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November 2006 News

November 2006

Published in the November 2006 issue of Today’s Hospitalist

Online resources can boost efforts to end dangerous abbreviations

As part of their national campaign to end the use of confusing drug abbreviations, the Institute for Safe Medication Practices (ISMP) and the FDA have created an online toolkit of resources to educate providers about medical abbreviations they should no longer use.

The toolkit includes the following:
“¢ An error-prone abbreviations list includes many of the same abbreviations on the “do not use” list published by the Joint Commission on Accreditation of Healthcare Organizations, but it is more comprehensive.

“¢ A brochure outlines the scope of the problem of sound-alike drugs and provides a short list of some of the most common and dangerous abbreviations.

“¢ A print public service ad can be used in organizations’ internal publications.

“¢ An abbreviations slide set designed for brief presentations can be used alone or incorporated into other medication safety presentations.

“¢ An FDA patient safety video is designed for educational presentations or training.

More information is online.

Leapfrog releases list of nation’s “top hospitals”

The Leapfrog Group’s first “Top Hospitals” list says that while U.S. health care has made some gains in meeting well-accepted quality measures, it still has a long way to go.

While 59 hospitals made the “Top Hospitals” list, more than 1,200 hospitals put their name into the ring by responding to a survey. The list was released last month by the Leapfrog Group, a leading national health care purchasing group that has issued standards for inpatient care.

The group compiled its “Top Hospitals” rankings by asking hospitals whether they had implemented computer physician order entry (CPOE), ICU physician staffing and evidence-based hospital referral, and made progress on safe practices endorsed by the National Quality Forum.

The following were among survey findings:

“¢ Nine in 10 hospitals fail to meet standards for performing coronary artery bypass graft surgery and abdominal aortic aneurysm repair.

“¢ Seven out of 10 hospitals do not use intensivists to oversee patient care in the ICU, one of Leapfrog’s quality standards. However, 26 percent of responding hospitals now have intensivists in the ICU, up from 10 percent in 2002, when Leapfrog began tracking the implementation of the standard.

“¢ Five in 10 hospitals do not have an explicit protocol to ensure adequate nursing staff.

“¢ Three in 10 hospitals lack procedures to prevent malnutrition in patients, and do not vaccinate health care workers against flu.

“¢ Less than one in 10 hospitals (7 percent) have implemented CPOE, with another 7 percent planning to implement such systems in 2007.

Survey results and the “Top Hospitals” list are online.

New CMS project will test gainsharing rewards for physicians

The Centers for Medicare and Medicaid Services (CMS) has announced a new demonstration project to test gainsharing initiatives and financial incentives for physicians who improve the quality of inpatient care.

The program will pay physicians a portion of the savings that result from quality improvement programs they implement. The CMS is looking for 72 hospitals to participate in the three-year project, which will begin next year.

The agency is inviting physician groups, integrated delivery systems, and coalitions of physician groups and hospital systems to apply. To boost the amount of quality and incentive data the project collects, the agency will give preference to proposals submitted by consortia composed of health care groups and affiliated hospitals.

The deadline for submitting proposals is Jan. 9, 2007.

Application requirements and more details of the physician hospital collaboration demonstration are online.

Quick facts: Inhaled corticosteroids reduce COPD death

“¢ Patients age 65 or older had a 23 percent reduced risk of death when receiving inhaled corticosteroids within 90 days of discharge, compared to receiving bronchodilators.

“¢ Patients age 65 or older receiving inhaled corticosteroids within
90 days of discharge had a
mortality rate of 11.7 percent, compared to 13.1 percent for those who did not.

“¢ The mortality rate of patients ages 35-64 receiving inhaled corticosteroids was 3 percent, compared to 6 percent among patients not receiving inhaled corticosteroids.

“¢ Researchers found the most significant results when inhaled corticosteroids were administered within the first 30 days after discharge.
Source: Chest, September 2006