Great Lakes Partners for Patients pools resources to improve patient safety and reduce HAIs and readmissions.
Hospital associations in Michigan, Illinois, and Wisconsin have created a joint Hospital Improvement Innovation Network (HIIN) to reduce readmissions and hospital-acquired conditions, and improve patient safety.
More than 330 hospitals and health systems in Michigan, Illinois, and Wisconsin are expected to participate in the Great Lakes Partners for Patients, according to a joint media release issued by the pact.
The partnership builds on the quality improvement work of the Michigan Hospital Association, Illinois Hospital Association, and Wisconsin Hospital Association through the federal Partnership for Patients Hospital Engagement Networks (HEN) 1.0 and 2.0.
The HIIN is a component of HEN, which has supported patient safety initiatives in 3,700 hospitals across the nation.
"Our partnership with IHA and WHA builds upon the extensive learning network developed for Michigan hospitals over the past decade, including four years under HEN 1.0 and 2.0," said Sam R. Watson, MHA's senior vice president of patient safety and quality.
"Our multi-state partnership with IHA in HEN 2.0, which has now expanded with WHA in HIIN under the Great Lakes Partners for Patients, gives our organizations the opportunity to share solutions that have been successful in communities across Michigan, Illinois, and Wisconsin.
"The partnership allows us to continue implementing innovations necessary to achieve goals to prevent harm, save lives and lower healthcare costs."
Over the next three years, Great Lakes Partners hospitals will focus on 11 inpatient safety concerns:
Adverse drug events
Central line-associated blood stream infections
Catheter-associated urinary tract infections
Clostridium difficile bacterial infection, including antibiotic stewardship
Injury from falls and immobility
Pressure ulcers
Readmissions
Sepsis and septic shock
Surgical site infections
Venous thromboembolism
Ventilator-associated events
Through 2019, the goal is a 20% decrease in overall patient harm and a 12% reduction in 30-day hospital readmissions as a population-based measure from the 2014 baseline. CMS will monitor and evaluate the HIINs to ensure that they are working.
Although they can raise the risk of medical errors, interruptions can also benefit technologists who work with radiopharmaceuticals.
What happens when nuclear medicine technologists get interrupted while working with dangerous, expensive radiopharmaceuticals?
Sometimes, these interruptions lead to better patient care. In fact, attempts to control interruptions might be counterproductive, according to a BMJ Quality & Safety Journal study published online.
Nuclear imaging technologists work in busy environments with a range of tasks and interruptions that could increase the risk of medical errors. Previous research had suggested that technologists are involved in about 70% of incorrect administrations of nuclear medicine.
However, the study authors found these technicians have effective systems in place to deal with constant interruptions.
They observed the staff of a nuclear medicine department at 975-bed teaching hospital in Sydney, Australia, which performs routine general nuclear medicine and positron emission tomography studies.
The department included six full-time and five part-time technologists with between one and 23 years of experience each.
During the study period, the technologists completed 5,227 tasks and experienced 569 interruptions. The interruptions during radiopharmaceutical preparation occurred an average of 4.4 times per hour. Most tasks were interrupted once only and all tasks were resumed after interruption.
Technologists used a variety of verbal and non-verbal strategies in all work areas to minimize the impact of interruptions and optimize the safe conduct of procedures, according to the study. Some of these strategies were formal departmental policy; others were individual choices.
Safety strategies linked to decisions made by individual technologists included not interrupting a colleague or deferring taking a break. Departmental strategies included using barcoding for syringes and use of whiteboards "to uphold safe work practices," the authors stated.
"Some interruptions were initiated by other technologists to convey important information [about patients or procedures] and/or to render assistance," the authors stated. "Some interruptions were beneficial."
Last year, for the first time, CMS's Comprehensive Primary Care the program generated savings: $57.7 million in total on Medicare Part A and Part B spending.
After failing to generate any shared-savings payments for primary care practices in 2013 and 2014, practices in four of the program's seven regions generated shared savings in 2015, Medicare reports.
In 2015, physician practices participating in Medicare's largest value-based payment initiative for primary care generated shared savings for the first time, according to a Centers for Medicare & Medicaid Services blog post published this week.
The Comprehensive Primary Care initiative was launched in October 2012, with the first year of the program running through December 2013. In the first year of the four-year program, 497 primary care practices participated. Last year, 481 practices participated. The program operates in seven states.
CPC features a monthly care management fee for participating physician practices that is not tied to patient visits and the opportunity for physician practices to earn shared savings payments from Medicare.
Last year, the program generated $57.7 million in total savings on Medicare Part A and Part B spending, with management fees pegged at $58 million, according to CMS.
Primary care practices in four states—Arkansas, Colorado, Oklahoma and Oregon—generated $13 million in earned shared savings, Conway wrote.
The net gains achieved in Arkansas, Colorado, Oklahoma and Oregon offset net losses in the other three states—New Jersey, New York and Ohio. Despite those losses, "the savings generated in the other four regions covered those losses, such that care management fees across CPC were offset by reduced spending on Medicare Part A and Part B services."
Last year, primary care practices participating in CPC served more than 376,000 Medicare beneficiaries and a total of more than 2.7 million patients, according to CMS.
The modest gains reported this week by Patrick Conway, MD, CMS principal deputy administrator and chief medical officer, in a blog post, mark a significant milestone for CPC, which generated no "statistically significant net savings over the first two years" of the program, according to an annual report on the initiative published in April.
"As the largest test of advanced primary care in U.S. history, CPC demonstrates the potential of primary care clinicians redesigning their practices to deliver better care to their patients, and provides clinicians support to innovate and deliver care in ways that better meet their patients' needs and preferences," Conway wrote.
In January, CMS is set to launch a two-track successor to CPC: Comprehensive Primary Care Plus (CPC+). As many as 2,500 primary care practices are expected to participate in each of the two tracks of the program across 14 regions.
CMS is reviewing applications from primary care practices seeking to participate in CPC+ and the agency plans to announce the list of participating practices before Thanksgiving.
CRM, niche audiences, and location-based advertising could net facilities more patients.
Hospitals that appeal to niche groups and know what patients need before they know they need it stand to rise above their competition in 2017, according to Smith & Jones' 2017 Hospital Marketing Trendswhite paper.
"With population health and high-deductible health insurance plans at the forefront of care, organizations will benefit from providing a more proactive and personalized patient experience," the Troy, NY–based communications firm's white paper stated.
"Hospitals and health systems that gain the attention of niche audiences and provide resources to help patients make healthier choices will outsmart the competition in 2017."
Following are three trends to watch:
1. Customer Relationship Management
Hospital marketers can become more proactive with customer relationship management (CRM) tools, according to the white paper, which listed CRM use as its number one trend for the year ahead.
"In 2017, hospital marketers will use CRM even more as a vehicle to attract new [patients] and retain existing patients while measuring marketing outcomes," the white paper states.
"The benefits are quantifiable. Organizations can use this platform to track campaign results and ROI. The benefits are also altruistic. With CRM, marketers can tailor messages and target people who can benefit the most from your care services."
For example, during Breast Cancer Awareness Month, a hospital could use a CRM database to identify patients who are statistically at greater risk for breast cancer or are overdue for a mammogram.
2. Targeting Niche Audiences
Hospital marketers who target focused audiences will have a better chance of competing for search ranking in today's oversaturated content marketing world, where Cleveland Clinic and WebMD dominate organic search rankings, the white paper states.
As such, marketers who create content for specific niche groups, like minorities, medical tourists, or young mothers, will be more likely to gain traction and traffic.
"Niche audiences tend to be more passionate about their specific interests, values, and hobbies. By adding a dimension of differentiation, you can zero in on specific audiences and better compete for their attention," the white paper reads.
Such differentiation might include an orthopedic campaign that targets older couples who regularly compete in pickle-ball tournaments and are at an increased risk of joint injury. Another example would be a cardiac campaign that targets Hispanic males who are at a high risk for heart disease.
"Your target audience may decrease in size, but your variables of engagement are going to increase significantly," the white paper states.
3. Location-based Advertising
In the year ahead, savvy healthcare facilities won't just be targeting patients by niche group—they'll also be targeting patients by their location.
Techniques like geoconquesting are gaining popularity, according to the white paper. Geofencing refers to the practice of defining a geographic region which, once entered, will trigger the ad copy to be displayed. Geoconquesting automatically directs consumers to a specific business when they are physically in a competitor's location.
These digital tools generate a deep pool of analytical data that hospital marketers can use to gauge how well their targeted offerings bring patients into their organization, the paper stated.
Geofencing and geoconquesting initiatives not only help drive awareness and build volume, but can also contribute to stronger relationships with patients, the white paper asserted.
"By exploiting a consumer's location, you can deliver content that may not have been sought after, but puts your organization on their radar."
Stamford Health's rebranding efforts didn't end with the grand opening.
The recent ribbon-cutting ceremony for the new $450 million Stamford Hospital in Fairfield, CT, marked the culmination of Stamford Health's year-long awareness and rebranding campaign.
Last summer, Stamford Hospital changed its name to Stamford Health, working with creative agency ab+c to aggressively roll out its new brand "Healing. Reimagined."
The challenge was to educate the public about what "Healing. Reimagined." meant and why the organization was changing its name to Stamford Health, said Maria Stearns, healthcare team director for ab+c.
To tackle this challenge, the ab+c team developed an integrated market-wide campaign to:
incorporate new brand messaging
promote Stamford's primary service lines
raise awareness about the new hospital
In January, the hospital launched its rebranding campaign internally. The effort included a brand video, direct mail to employees, and a comprehensive internal communications plan.
This assured that employees understood the goals and were prepared to be brand ambassadors, Stearns said.
The rebranding campaign launched marketwide in February, with a focus on leveraging the brand and the new hospital to differentiate Stamford Health from others in the market.
A series of brand- and service-line-specific ads on broadcast and social media, mass transit, and outdoor signage directed people to landing pages on Stamford Health's website, where they could see new physician videos, find a doctor, make an appointment, learn about the new hospital, and engage with the Stamford team.
The campaign ran through late September, and the new hospital opened on September 26.
After the hospital opened, marketers launched a new commercial and virtual tour to encourage the public to take a closer look at the new facility—which occupies 650,000 square feet and includes 180 private patient rooms—and understand how it will change patient care.
The home health provider Almost Family, Inc. will pay Community Health Systems $128 million for 80% equity, creating the nation's largest for-profit hospital/home health joint venture.
Home healthcare provider Almost Family, Inc. will pay $128 million to acquire an 80% stake in the home health and hospice unit of Community Health Systems, Inc., the two companies announced Monday.
When finalized by the end of the year, the deal is expected to create the largest joint venture between a publicly traded hospital and a home healthcare provider, the two companies said in a joint media release.
CHS Home Health operates 74 home health and 15 hospice branch locations in 22 states. When the deal is finalized, Almost Family will operate 340 branches across 26 states with annual net revenues expected to exceed the $800 million.
Almost Family CEO William B. Yarmuth said the Louisville, KY-based home health provider has grown dramatically in size and in scope since its founding in 1976.
"This partnership with CHS may be the most strategic of all the investments we've made yet," Yarmuth said. "We believe it will enable us to see the healthcare continuum and home care specifically through the eyes of not only one of America's best hospital companies, but one of America's best healthcare companies, leading us to an even better understanding of the needs of our patients and how to meet them."
Almost Family said the acquisition would:
Create the nation's third-largest Medicare home health provider.
Substantially add scale with approximately $200 million in annual revenues: $170 million in home health and $30 million in hospice.
Create a true post-acute healthcare partnership to better manage patient needs across the CHS hospital network; collaborate on improving care coordination and transitions at a lower cost to Medicare; and provide development opportunities for additional joint ventures in CHS locations not supported by a common owned certified agency.
Expand Almost Family's geographic footprint in 26 states.
Wayne Smith, CEO of Franklin, TN-based CHS, said retaining "a meaningful interest" in the home health unit would "help ensure appropriate post-acute care coordination for the benefit of our patients."
"We believe hospitals need strong strategic post-acute partners to provide the right care for patients and return them safely and securely home following a hospital stay. We selected a partner with proven capabilities and a successful track record," Smith said.
Community Health Systems, Inc. is one of the largest publicly traded hospital companies in the United States and owns, leases or operates 158 hospitals in 22 states.
The nation's largest nursing home pharmacy received kickbacks from Abbott Laboratories in exchange for promoting the prescription drug Depakote, says the Department of Justice.
Omnicare Inc., will pay $28.1 million to resolve whistleblower claims that it asked for and got kickbacks from Abbott Laboratories to promote the anti-epileptic drug Depakote to nursing home patients, the Department of Justice announced Monday.
"It is disturbing that any healthcare corporation would pay kickbacks that corrupt the professional medical decision making process in order to pad their profits," said Special Agent in Charge Nicholas DiGiulio of the Department of Health and Human Services Office of Inspector General. "These practices are unacceptable and will not be tolerated."
The government complaint said Omnicare hid the illicit payments from Abbott in a variety of ways, such as calling the lucre "grants" and "educational funding." In one instance, investigators said Omnicare solicited money from Abbott and other pharmaceutical manufacturers to its "Re*View" program.
Omnicare claimed that Re*View was a "health management" and "educational" program, but investigators said it was a way for Omnicare to solicit kickbacks from drug makers to use their drugs on nursing home residents. In internal documents, Omnicare referred to Re*View as its "one extra script per patient" program.
The complaint also alleges that Omnicare conspired with Abbott to increasing rebates based on the number of nursing home residents serviced and the amount of Depakote prescribed per resident.
The complaint further alleges that Abbott paid for Omnicare management junkets on Amelia Island, FL, provided tickets to sporting events for Omnicare executives, and made other payments to local Omnicare pharmacies.
The allegations predate by six years the $12.9 billion acquisition of Ohio-based Omnicare by CVS Health Corporation in August, 2015.
In a statement Monday, Woonsocket, RI-based CVS Health stressed that the scheme "involved Omnicare only and no allegations were made against any of CVS Health's other businesses, including CVS Pharmacy and CVS Caremark. CVS Health is committed to the highest standards of ethics and business practices and there was no admission of wrongdoing. The Company agreed to settle this matter to avoid the expense and uncertainty of protracted litigation."
Approximately $20.3 million of the settlement will go to the United States, while $7.8 million has been allocated to cover Medicaid program claims by states that elect to participate in the settlement.
In May 2012, the United States, numerous states and Abbott entered into a $1.5 billion global civil and criminal settlement that resolved Abbott's liability under the False Claims Act for alleged kickbacks to nursing home pharmacies, including Omnicare and PharMerica Corp.
In October 2015, PharMerica agreed to pay $9.25 million to the United States and numerous states to resolve civil liability under the False Claims Act for the alleged kickbacks from Abbott. The settlement announced today resolves Omnicare's role in that alleged kickback scheme.
Survey shows that 97% of healthcare lawyers expect their involvement in cybersecurity matters to increase within the next three years, but many worry that their healthcare industry clients are ill-prepared to deal with an attack, and lagging other sectors of the economy.
More than eight in 10 (84%) healthcare sector attorneys have been called on to evaluate security incidents and develop internal policies and procedures, and nearly all of them (97%) expect their involvement in cybersecurity matters to increase over the next three years.
That's according to a nationwide survey of more than 300 healthcare sector attorneys conducted by Bloomberg Law and the American Health Lawyers Association (AHLA). The survey also found that:
More than 90% of corporate healthcare attorneys believe their organizations are at greater risk for a cyberattack than companies in other industries.
About 40% said their plans are too generic and lack specific guidance for the types of incidents their organizations or clients might face and have not been adequately tested.
One-third of attorneys said that plans are not updated to reflect the most recent types of cyber threats or organizational changes.
"Healthcare providers have stepped up in recent years to identify and address cyber threats before they materialize, but according to survey findings, healthcare attorneys still believe that the health care industry is more vulnerable to breaches and attacks than other industries," David Cade, CEO at the AHLA, said in remarks accompanying the survey. "Quality education for attorneys working in this area will help them effectively counsel clients in preventing and responding to cyberattacks."
The dramatic rise in IT system security breaches across all sectors of the economy – from banking to government and including healthcare, prompted Moody's Investors Service last year to include "cyber risk" as a "stress-testing scenario" when assessing credit scores.
The not-for-profit healthcare sector is not immune to the threat or its consequences, particularly as it relates to patient records and the disruption of medical technology, Moody's said.
"An information breach would likely not materially disrupt services and the financial impact would be limited," Moody's stated. "A breach in medical technology security would present more immediate risk and impair the hospital's reputation, volumes, and financial performance. Whether or not such a cyber-event would be covered by a hospital's medical malpractice insurance is untested."
Lisa Goldstein, associate managing director, public finance group at Moody's, compared preparing for cyber risks to preparing for Medicare or Medicaid cuts.
"We look at it through the lens of any hospital's next year's operating and capital budget; what the expenditures are going to be; what the pressures on operations may be," Goldstein said.
Half of surveyed medical doctors believe that they likely had a mental illness at some point. One in three have received a formal mental health diagnosis since medical school.
Physicians might urge their patients to seek treatment for issues like depression and anxiety, but when it comes to their own mental health, many are far less willing to get help.
They fear stigma and even possible sanctions for revealing their diagnosis, according to a study published in General Hospital Psychiatry.
Nearly half of the surveyed physicians in the study believed they had met the definition for a mental illness at some point during their career, but had not sought treatment.
Researchers at the University of Michigan Medical School fielded an anonymous 24-question survey among more than 2,100 female physicians who are also mothers via a closed Facebook group.
Almost half the respondents believed that they likely had a mental illness at some point. One in three had been given a formal mental health diagnosis since medical school.
However, two–thirds reported that fear of stigma drove them to keep their worries quiet.
Many thought they could manage their situation on their own, including writing their own prescriptions or paying cash for visits to avoid having an insurance company record, says lead researcher Katherine Gold, MD, MSW, MS.
Many states require physicians to report any mental diagnosis to their state medical licensing board. Such reports often result in increased investigation by boards, the researchers said.
"There has always been a stigma and a fear around mental illness, and that's what's reflected in many state licensing board questionnaires," Gold said in a statement accompanying the publication of the study.
Inconsistent Reporting Guidelines
"There's a huge discrepancy between what states ask about physical conditions—such as whether those conditions affect their ability to practice—and what they ask about mental conditions, where the impact on their abilities is not asked about."
State licensing board questionnaires vary widely, the researchers noted. Some ask if physicians have ever been diagnosed with a mental health problem, while others ask if they've had such a diagnosis in the last few years. Others ask if physicians have ever been hospitalized for a mental health reason.
Simply not disclosing their mental health diagnosis at all seems to be the solution for most physicians: The survey showed that just 6% of those who had ever been diagnosed had reported it to their state licensing board, as most felt their condition didn't affect the care they gave.
Other reasons for non-disclosure included:
Respondents' belief they could manage independently
Limited time
Embarrassment or shame about a diagnosis
Researchers called for several reforms in response to their findings, including modernizing state licensing board questionnaires, modifying hospital credentialing, and increasing support and education among physicians and medical students to destigmatize mental healthcare.
Certain programs designed to keep patients out of the hospital are safe for some acute conditions, research shows.
Several methods designed to keep patients out of the hospital are safe, according to an analysis of 20 years of research.
Researchers from Massachusetts General Hospital in Boston looked at 22 review articles published between 1995 and 2016 on approaches for treating conditions commonly treated in an inpatient setting. The studies covered pulmonary embolism, deep venous thrombosis, pneumonia, chest pain, kidney stones, and symptoms of heart failure or emphysema.
The following alternative approaches to care were deemed safe, according to the analysis:
Outpatient management after initial diagnosis: Use of this approach for several acute medical conditions produced no significant difference in mortality, disease-specific outcomes, or patient satisfaction compared with inpatient admission.
Quick diagnostic units designed to rapidly diagnose serious conditions, such as certain cancers: The evidence was more limited but indicated low mortality rates and high patient satisfaction, the researchers reported.
Programs that deliver inpatient-level care to patients treated in the emergency department or an outpatient clinic: A variety of acute medical conditions had mortality rates, disease-specific outcomes, and patient and caregiver satisfaction that were either improved or no different compared with inpatient admission, the researchers stated. The exception was chronic obstructive pulmonary disease, where alternative programs did not increase patient satisfaction.
The use of observation units within hospitals for 24 to 48 hours with outpatient follow-up: For asthma, chest pain, and atrial fibrillation, there was no difference in mortality, shorter lengths of stay, and better patient satisfaction compared to inpatient admissionst. Results for some conditions were more limited, the researchers noted.
The analysis showed there are opportunities for safe and effective health system redesign to include alternative management strategies for certain acute medical conditions, "although further evaluation is required in some cases," they concluded.