This week, we’re introducing a new, interactive feature to Across My Desk. Please be sure to read Anne’s weekly editorial for details on how to respond — and how you can win a special prize for sharing your thoughts with me and other Across My Desk readers!
300 Million and Growing
The United States’ population has officially reached 300 million. According to government calculations, America reached the milestone at 7:46 a.m. EDT on Tuesday. The U.S. is only the third country in the world to reach 300 million people. In this report, Steve Inskeep from NPR talks to Carl Haub, a senior demographer at the Population Reference Bureau, about the 300-million figure and how it — and the exact time it was reached — was calculated. NPR (Click “Listen” to hear the audio report.)
Editor’s Note: I hope all readers of Across My Desk take the time to go to this site as there is interesting information regarding this topic, and an interactive map you can click on to learn your state’s population.
New CDC guidelines target drug-resistant infections
The Centers for Disease Control and Prevention (CDC) has just released new guidelines designed to cut the spread of drug-resistant infections within hospitals and other healthcare facilities. According to the CDC, 2 million people acquire infections in hospitals each year, resulting in 90,000 deaths. The risks from such infections have grown dramatically in recent years. For example, only 2 percent of staph infections were drug-resistant in 1972; today, 63 percent are resistant. Report: “Management of Multidrug-Resistant Organisms in Healthcare Settings.” (PDF)
Question: What do you think the number-one prevention method is to reduce multidrug resistance in healthcare settings? Email your thoughts to me at allewellyn@dorlandhealth.comand I’ll select some to post in Across My Desk.
New Jersey hospital on cutting edge of quality care
Teamwork and good communication are credited with bringing the quality of care at Hackensack University Medical Center to well above par, and the hospital is considered to be on the cutting edge in a national movement to redesign health care. The hospital has developed policies to make sure patients get proven therapies to save lives, and it has earned a $1.9 million grant from the Pursuing Perfection program sponsored by the Robert Wood Foundation. USA TODAY
Request: This story is an example of how teamwork can develop best practices. The February issue of Case in Point will focus on hospital case management. If you practice case management in a hospital setting, please share with us some of the innovative ideas you are working on to ensure safe, quality, cost-effective care within your organization. You can email your comments to me at allewellyn@dorlandhealth.com.
FDA to give faster reviews to first-eligible generics
An FDA official says the agency intends to speed up its reviews of some generic drugs in an effort to get them on the market faster. The director of the Center for Drug Evaluation and Research (CDER) says drugmakers will get a priority for consideration if their application is the first to propose a generic version of a branded drug losing patent or market-exclusivity protection, or if a drug is needed in the event of a public health emergency or shortage. Reuters
Editor’s Note: As a cost-cutting measure, managed care encourages consumers to utilize generic medication when available. FDA efforts such as this will help speed up the approval process. Case managers have a role to play in educating patients about the safety and efficacy of generics, so I encourage you to stay up-to-date on FDA approvals.
Experts: Health care needs better spending of existing money
A key to fixing the nation’s health care woes is not to spend more money, but to spend what is already available more effectively, leading health experts say. ABC News
Request: This type of story is a call to action for proactive case management. The essence of case management practice is to ensure that consumers of care receive evidence-based treatment at the right time, in the most appropriate setting, and at the most cost-effective price. Please provide an example of how your involvement in the process as a case manager helped ensure the plan of care was streamlined and cost-effective.
Physician group will rate payers
Family physicians, who for years have had their performance rated by managed care plans, are about to turn the tables and offer their own set of performance ratings — for managed care plans. The American Academy of Family Physicians (AAFP) has set plans to launch what it calls a “massive” payer report card, assigning grades from A to F to health plans on their contracting processes, customer service, payment rates, claims processing performance, formularies, responsiveness and more. The group plans to publish an aggregated report card in April 2007 in its Family Practice Management magazine. Family Practice Management
Editor’s Note: It was just a matter of time before this kind of approach was undertaken type by physician groups. Instead of a cooperative, team approach to improve the system, it appears the “us-versus-them” mentality will continue.
Study: 700,000 ER cases yearly from drug reactions in U.S.
Results from a government-backed survey indicate more than 700,000 Americans go to hospital emergency rooms each year because of reactions to prescription drugs. The study found insulin for diabetics, warfarin for clotting problems and amoxicillin for various infections were most commonly involved in the reactions. The Washington Post
Request: One of the areas where case managers can show positive outcomes is in the area of patient education and empowerment. This type of study provides a baseline for both managed care and provider-based case managers to measure improvement. Please read the report, and then give us a few examples of things you’re doing to reduce complications related to medical care.
Hospital mortality gaps grow among elderly
While risk-adjusted mortality rates for elderly patients has improved, the mortality rate gap between high-performing and poorly-performing hospitals has grown in recent years, according to research by healthcare rating firm HealthGrades. For its ninth-annual study, HealthGrades analyzed over 40 million Medicare records taken from 2003 through 2005, examining care at the nation’s 5,000 non-federal hospitals. The firm then gave hospitals a one-, three- or five-star rating, based on outcomes in each of 28 medical categories. The study found that overall mortality rates improved 7.9 percent from 2003 to 2005, but that top-tier hospitals showed more improvement than lower-performing organizations. On average, a patient has a 69-percent lower chance of dying at a five-star hospital than at a one-star hospital, but mortality rates varied significantly by procedure, researchers noted. HealthGrades Press Release (PDF)/Full Report (PDF)
Editors Note: The availability of better data has enabled this kind of greater transparency so that providers, employers and consumers can better understand quality-of-care issues and make informed choices about where to spend their healthcare dollars. Case managers need to have access to these reports, and be able to analyze and explain them to providers, employers and consumers. These skills are possessed by many case managers and open a door of opportunity for business-minded case management professionals. In future issues of Case In Point magazine, we are going to report on business skills that will empower case managers to be prepared to address some of the challenges they are seeing in the changing world of healthcare, and assist them in building their skills so they are prepared to become leaders in the industry.
End-of-life care costs vary widely according to location
Healthcare costs in the final stages of life can vary tremendously, according to research from Dartmouth Medical School’s Dartmouth Atlas Project. The project found that the costs of doctor visits and hospital stays during the last six months of life in Miami may exceed $23,000, but in Portland, Oregon, would be only slightly more than $14,000. USA Today
Question: What role do case managers play in improving quality of life for those at the end of life? Send me your thoughts on this important topic. You also may want to click on the other stories that USA Today addressed in its weeklong series entitled “Prescription for Change: Fixing American Healthcare.” The coverage was well done and raised key questions that all members of the healthcare team need to take the time address.
Side note: Elections are coming up on November 7th and this is a good time for all to start reading about the candidates who are running on the local, state and national level and what their views are on healthcare.
Service helps limited-english speakers with insurance and bill-paying
Language Line Services has introduced “Your World, Your Language,” a toll-free service allowing limited-english speakers to contact a phone interpreter who can give information on paying bills, signing up for insurance or obtaining city services. The translation service will premiere in San Francisco and offer support in eight languages. San Francisco Chronicle
Editor’s Note: This is an interesting article that addresses a key area pertinent to the practice of case management. Cultural diversity is one of the areas case managers are required to understand. As noted in Case Management Society of America Standards of Practice, case managers — regardless of setting — are required to understand how culture impacts the patients and their families we manage. This service is a resource that many may want to file for future use!
More adult health conditions seen in obese children
With U.S. children facing higher rates of obesity, more are developing conditions typically seen in adults, such as Type 2 diabetes, gallstones and nonalcoholic cirrhosis (which can require a liver transplant). With such conditions raising the risk of more health problems in adulthood, health experts say obesity is clearly more than just a “cosmetic problem” for children. Atlanta Journal and Constitution
Question: Obesity is out of control. What unique steps can case managers implement in their communities to turn this epidemic around? How can we turn research into practice and engage the public to take action? Email your thoughts to me at allewellyn@dorlandhealth.com and I’ll select some to post in Across My Desk.
National Breast Cancer Awareness Month: A must-view (even if you just watch the sneak preview)
October is National Breast Cancer Awareness Month. Make sure you get your mammogram. Also, there will be a great deal of coverage on prevention, and the reaction when one is diagnosed. I saw an interesting trailer for a show that will be broadcast on Lifetime on Monday, October 23. Unfortunately, by the time you read this, the show will be over, but you can view the trailer and other videos related to the program here.
Request: If you are a breast cancer survivor who had an opportunity to view the show, email me your thoughts. Or, share with us how you coped with getting through the process.
Religious broadcasters grab closed-caption waivers
Lastly, I heard this story over the weekend on closed-caption waivers for religious groups on NPR. I wanted to share as this is a vital option for the hearing-impaired. Take a few moments to listen to the story. NPR (Click “Listen” to hear the audio report.)
Request: Please listen to the story, and email me your thoughts and ideas about how to ensure that the hard-of-hearing have the same access to venues as those with the ability to hear.
