The campaign aims to differentiate the hospital from other children's hospitals in the Chicago area and around the country.
Ann & Robert H. Lurie Children's Hospital in Chicago, IL, has launched an advertising campaign aimed at differentiating itself from the competition. The campaign's tagline, "All, for your one" emphasizes the hospital's promise to families to give its "all" for each young patient.
"'All, for your one' helps distinguish us from other children's hospital in the Chicago area and the country," Kary McIlwain, vice president of marketing at Lurie Children's, said in a media release.
"The creative focuses on all of our clinical expertise, all the research, all the compassion, all the advocacy, all our locations, everything the hospital brings to the care of each child."
The campaign features print, outdoor, digital, and radio ads, and will run throughout the summer.
"Four words that perfectly articulate the promise we make to every family, every day. It's not just a tagline—it's our rallying cry," states the campaign's microsite.
"Whether it's cutting-edge research, community advocacy, or the very best clinical care, everything we do is driven by an intense passion to help kids become healthy, happy adults. Lurie Children's ranks among the nation's best pediatric hospitals because we put all that we have into delivering on this promise. Think of it as world-class care with a Midwestern work ethic."
Hospital marketers are also promoting the campaign on social media, including a 60-second video that has been viewed more than 4,000 times on YouTube.
They are also encouraging the hospital community to discuss the campaign online using the hashtag #all4your1.
Lurie Children's is a free-standing children's hospital that treats complicated disorders. It boasts more than 1,350 physicians and allied health professionals in 70 pediatric subspecialties. "We want people to think of us also when their kids need tonsillectomies or ear tubes," McIlwain said.
Lurie Children's partnered with ad agency Leo Burnett to develop the campaign.
A Johns Hopkins study shows that the abilities of orthopedic surgeons in training are more accurately ascertained when detailed checklists are coupled with rigorous error tracking.
Tracking surgical trainees' performance on cadavers can be greatly enhanced by coupling step-by-step checklists and measures of general surgical skills works with a rigorous system for tracking errors, according to researchers at Johns Hopkins University.
"The takeaway message is that checklists of procedural steps are a good way to assess the technical skills of these surgical residents. But they don't measure quality, highlighting a need to measure and give feedback on errors as part of the training," says Dawn LaPorte, MD, professor of orthopedic surgery at the Johns Hopkins University School of Medicine and an author of a report on the study in the Journal of Surgical Education.
Most training models rely on case numbers that serve as a proxy for a resident's mastery of a procedure. In reality, that only measures volume, not skill level, she says, adding that learning opportunities have been reduced with caps on resident work hours that are designed to reduce fatigue-related errors.
Residents rarely get formal feedback on their motor skills or errors under the current system, LaPorte says, which allows mistakes to perpetuate.
Evaluating residents as they work on cadavers identifies areas in need of improvement and allows them to learn from mistakes. "They can practice repeatedly in a safe environment before they're holding the knife to operate on real people," LaPorte says.
Johns Hopkins researchers created the study as a means to address shortcomings in the assessment of motor skills by using the Objective Structured Assessment of Technical Skills checklist that was modified for surgical procedures of the shoulder.
The researchers tested the checklist in residents practicing three different approaches to accessing a shoulder in need of repair: from the front, back, or side. The procedures are common first steps for shoulder surgeries to address injuries to the bicep, shoulder bones, or rotator cuffs.
Three orthopedic specialists from Johns Hopkins used the grading systems to evaluate the work of 23 Johns Hopkins medical residents ranging from their first to fifth year of residency as they performed each of the procedures on cadavers.
Under OSATS, the residents received a point for the successful completion of each step in the checklist and a zero for failed or incomplete steps. They also received zeros if they performed the steps out of order. The crucial steps in this case involved making the incision in the right place and avoiding important structures, such as nerves and arteries.
Besides the OSATS checklists, the faculty surgeons rated residents using the so-called Global Rating Scale and a simple pass/fail system.
The Global Rating Scale was developed by Richard Reznick in 2006 and is applicable to all surgical procedures, taking a holistic view of the surgical process and offering residents feedback on such things such as whether or not they used the surgical instruments correctly and if they display a broad understanding of the procedure.
Under the pass/fail system, residents receive a failing grade if they commit an egregious error — in the case of shoulder surgery, severing a nerve or blood vessel.
The Johns Hopkins team found that OSATS and the Global Rating Scale provided good, objective ways of measuring resident performance, while the pass/fail system gave residents unambiguous feedback.
More advanced residents received higher OSATS and Global Rating Scale scores than those just beginning their residencies. Scores on all three procedures ranged from the low single to double digits for first-year residents to the high double digits for fifth-year students.
Across all three procedures, examiners observed 11 incidents in which residents damaged the nerves or veins. First- and second-year residents were responsible for nine of those mistakes.
The researchers found that none of the three evaluations adequately captured those mistakes. The pass/fail scheme came closest, in that residents received a failing score for severing a nerve or major blood vessel, but it is not set up to subsequently inform residents of the precise nature of their mistakes.
And residents could theoretically perform well on the OSATS checklist even if they made an egregious error because points are not deducted, only earned in the grading system. To mitigate this, the researchers propose adding safety steps, such as identifying and protecting important structures, to the checklist.
LaPorte wants to implement these training protocols for other common surgical procedures.
Next up is developing an OSATS checklist for treating compartment syndrome, an injury in which bleeding or swelling prevents blood from flowing to affected tissues.
The residents under review said they like an objective evaluation system like the checklist because it gives them the confidence they need before entering an actual operating theater. "The goal is to make objective evaluations standard for all procedures expected of residents," LaPorte says.
Healthcare providers are not well prepared for the "unintended consequences" of the shift to greater use of health information technology, researchers say.
Providers are not equipped to recognize, analyze, and learn from patient safety problems linked to the use of health information technology, according to speakers at a health services research conference in Boston last week.
Providers are familiar with patient safety issues from the Institute of Medicine's landmark 1999 report on medical error, said Hardeep Singh a safety researcher at Michael E. DeBakey VA Medical Center in Houston. But health information technologies are completely changing the way doctors practice, he said.
Providers were not prepared for the "unintended consequences" of the shift to greater use of HIT, he said.
Singh cited cases from unpublished research of an HIT-linked delayed diagnosis of a life-threatening problem and a fatal fentanyl overdose linked to errors in electronic medical records.
"This stuff is happening," he said at the annual Academy Health meeting on health services research. "People are experiencing these events, but we are really, really not understanding or learning from these events."
Some errors are related to technology glitches. For example, in one case in England, 900 patients were prescribed Viagra instead of the antidepressant Wellbutrin. The error was discovered when the women in the group tried to fill their prescriptions, Singh said.
Others are related to human error and workflow changes. Even the best EHR system can be unsafe because humans are going to make errors, he said. Another potential problem. "You can have a perfectly functioning lab system and perfecting functioning EHRs, but they just don't connect very well and that interaction can lead to failure."
Andrew Lyzenga of the National Quality Forum said a literature review found the documented evidence of HIT safety is limited, so it is hard to draw definitive conclusions.
Some studies suggest that HIT can improve medication safety; others found HIT systems have little effect on patient safety. Some studies failed to report the harms of adverse events; others were narrowly focused.
Participating practices have committed to providing evidence-based, person-centered care for patients receiving chemotherapy. Under the Oncology Care model, performance-based payments go into effect July 1.
Nearly 200 group practices across the country—more than double the amount initially expected by the Centers or Medicare & Medicaid Services—will participate in a five-year demonstration program aimed at improving the quality and cost-effectiveness of oncology care.
The Oncology Care Model, which will involve 17 health insurance companies, more than 3,200 oncologists, and approximately 155,000 Medicare beneficiaries, is scheduled to run from July 1, 2016, through June 30, 2021.
"The Oncology Care Model encourages greater collaboration and information sharing so that cancer patients get the care they need," said U.S. Department of Health and Human Services Secretary Sylvia M. Burwell, in an announcement.
"This patient-centered care model furthers the goal of the Vice President's Cancer Moonshot to improve coordination, care, and outcomes while spending dollars more wisely."
Under the bundled payment model, participating physician practices will receive performance-based payments for episodes of care surrounding chemotherapy administration to Medicare patients with cancer, plus a monthly care management payment for each beneficiary.
The two-sided risk model will qualify as an Advanced Alternative Payment Model under the proposed rule for MACRA.
Physician group practices participating in the program have agreed to provide treatment following nationally recognized clinical guidelines for beneficiaries undergoing chemotherapy, with an emphasis on person-centered care.
Examples of enhanced services provided by the medical groups include:
Help coordinating appointments and diagnostic tests outside the practice
Availability of test results prior to appointments
Access to additional support services
24/7 access to the practice itself
"With this after-hours care, there's a way to treat [symptoms such as] nausea or vomiting… or dehydration without the patient going to the ED and being hospitalized," Patrick Conway, MD, CMS Chief Medical Officer, explained when the model was announced in February 2015.
"That's where the largest savings from this program will come from."
The price differential is so great that a cesarean delivery in Cleveland is less expensive than a routine vaginal delivery in 17 of the 30 costliest cities, researchers find.
Having a baby in Sacramento? It might be worth it to go elsewhere.
Sacramento tops the list of the costliest places to have a baby, on average, topping even San Francisco, in second place. Stay away from Minneapolis, Philadelphia, and Portland, OR, too.
The Costliest Babies Analysis, released Thursday by Castlight Health and based on claims data, has found wide, unexplainable differences among delivery costs.
Wide variances variances were identified not only from one city to another, but also from one organization to another in the same city.
In Los Angeles, depending on the hospital, the cost for a vaginal delivery can range from $4,223 to $27,326 for the same care.
Nationally, delivery costs range from about $6,000 to more than $40,000, based on negotiated rates for in-network providers. The average price for a routine delivery is $8,775, the research shows.
The price differential is so great that a cesarean delivery in Cleveland ($8,772) is lessexpensive than a routine vaginal delivery in 17 of the 30 costliest cities.
Prices are defined as the employee cost-sharing plus the amount paid by the employer, indicating that employers potentially have a huge opportunity to pressure hospitals and health systems on prices for such care.
"The price variances seen in both routine and cesarean deliveries reflect the larger systemic problems in our nation's healthcare system," said Kristin Torres Mowat, Castlight's senior vice president of plan development and data operations, in a press release.
Medical claims data were the primary source of data used for the analysis, augmented by other publicly available data, including actual provider rate sheets that list the negotiated price between a provider and an insurer.
Castlight used that information and proprietary algorithms to obtain the provider prices used in the analysis.
Regardless of delivery method, prenatal office visits, required ultrasounds, delivery, the hospital stay, and one visit after delivery were included in the cost totals. Not included were tests, elective ultrasounds, imaging, medicine, and anesthesia.
The "build-it-and-they-will-come" approach just doesn't work. Hospital marketers must create purposeful content in order to truly connect with consumers and, ultimately, drive them to change their behavior.
Increasingly, hospital marketing departments are beefing up their content marketing strategies, but many ultimately flounder when they fail to achieve the desired results.
That's because not all content marketing is created equal—the "build it and they will come" approach just doesn't work. Hospital marketers must create purposeful, thought-out pieces of content in order to truly connect with consumers and, ultimately, drive behavior change.
"Achieving long-term engagement with audiences requires concerted comprehensive strategies and content is the key element to the experience," says Rachel Weatherly of Sapient Government Services.
"Publishing helpful content—particularly content that can help a patient or potential patient change their health behavior—can deliver a positive brand experience, influence facility selection, and deepen loyalty."
Here are three ways hospital marketers can boost engagement via content.
1. Tailor Content to Your Target Audience
Before creating any piece of content, think about the specific group you're trying to reach and how to best interact with them.
Vanderbilt University Medical Center in Nashville, TN, has clearly done this with the content on its patient education website, which focuses on creating and maintaining a healthy lifestyle, targeting this audience in a unique way.
The site, My Southern Health, plays on their location—where the majority of its audience group resides—and the pride they have in their region and their way of life.
"It's uncluttered and well-curated," Weatherly says. "The content of the site is presented in a way that's easy to scan for information and dive deeper as desired. And the site uses plain language that is relatable and speaks directly to their audience."
2. Make an Emotional Connection via Language and Tone
My Southern Health's plain language and relatable tone helps its content to stand out amidst the noise of other content offerings. And, once the site draws readers in, it is the content that deepens engagement with readers.
"Digestible, actionable information that relates to the needs of the audience through their engagement journey causes a person to pause, consider their next move, and possible change their behavior," Weatherly says.
"Aligning with the cultural perspectives and health literacy levels of key audience members is also critical."
"Creating inclusive or targeted content that is delivered in a way that encourages engagement, comprehension, and recommends action is challenging, but also necessary, as the populations often most in need of the information and support are also the ones least able to prioritize their health," Weatherly says.
3. Create Actionable Content to Enhance Engagement
Once your content does the job of connecting with its target audience, it's time to drive users to the next step in their engagement journey.
"Hospital and health system content must not only give the patient the who, what, and why but also when and how, making it relevant, 'real' and actionable," Weatherly says.
"Always asking what is important to the patient, will they connect with the information provided based on the relationship and experience with the organization, how to frame content that makes it digestible and empowering, and what format makes sense at the time, are just a few of the best practices needed for successful content development."
Although 44% of health plan executives surveyed believe primary care physicians have the tools needed to succeed in a value-based care system, only 29% of physicians agreed.
Physicians and health plan executives have very different perceptions of value-based care, from the barriers to implementing it, to its importance to the health system.
They even differ on whether physicians have the tools they need to make value-based care succeed.
These findings are the result of a study, commissioned by Quest Diagnostics and tech company Inovalon. Researchers surveyed 300 primary care physicians employed in private practice, but affiliated with a hospital. Researchers also polled150 health plan executives.
The study also found a discrepancy between physicians and health plan executives in their perception of value-based care.
According to the survey, 57% of health plan executives believed the United States healthcare system should be a value-based model (versus fee-for-service or some other approach), compared to just 33% of physicians.
And although 44% of health plan executives believed that physicians have the tools needed to succeed in a value-based care system, only 29% of physicians agreed. Nearly half (48%) of all respondents disagreed or said theyweren't sure.
In addition, 87% of all respondents said that it's very important (26%) or extremely important (61%) to have access to all of a patient's medical records.
Yet, 65% of physicians said they do not have all the healthcare information they need about their patients. In addition, only 36% of physicians said they're satisfied with access they have to patient data within their existing workflows.
The survey data "reveals that complexity and incomplete access to patient information may be greater obstacles to adoption than previously realized," said Harvey M. Kaufman, MD, in a media statement. Kaufman is senior medical director at Quest Diagnostics.
Limitations to having better information include: "patients can have many physicians [who] may not share information across EHRs or other channels" (78%), "lack of interoperability" (74%) and "no way to integrate into current workflow" (37%).
There is some common ground between physicians and health plan executives on the matter of quality measures.
The majority (75%) of respondents agree that "quality measures are too complex, and this makes it difficult for physicians to achieve them."
Also, only 54% of all respondents agree that "it's clear to physicians which quality measures apply to their individual patients under relevant value-based care models."
Reaction to CMS's proposed rule includes a claim from MGMA that the proposal "provides almost no opportunities for medical groups to begin the shift away from fee-for-service reimbursement."
Physicians may not despise (MACRA) as much as they did the sustainable growth rate (SGR) formula, but the Centers for Medicare & Medicaid Services' proposed rule for implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act isn't winning any popularity contests.
Emblematic of how physicians responded were the comments left by Charles A. Adams, Jr., MD. "While anything that did away with the flawed and completely ineffective SGR should be an improvement, adoption of MACRA will likely not have the desired effect that it hopes to realize," he wrote.
In all, more than 1,200 comments were submitted by individuals, hospital and physician groups, and consumer advocates.
The American Hospital Association
"The AHA is extremely disappointed that few of the models in which hospitals have engaged will qualify as advanced alternative payment models (APMs); we urge CMS to adopt a more inclusive approach," said the American Hospital Association in its comments.
"Specifically, we are concerned that CMS's proposed approach fails to recognize the significant resources providers invest in the development of APMs, because under the proposal, an APM generally must require participating entities to accept significant downside risk to qualify as an advanced APM."
Major physician organizations, including the American Academy of Family Physicians (AAFP), voiced concerns about the proposed pace of implementation.
"While our support for MACRA remains strong, we must state that we see a strong and definite need and opportunity for CMS to step back and reconsider the approach to this proposed rule which we view as overly complex and burdensome to our members and indeed for all physicians," the AAFP wrote in a 107-page letter to CMS Acting Administrator Andrew Slavitt.
"Given the significant complexity of the rule, we strongly encourage CMS to issue an interim final rule with comment period rather than to issue a final rule."
"Under MACRA, high-quality, high-value care and improved health outcomes for patients will be rewarded, but ensuring a smooth transition away from SGR requires up-front work today," said AMA president Andrew W. Gurman, MD.
The rule's timing and complexity are key complaints among specialty groups as well.
The American College of Rheumatology (ACR), for example, argued that most rheumatologists wouldn't be able to comply with the law's requirements under the proposed timeline.
In a joint statement, the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) called the timeline to implement MACRA "overly ambitious" and recommended the initial performance period be delayed from January 1 to no earlier than July 1, 2017, "but ideally not until Jan. 1, 2018."
AANS and CNS also called for participation in a qualified clinical data registry to automatically satisfy multiple Merit-based Incentive Payment System (MIPS) categories, including quality, clinical practice improvement activities, and advancing care information—the MACRA replacement for the meaningful use program for physician practices.
The majority of physician practices with fewer than 25 clinicians, which reflect most neurosurgical practices, will receive negative payment adjustments under the proposed rule, AANS and CNS said.
The two organizations suggested CMS raise the MIPS low-volume exclusion threshold to $30,000 in charges allowed by Medicare, or for practices seeing fewer than 100 Medicare patients.
MIPS and APMs
As for the reporting mechanisms themselves, groups generally decried the bars set by both the Merit-Based Incentive System (MIPS) and Alternative Payment Models (APM) as being unrealistically and unnecessarily high.
"Unfortunately, the MIPS/APM proposed rule strays significantly from Congress's intent to simplify quality reporting and provide new value-based opportunities for physicians in Medicare," Halee Fischer-Wright, MD, president and CEO of the Medical Group Management Association (MGMA), said in an media statement.
"The rule's proposed MIPS scoring system is nothing short of a mathematical marvel. Its narrow definition of APM provides almost no opportunities for medical groups to begin the shift away from fee-for-service reimbursement," she said.
The MGMA submitted a 54-page letter to CMS, while a 70-page letter from the AMA details more recommendations still.
Suggestions for Improvement
Among the scores of public comments urging CMS to halt MACRA, MIPS, and APMs altogether, physicians did offer straightforward suggestions for improvement.
"Establish objective and timely measurement and reporting systems that are simpler and less costly than those required under current programs like PQRS and meaningful use," wrote Texas physician John Ghiodi.
"The focus should be improving care for all Medicare patients, not creating yearly physician winners and losers with payment affected two years after care has been delivered."
Perhaps the most often-recurring theme is summed up by Ghiodi's first suggestion: "Keep it simple."
CHIME Chimes In
The College of Healthcare Information Management Executives (CHIME) also urged CMS to simplify the MACRA rules as proposed.
In particular, CHIME suggested that requirements for providers to attest that they are being compliant to exchange information in standard ways with each other be relaxed until such standards are more clearly defined.
"Because the work underway at the Office of the National Coordinator for Health IT (ONC) to tackle these challenges is not yet complete, CMS is inadvertently asking providers to attest to more than they reasonably can at this time," CHIME stated. "The attestations in the final rule should be modified to recognize this."
CHIME also expressed concern that hospitals and clinicians "are on separate trajectories for pathways to achieve meaningful use… the pass/fail construct and full-year reporting period... [do] not advance interoperability enough to achieve the goals of a value-based delivery system."
Consumer Advocates React
A coalition of consumer groups applauded the proposed rule. The Consumer Partnership for eHealth, representing consumer, patient and labor organizations, did recommend changing the single-patient requirement for e-prescribing, patient electric access and secure messaging, to 5% of all patients in 2019.
Premier, a healthcare performance improvement alliance of approximately 3,600 U.S. hospitals and 120,000 other providers, proposed modifications related to APMs, including adding Comprehensive Care for Joint Replacement and Bundled Payment for Care Improvement as Advanced APMs.
By statute, the final rule for MACRA must be issued no later than November 1.
Making the Department of Veterans Affairs health system an attractive place to work is a key priority in the wake of negative reports about wait times and reimbursements to physicians in the private sector.
The U.S. Department of Veterans Affairs (VA) is looking for 1,800 physicians and 44,000 employees of all kinds, David Shulkin, MD, the department's undersecretary of health, announced last week at the American Medical Association's annual meeting in Chicago.
The VA health system currently employs more than 300,000 people.
Making the VA an attractive place to work is a key priority in the wake of negative reports about wait times, cost overruns and delays at VA facilities being built in Orlando and Denver, and complaints of slow reimbursements to physicians under the Veterans Choice program.
To help achieve this goal, the VA is focused on five initiatives:
Reducing wait times for patients
Engaging employees once again in their sense of mission
Adopting best practices consistently across all VA facilities
Partnering with the private sector to expand access to care
Restoring the confidence of veterans and the public in the VA
Some benefits to working for the VA already exist, Shulkin noted, such as not having to contract with insurance companies or worry about medical liability issues.
VA physicians "don't have to deal with a lot of the things that create burnout in the private sector," he told physicians at the meeting.
Indeed, a 2015 report from The Medicus Firm revealed that 36% of physicians in practice said they would be "very likely" to at least consider a government practice opportunity, with the VA health system being the most popular choice.
More than a quarter of physicians (29%) said, however, that they would "definitely not consider" government employment.
The VA's announcement of its recruiting effort comes closely on the heels of a proposal to allow advanced practice nurses to practice independently within the VA system.
The AMA and other organizations swiftly denounced the proposal, claiming it would "significantly undermine the delivery of care within the VA."
The VA's APRN proposal will be open for comment through July 25.
Physicians who use EHRs and CPOEs are not just less satisfied with their clerical burdens, but also at higher risk for professional burnout, according to a national study.
Add electronic health records systems to the list of factors that contribute to physician burnout.
So far, EHRs and computerized physician order entry systems aren't making good on their promise to make physicians' lives easier.
To the contrary, physicians who use EHRs and particularly CPOEs within their electronic practice environments are not just less satisfied with their clerical burden, but also at higher risk for professional burnout, according to a national study of physicians led by Mayo Clinic.
"Although electronic health records, electronic prescribing, and computerized physician order entry have been touted as ways to improve quality of care, these tools also create clerical burden, cognitive burden, frequent interruptions and distraction—all of which can contribute to physician burnout," Tait Shanafelt, MD, Mayo Clinic physician and lead author of the study, said in a news release.
"Burnout has been shown to erode quality of care, increase risk of medical errors, and lead physicians to reduce clinical work hours, suggesting that the net effect of these electronic tools on quality of care for the U.S. health care system is less clear."
A Mayo study released in April found that for every one-point increase in the seven-point scale of emotional exhaustion, one of three domains measured by the Maslach Burnout Inventory, there was a 40% greater likelihood a physician would cut back his or her work hours over the next 24 months.
It's a problem that could exacerbate the already substantial projected U.S. physician workforce shortage as well as impact continuity of care for patients, Shanafelt told HealthLeaders Media at the time.
The study appearing in the July issue of Mayo Clinic Proceedings, also found that physicians in family medicine physicians, urologists, otolaryngologists, and neurologists, experienced even higher dissatisfaction with these tools than other specialists.
The study used data from 6,560 physicians included in the American Medical Association's Masterfile surveyed between August and October 2014.