Published in the March 2012 issue of Today’s Hospitalist
Patient satisfaction scores: Who’s happy?
A LOOK AT PATIENT SATISFACTION SCORES for physicians finds that patients are less satisfied if they have to spend time in the ED, but more likely to be satisfied if they are admitted and have higher total and drug-related costs. The analysis, which was posted online by the Archives of Internal Medicine, also found a correlation between higher reported satisfaction levels and higher mortality.
Researchers looked at Medicare survey data from 2000-05. They noted that because higher satisfaction was related to not being in the ED, patients who are more satisfied may be in the hospital for elective or non-urgent reasons.
The authors claim that higher drug costs for patients with higher satisfaction scores could also be tied to doctors’ prescribing requested drugs. They also noted that an undue emphasis on patient satisfaction might discourage physicians from having essential conversations on topics that make patients uncomfortable including drug use, noncompliance and psychiatric issues.
Hand hygiene goes high tech
RESEARCHERS USING VIDEO MONITORING to boost handwashing compliance learned that the high-tech approach works, as long as providers receive feedback on how often they wash (or don’t wash) their hands.
A 17-bed ICU was outfitted with video cameras to record activity at every sink and hand dispenser, as well as door sensors to note when anyone came in or out. During one 16-week period in 2008, handwashing was monitored by video auditors but no feedback was given to providers. During that period, handwashing compliance was less than 10%.
That rate rose to 81.6%, however, when performance feedback was electronically posted on the ICU walls as well as e-mailed in summary reports to supervisors. Post-intervention, the rate of compliance rose to 87.9% and was maintained at that level for nearly two years. Results were published online by Clinical Infectious Diseases.
Problems with off-the-shelf CPOE
COMMUNITY HOSPITALS that rely on vendor CPOE systems may find their rates of adverse events going up, not down, after implementation.
That’s the conclusion of a study posted online by the Journal of General Internal Medicine. In the study, researchers looked at adverse events after off-the-shelf CPOE systems were installed in five community hospitals in Massachusetts. Authors noted that previous research on CPOE has been done at academic centers, most of which have internally developed IT systems.
While the five sites studied had a 34% decrease in preventable adverse events, they saw a 29.5% rise in potential adverse events “and an overall increase in adverse events from 14.6 per 100 admissions to 18.7 per 100.
The authors suggested that the rise in adverse-event rates post-CPOE implementation could be due to more thorough documentation of errors. However, they also suggested that increased error rates may have been associated with newly-implemented order sets.
While the authors recommended adopting CPOE, they urged community hospitals to consider making refinements to vendor-supplied CPOE and to track before and after error rates.
Clock ticking on certification deadline
PHYSICIANS WHO’VE BEEN PUTTING OFF board certification indefinitely are about to run out of time. That’s because the American Board of Medical Specialties (ABMS) last month announced that, for the first time, member boards will need to set a time limit on how long physicians have after residency to complete their board certification.
According to an ABMS press release, each of the 24 boards needs to set a time limit by April 16, 2012, for completing certification that can be no fewer than three years and no more than seven after doctors finish their training. Member boards will also have to announce how long physicians who’ve already applied for certification have to complete that process “deadlines that should fall between 2015 and 2019.
The new policy allows physicians to continue to report themselves as being “board eligible” if they’ve applied for but not completed certification. However, the policy will not allow physicians to claim that “board eligible” status indefinitely.