looking to create a blueprint for managing the transition to ICD-10.

Madara's letter is similar to a resolution that AMA's House of Delegates passed in November 2011. According to Madara, the change to ICD-10 codes will cost medical practices up to $2.7 million, depending on their size (Conn, Modern Healthcare, 1/26 [subscription required]; Pecquet, "Healthwatch," The Hill, 1/26).