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In The News

CDC: big drop in bloodstream infection rates
In its first breakdown of hospital-acquired infections by state, the CDC is reporting that hospitals in 20 states in 2010 were able to drive down their central line-associated bloodstream infection rates. That decline translated to a 32% national reduction in those rates in 2010 from 2009. (Only Arizona and Delaware, according to a new CDC report, experienced higher rates in 2010 than the year before, while the infection rate in 20 states was unchanged. Nine states didn't report data.) The report also found that the incidents of catheter-related UTIs had fallen 3% while the rate of surgical site infections in 2010 dropped 8%.

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Posted on 04-23-2012 at 10:47 AM

Financial woes mean fewer office visits, admissions
Patients' financial pressures last year translated to fewer office visits and elective admissions, according to a new report. IMS Health, a health care data company, found that non-emergency admissions in 2011 fell only 0.1%, but that emergency admissions rose 7.4%. Commentary on that report claimed that was a sign that patients were postponing or spacing out therapies and coming into hospitals sicker. The IMS report found that the number of office visits in 2011 dropped 4.7%, following a 4.2% decline in office visits in 2010. For patients age 65 and older, the report also found a 3.1% reduction in prescription drug spending, with the biggest drop in spending for hypertension drugs.

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Posted on 04-23-2012 at 10:45 AM

Surgery bests medical therapy for obese diabetics—again
A new study that randomized morbidly obese patients with diabetes to either laparoscopic sleeve gastrectomy or medical therapy found that most patients in the surgical arm had their diabetes in remission after 18 months and much better control of other comorbidities. Italian researchers randomized 60 patients with an average BMI of 40 and type II diabetes to either bariatric surgery or medical therapy. After 18 months, 80% of the surgical patients had their diabetes in remission, much better control of hypertension and dyslipidemia, and an average BMI of 28. The patients receiving only medical therapy, on the other hand, still needed diabetes medications and had lost much less weight. (Recent studies in NEJM had similar results.) The study was published in the Archives of Surgery, with an accompanying editorial calling for guidelines to help clinicians refer patients for surgery.

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Posted on 04-19-2012 at 10:05 AM

The high price of inpatient infections
An analysis of U.S. hospital data finds that the presence of a hospital-acquired infection in ICU patients quadruples patients' rate of in-hospital mortality and doubles LOS in critical care units. That's according to results of a study recently presented at the European Congress of Clinical Microbiology and Infectious Diseases. Researchers found that 16.9% of ICU stays are associated with hospital-acquired pneumonia while 14.5% are associated with bloodstream infections. For patients with a hospital-acquired infection, ICU LOS jumped from 8.1 days to 15.8.

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Posted on 04-19-2012 at 10:04 AM

Curbing elective deliveries cuts NICU admissions
A hospital in Louisiana that adopted a state initiative to cut back on elective deliveries and wait until a pregnancy has progressed to at least 39 weeks has seen its number of NICU admissions drop 20%. According to local coverage, that reduction is due to ending elective deliveries earlier in pregnancies and having many fewer babies whose lungs haven't fully developed. A doctor quoted in that local coverage states that due dates can be off as much as two weeks so that some induced deliveries are taking place as early as 35 weeks into a pregnancy.

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Posted on 04-19-2012 at 10:02 AM

Is your hospital wasting money?
Research from a national performance improvement alliance finds that hospitals routinely overspend due to inefficient care processes and having the wrong number or wrong type of personnel delivering care. Researchers with the Premier health alliance, which includes more than 2,500 U.S. hospitals, focused on community hospitals with between 200 and 300 beds. They found that the average hospital is wasting money in these five areas: unnecessary labor costs, with more clinicians working on tasks than are needed (an excess cost per hospital of $6 million a year); excess readmissions, costing close to $4 million per year per hospital; inappropriate LOS; a skill mix variance, where clinicians with higher licenses are performing low-level tasks; and excess lab testing and imaging. Premier has released a dashboard that enables hospitals to assess their own spending and where they're incurring unnecessary costs. That assessment tool is free to Premier members.

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Posted on 04-17-2012 at 12:20 PM

Gap between ethical EOL practices and perceptions
A survey of physicians who work in hospice and palliative care finds that more than one-half of them report at least one incident within the last five years in which legal and ethical EOL care was characterized as euthanasia or killing by a patient, family member or another physician. Survey results, published in the Journal of Palliative Care, were based on responses from more than 660 physicians. The authors found that 4% of those respondents had been formally charged by their institution, state medical board or prosecutor with hastening a patient's death, although none had been found guilty of any charge. The authors indicated that palliative sedation and discontinuing artificial feeding or hydration were particularly prone to misperceptions.

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Posted on 04-16-2012 at 12:10 PM

Clinicians increasingly use social media to land a new job
Hospitals interested in recruiting should be gearing up their Facebook pages and Twitter accounts. That's because a new survey finds that a growing number of health care professionals, particularly those who work in hospitals, are using social media to find—and respond to—job openings. Survey results released by AMN Healthcare, a national recruiter, indicate that 31% of those surveyed in 2011 used social media as part of their job search vs. only 21% in 2010. Of those who used social media for job listings, 36% were allied professionals, 33% were nurses, 29% were pharmacists and 23% were physicians. According to survey results, mobile job alerts were particularly effective in attracting professionals who were happy in their current jobs but were enticed to follow up on a publicized job opening.

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Posted on 04-16-2012 at 12:09 PM

Decision aid steers low-risk patients away from stress tests
Mayo researchers using a teaching tool for low-risk chest pain patients in the ED learned that many more of those patients opted out of observation admission and stress testing than patients receiving usual care. More than 200 patients with chest pain who had no troponin elevation, risk factors or history of acute coronary syndrome were randomized to either be given the decision aid or not. The tool consisted of a pictograph showing that only two out of 100 people at low risk had a heart attack within 45 days and explained that patients could be admitted to the observation unit for a stress test and monitoring or could pursue outpatient follow-up within 72 hours. Among the teaching-tool group, only 58% opted for stress testing and observation admission vs. 77% in the other arm, a 19% reduction, although more patients who received the teaching aid went for outpatient follow-up. (Neither group had any 30-day major adverse events.) The authors, writing in Circulation: Cardiovascular Quality and Outcomes, noted that routine stress testing for low-risk patients results in some false positives and unnecessary procedures and costs.

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Posted on 04-12-2012 at 9:37 AM

Hospitalization itself contributes to cognitive decline
A recent study targeting elderly patients found that those patients suffered marked declines in cognition, memory and executive function following a hospital stay. Researchers publishIing in Neurology interviewed 1,870 adults in three-year intervals for up to 12 years to obtain baseline scores for global cognition. They found that a hospitalization was associated with a 2.4-fold increase in decline for global cognition, as well as with functional and memory losses. Even adjusting for illness severity, older age and length of stay, the authors wrote, didn't account for "the effect of hospitalization."

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Posted on 04-12-2012 at 9:34 AM

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