June 28, 2012
Background: Acute hospital discharge delays are a pressing concern for many health care administrators. In Canada, a delayed discharge is defined by the alternate level of care (ALC) construct and has been the target of many provincial health care strategies. Little is known on the patient characteristics that influence acute ALC length of stay. This study examines which characteristics drive acute ALC length of stay for those awaiting nursing home admission.
Posted in Journal Articles, READ Portal | Tagged with Canada, Health care costs, Hospitals | No Comments
June 15, 2012
Background:
Screening at hospital admission for carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been proposed as a strategy to reduce nosocomial infections. The objective of this study was to determine the long-term costs and health benefits of selective and universal screening for MRSA at hospital admission, using both PCR-based and chromogenic media-based tests in various settings.
Posted in Journal Articles, READ Portal | Tagged with Cost effectiveness, Hospitals, Infection control | No Comments
June 11, 2012
Background:
Wait time targets are controversial since some claim that the push for improved efficiency could compromise patient safety. On the other hand, spending long hours waiting for care in an ED has itself been shown to have safety risks. We tested the question of whether ED patients, who arrived during a shift when a greater percentage of all ED patients seen on that shift met their respective MOHLTC ED LOS targets, had a lower risk of mortality or hospital admission in the 7 days following ED discharge. We looked only at outcomes among patients discharged from the ED, since subsequent outcomes among admitted patients could be due to in-patient, as opposed to ED, care.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Hospitals, Wait lists | No Comments
June 8, 2012
This is the sixth issue of Patient Safety Papers, published by Longwoods. The first five issues, published since 2005, presented reports on research studies, demonstration projects and leading practices from organizations across Canada. In this issue, we assess our progress and examine the future. To do so, we asked a selection of patient safety experts from across this country to reflect on critical patient safety initiatives in specific domains.
Articles in this issue cover various aspects of patient safety, including:
- The use of reporting systems to enhance organizational learning and create safer systems
- How teamwork and communication can contribute to patient safety events
Posted in Journal Articles, READ Portal | Tagged with Canada, Hospitals, Quality of care, Safety | No Comments
May 21, 2012
“Background: Pay for performance has become a central strategy in the drive to improve health care. We assessed the long-term effect of the Medicare Premier Hospital Quality Incentive Demonstration (HQID) on patient outcomes.
Posted in Journal Articles, READ Portal | Tagged with Cost effectiveness, Hospitals, Quality improvement | No Comments
May 17, 2012
“Key messages:
Continuity is fundamental to high-quality care. Without it, care is unlikely to be clinically effective, safe, personalised, efficient or cost-effective. Breakdowns in continuity of care put patients at risk, cause duplication and add avoidable costs to both health and social care.
This paper focuses on the experiences of older people with multiple health problems, and particularly on their experiences inside hospital. Continuity is especially important for these older patients because: they are more likely to spend time in hospital and to be in hospital for longer; if they are frail, a stay in hospital can be life-changing; and, regrettably, in some hospitals and some wards older patients are exposed to unacceptable standards of care….”
Posted in READ Portal, Reports & Papers | Tagged with Health services for the aged, Hospitals, Patient-centered care, Quality of care | No Comments
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.”
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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
