5. EHR Adoption
Payment and quality are all tied in to the scramble to achieve meaningful use with appropriate and effective electronic health records for physicians and hospitals in 2011.
Meaningful use guidelines released earlier this year call for these elements to satisfy the criteria. To kick off the new year, providers are looking to adopt EHRs that work for their practices while still meeting regulation standards.
Increasingly, payers and the public have access online to an amazing amount of detail about providers' quality of care at a hospital and at a physician level. The Centers for Medicare & Medicaid Services is updating its Physician Compare website, and an increasing amount of information about hospital quality will be available on Hospital Compare and other federal and state health websites as well.
Hospital executives will have to decide how to market the information in their favor, and they will have to figure out whether to fight back against advertising campaigns launched by competitors who have scores that are better than their own.
How risk adjustment formula are used to calculate these scores to account for tougher patient mix is an area that's due for some scrutiny and probable refinement.
There have always been medical errors in the healthcare industry and year 2011 will be no exception. Medical errors makes our list of top quality issues because of the high attention and cost these errors received in 2010, sure to carry over into 2011.
8. Nurses' Role
State legislators and hospital leadership teams are continuing to debate about whether to impose nurse-patient staffing ratios, as California has done. Hospital groups have sued to block such ratios, saying they impede flexible flow and cost too much. Nursing groups, predicably, believe otherwise.
Advocates say nurses are happier, fewer leave the profession, the number of mistakes has dropped and patient satisfaction scores, becoming increasingly important, are higher.
Most controversial is the requirement that one nurse be on staff for every two patients in the intensive care, critical care, and neonatal intensive care units, as well as in post-anesthesia recovery, labor and delivery, and when patients in the emergency room require intensive care.
National nursing researcher Linda Aiken's June report sided with the nurses, saying there's less burnout when staff ratios are lower, and that nurses have greater ability to actually care for their patients.