May 10, 2012
“Objective. Hospital readmissions are a current target of initiatives to reduce healthcare costs. This study quantified the association between having a clinical culture positive for 1 of 3 prevalent hospital-associated organisms and time to hospital readmission.
Design. Retrospective cohort study.
Patients and setting. Adults admitted to an academic, tertiary care referral center from January 1, 2001, through December 31, 2008.
Methods. The primary exposure of interest was a clinical culture positive for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), or Clostridium difficile obtained more than 48 hours after hospital admission during the index hospital stay. The primary outcome of interest was time to readmission to the index facility. Multivariable Cox proportional hazards models were used to model the adjusted association between positive clinical culture result and time to readmission and to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results. Among 136,513 index admissions, the prevalence of hospital-associated positive clinical culture result for 1 of the 3 organisms of interest was 3%, and 35% of patients were readmitted to the index facility within 1 year after discharge. Patients with a positive clinical culture obtained more than 48 hours after hospital admission had an increased hazard of readmission (HR, 1.40; 95% CI, 1.33–1.46) after adjusting for age, sex, index admission length of stay, intensive care unit stay, Charlson comorbidity index, and year of hospital admission.
Conclusions. Patients with healthcare-associated infections may be at increased risk of hospital readmission. These findings may be used to impact health outcomes after discharge from the hospital and to encourage better infection prevention efforts.”
Posted in Journal Articles, READ Portal | Tagged with Health care costs, Hospitals, Infection control | No Comments
February 15, 2012
“Patients need much more than just medication and skilled treatment in order to get well. Attentive care demonstrably accelerates people’s recovery. Hospital architecture and the design of workplaces and patients’ rooms also play an important role – for the patient’s wellbeing, but also an efficient workflow at the hospital.
At the beginning of the year, the staff at the St. Josef Hospital and Pediatric Clinic in Neunkirchen, Germany, faced the difficult task of moving their patients and all of the medical equipment to a new hospital building. Despite all of the cost pressures, this new beginning gave planners the rare opportunity to design and configure the hospital building and wards from the ground up. Upon entering the red-and-white painted hospital facility, visitors arrive in a foyer with a waiting area containing a piano. The corridors are painted in warm shades of yellow, and the patients’ rooms are much friendlier and more comfortable than those in the previous building. The impression of being in a living room is further enhanced by curtains and movable cupboards for the patients. Even such comparatively simple measures seem to have a big effect. “The patients say that they immediately feel as though they’re in a five-star hotel,” reports Dr. Ernst Konrad, Chief Physician of the Clinic for Anesthesiology and Intensive Care Medicine. In the intensive care units, doctors and nurses find it easier to do their work, and here too the rooms are more comfortable and colorful than those in the previous hospital building.”
Posted in Mass Media Articles, READ Portal | Tagged with Hospital administration, Hospitals, Patient-centered care | No Comments
November 4, 2011
“Background: Many hospitals have adopted smoke-free policies on their property. We examined the consequences of such polices at two Canadian tertiary acute-care hospitals…
Results: Noncompliance with the policy and exposure to secondhand smoke were ongoing concerns. Peoples’ impressions of the use of tobacco varied, including divergent opinions as to whether such use was a bad habit or an addiction. Treatment for tobacco dependence and the management of symptoms of withdrawal were offered inconsistently. Participants voiced concerns over patient safety and leaving the ward to smoke.
Interpretation: Policies mandating smoke-free hospital property have important consequences beyond noncompliance, including concerns over patient safety and disruptions to care. Without adequately available and accessible support for withdrawal from tobacco, patients will continue to face personal risk when they leave hospital property to smoke.”
Click here to read the full article
Posted in Journal Articles, READ Portal | Tagged with Hospitals, Risk assessment, Safety | No Comments
July 12, 2011
Tablet technology has become ubiquitous in the hospital setting. Doctors use them to review patient data, demonstrate health concepts, and much more. There are a number of types of tablets available, from consumer models like the iPad to healthcare targeted models like the Toughbook H1. While MDs are lauding the advancement of tablet technologies, there are still a plethora of concerns regarding their use in a healthcare setting. Some of the obvious concerns include privacy issues- if a tablet device leaves the workplace then there is a chance sensitive data could fall into the wrong hands. Other challenges include sanitation issues, like ensuring the devices stay clean in a hospital setting, and gadget overload, faced by many doctors that have too many mobile devices. Despite these concerns, the advantages of tablet technology cannot be ignored. They allow for greater control of patient care through a number of avenues, including the increased ability to monitor patient data remotely and through the ability to look for resources in an easy to access handheld device.
Posted in READ Portal, Reports & Papers | Tagged with Hospitals, Information technology, Technology | No Comments
July 11, 2011
Should hospitals be run by doctors? That’s the question posed in a new report from Amanda H. Goodall, senior researcher at the Institute for the Study of Labor in Germany. According to Dr. Goodall’s research, the answer is seems to be yes. A study of of the top 100 hospitals in the United States found a strong correlation between between high-performance and physician CEOs, as hospitals that are run by MDs achieve a 25% higher quality score then hospitals run by MBAs or other qualified executives. While Dr. Goodall’s research does not explain why this is, the findings are undeniable. Read the full report from Dr. Goodall here.
Posted in READ Portal, Reports & Papers | Tagged with Hospital administration, Hospitals | No Comments
June 22, 2011
According to a new report by the Wait Times Alliance, patients waiting for different levels of care are one of the main reason for long waits in hospitals. Patients that could receive better care elsewhere are put into hospital care while waiting to receive treatment. Typically these are elderly patients with chronic conditions who enter the hospital by way of the emergency departments and stay for an average of 26 days. It is estimated that for every hour they remain at the hospital, four people are denied emergency department access
There are a number of suggestions for dealing with this issue, including investing more into home care and providing support to home health care workers. However it is achieved, the goal is to ensure that patients receive care in the most appropriate setting.
Posted in Mass Media Articles, READ Portal | Tagged with Hospitals, Wait lists | No Comments
February 22, 2011
In response to growing interest from the hospital community in better understanding and improving the experience of patients and their families during hospitalization, the Institute for Healthcare Improvement (IHI) conducted an in-depth review of the research, studied exemplar organizations, and interviewed experts in the field. Our aim was to identify the primary and secondary drivers of exceptional patient and family inpatient hospital experience (defined as care that is patient centered, safe, effective, timely, efficient, and equitable), as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey’s “willingness to recommend” the hospital.
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Hospitals, Indicators, Patient satisfaction, Quality assessment, Quality improvement | 1 Comment
