A startling number of people—especially women—living primarily in the Deep South and in Appalachia saw a drop in life spans beginning in 1983, according to researchers at the Harvard School of Public Health. The study found that found that 4% of the male population and 19% of the female population experienced either declines or stagnation in their life expectancy in the ’80s and ’90s. In addition to race and poverty, other contributing factors include an increase in diabetes, cancers and chronic obstructive pulmonary disease, researchers said.
New research shows that in hospitals and other healthcare facilities with MRSA, aggressive screening of healthcare workers should be combined with other measures to help reduce infection rates. The study’s authors looked at data from 169 studies of 33,318 healthcare workers in 37 countries, and found that 4.6 percent of the workers carried MRSA and, of these, 5.1 percent had clinical MRSA infections.
The New York Immigration Coalition and other groups have released a report on the availability of language assistance at city hospitals for non-English-speaking patients. The report says that such help at hospitals seems to have improved since 2006, when state health officials began regulating communication between hospitals and their non-English-speaking patients. Much more still needs to be done, however, particularly regarding languages such as Korean, Haitian Creole, Russian, Arabic and Bengali, the report states.
The federal government is not doing enough to protect patients from hospital infections, and as a result is endangering tens of thousands of lives and costing billions of dollars, according to a report from the Government Accountability Office. Although private groups demand steps such as requiring doctors and nurses to wash their hands, the government has not established sufficient standards for hospitals to follow or prodded hospitals to follow those standards to reduce infections, the GAO added in the report. The GAO report urged the government to prioritize its standards and improve data collection.
The death of a 76-year-old man and a list of other violations triggered an investigation that almost cost Louisburg, NC-based Franklin Regional Medical Center its federal dollars to treat poor and elderly patients. Franklin Regional was found by the Centers for Medicare & Medicaid Services to have acted unacceptably after the elderly patient arrived at the hospital for an elective knee surgery and complained to the nurse that he had chest pains and loss of feeling in his left arm. The man died of heart failure the following day. The case is one of several failures outlined in a 44-page report from the CMS, resulting in a threat to pull Franklin Regional's federal funding, a major revenue stream for the hospital.
As I was putting together this week’s edition of QualityLeaders, the Centers for Medicare & Medicaid released nine new proposed “never events” that hospitals won’t be reimbursed for if they are acquired while a patient is receiving care at the organization.
These conditions include:
Blood clots in the vascular system
Bloodstream infections
Ventilator-associated pneumonia
Legionnaire’s disease
Delirium
Collapsed lung as a result of medical treatment
The nine new conditions on the “won’t reimburse” list aren’t much of a surprise to anyone. Many of the quality leaders I’ve spoken with in recent weeks seemed to expect that the original eight on CMS’s list would soon have company. Some even went so far as to say that the first eight were the “low-hanging fruit” or the most obvious of the conditions that hospitals must take care of to provide quality and safe care to patients. But what do these new additions tell us about where CMS is headed? Are they reasonable?
James Kennedy, MD, CCS, of FTI Healthcare in Brentwood, TN, told my colleague Lisa Eramo that although the majority of the new conditions listed by CMS are reasonable, there are some that raise eyebrows. For example, patients can acquire Legionnaires’ disease both in and out of the hospital setting, particularly through air conditioning units that contain waterborne pathogens. Certainly, he says, patients have acquired the disease from hospital air conditioning units, but it isn’t clear how hospitals will determine if the condition was present on arrival.
The additions of clostridium difficile colitis and delirium have also been questioned, as these two conditions often occur as a side effect of medication or being in the hospital for expanded periods of time.
Fortunately, CMS gives us until June 13 to comment on these proposed additions before it releases the final rule on or before Aug. 1. Will you be sending your comments? If so, what will you tell them? Do you think your feedback will be addressed in the final rule?
A note to my faithful readers: In last week’s column, I promised to introduce you to more “zero heroes.” I haven’t forgotten about them. Stay tuned.Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at mlarkin@healthleadersmedia.com.