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November 2004 News Briefs

November 2004

Published in the November 2004 issue of Today’s Hospitalist

California hospitalsl mixed grades in large patient survey

In one of the largest publicly reported patient satisfaction surveys to date, consumers said that roughly one-quarter of 200 California hospitals did an above-average job. Consumers rated another 51 percent as average, and 25 percent as below average.

Just over half of the state’s acute care hospitals participated in the study, which was conducted by the California HealthCare Foundation and the California Institute for Health Systems Performance. The study asked patients to rate their perception of everything from how well hospitals coordinate care to the safety of medical practices.

More than 36,000 consumers participated in the survey and answered questions on eight areas: respect for patient preferences; coordination of care; information and education; physical comfort; emotional support; involvement of family and friends; transition to home; and safe medical practices. The last area was new this year.

Hospitals in the survey saw the best scores in areas like physical comfort, coordination of care while patients were in the hospital, and respecting personal preferences.

They saw lower scores on measures like providing support to cope with fears and anxieties, help with the transition from hospital to home, and including friends and family.

Analysts noted that consumers gave hospitals slightly lower results compared to last year, but that the difference wasn’t significant.

More hospitals have formal error-disclosure policies

About three-quarters of hospitals have formal, board-approved policies to disclose medical errors to patients, continuing a recent trend in which hospitals have been adopting such policies.

According to a survey conducted by the Premier Safety Institute, about 12 percent said they had no policies in place. That number is down significantly from early 2002, when about two-thirds of hospitals said they had no policy in place.

The survey also found that 57 percent of respondents said errors causing serious or short-term harm are frequently disclosed to patients or families. Thirty seven percent said they always made such disclosures.

Nearly all–99 percent–of respondents said that when they disclose a medical error that results in harm, they usually provide an explanation. In about 90 percent of cases, the disclosure includes an apology.

More than 200 hospitals responded to an informal, anonymous survey on disclosure practices. The survey defined disclosure as “honestly telling patients or their families about unexpected harm that occurs as a result of treatment or care not directly because of patient’s illness or underlying condition.”

The Premier Safety Institute is part of Premier Inc., an alliance of 200 large hospitals and health care systems.

Joint Commission studies smoking cessation services

The Joint Commission on Accreditation of Healthcare Organizations has begun studying smoking cessation efforts for patients who have been diagnosed with myocardial infarction, heart failure and pneumonia.

The Joint Commission has begun to collect information on how well hospitals are trying to help these patients kick the habit. The agency is working with the Smoking Cessation Leadership Center, which is located at the University of California, San Francisco, and supported by the Robert Wood Johnson Foundation.

The Joint Commission began by randomly surveying 185 hospitals about their smoking cessation counseling practices. Since that original survey, more than a dozen other hospitals have joined the effort voluntarily to see if their programs are working or to identify weaknesses.

One goal of the survey is to determine whether hospitals do a better job of offering smoking cessation services for patients with some diseases.

The Joint Commission plans to publish the survey results and disseminate the best practices it identifies.

How the medical liability crisis is hurting hospitals

In states that have suffered double-digit increases in the costs of medical liability insurance, physicians and hospitals alike are suffering. An American Hospital Association survey found that many hospitals in these states have had to increase their insurance risk by raising deductibles and reducing coverage for physicians, and have lost physicians, among other things. Here is a snapshot of how hospitals say the crisis has affected them:

  • Increased insurance risk: 64%
  • Lost physicians: 50%
  • Ability to provide services suffered: 42%
  • Access to care significantly hurt: 14%

Source: American Hospital Association survey

Are your hospitalist earnings keeping pace ? Find out in the forthcoming feature: 2008 Hospitalist Salary Survey appearing in October 2008.