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Hospitals during recession and recovery: Vulnerable institutions and quality at risk.
From: Virtual Journal Club
Hospitals during recession and recovery: Vulnerable institutions and quality at risk. J Hosp Med. 2010 Jun 9;5(5):302-305 Authors: Sussman JB, Halasyamani LK, Davis MM For generations, American hospitals have been considered recession-proof, but there is reason to believe the current economic crisis is an exception. Hospitals have shown declining financial margins and decreased admissions. The severe recession has adversely affected many hospitals' finances, creating a risk of closure and constraining plans for expansion. We believe there is also a risk of harming clinical quality, through decreased staffing that may limit the momentum of the hospital quality movement, especially in fiscally vulnerable institutions. We consider ways the federal government ...
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The performance of US hospitals as reflected in risk-standardized 30-day mortality and readmission rates for medicare beneficiaries with pneumonia.
The performance of US hospitals as reflected in risk-standardized 30-day mortality and readmission rates for medicare beneficiaries with pneumonia. J Hosp Med. 2010 Jul 21; Authors: Lindenauer PK, Bernheim SM, Grady JN, Lin Z, Wang Y, Wang Y, Merrill AR, Han LF, Rapp MT, Drye EE, Normand SL, Krumholz HM BACKGROUND:: Pneumonia is a leading cause of hospitalization and death in the elderly, and remains the subject of both local and national quality improvement efforts. OBJECTIVE:: To describe patterns of hospital and regional performance in the outcomes of elderly patients with pneumonia. DESIGN:: Cross-sectional study using hospital and outpatient Medicare claims between 2006 and 2009. SETTING:: A total of 4,813 nonfederal acute care hospitals in the United States and its organiz...
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Hospital patient safety levels among healthcare’s “most wired” institutions.

Related Articles Hospital patient safety levels among healthcare's "most wired" institutions. J Healthc Qual. 2010 Mar-Apr;32(2):16-23 Authors: Yu F, Menachemi N, Houston TK Our study compared adverse patient safety events among hospitals that have received the distinction "Most Wired" as rated by the Hospital and Health Network publication versus comparison hospitals. Risk-adjusted Patient Safety Indicators (PSIs) were calculated for 558 general adult medical/surgical hospitals participating in the Agency for Healthcare Quality and Research's Nationwide Inpatient Sample. When compared using mean...
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A cluster-randomized trial to improve stroke care in hospitals.

Related Articles A cluster-randomized trial to improve stroke care in hospitals. Neurology. 2010 May 18;74(20):1634-42 Authors: Lakshminarayan K, Borbas C, McLaughlin B, Morris NE, Vazquez G, Luepker RV, Anderson DC OBJECTIVE: We evaluated the effect of performance feedback on acute ischemic stroke care quality in Minnesota hospitals. METHODS: A cluster-randomized controlled trial design with hospital as the unit of randomization was used. Care quality was defined as adherence to 10 performance measures grouped into acute, in-hospital, and discharge care. Following preintervention data collection, al...
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Venous thromboembolism prevention: a systematic review of methods to improve prophylaxis and decrease events in the hospitalized patient.
Related Articles Venous thromboembolism prevention: a systematic review of methods to improve prophylaxis and decrease events in the hospitalized patient. Hosp Pract (Minneap). 2010 Feb;38(1):97-108 Authors: Mahan CE, Spyropoulos AC Prevention of venous thromboembolism (VTE) is currently a key initiative internationally and in US hospitals, where there has been a recent focus on national quality initiatives to prevent hospital-acquired VTE. Multiple strategies exist to prevent VTE by increasing prophylaxis rates in the hospitalized setting. Active, multifaceted interventions, including provider education, an active reminder to the provider, and regular audit and feedback to medical and hospital staff, appear to be the most effective current interventions. A...
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Weekend hospital admission, acute kidney injury, and mortality.

Related Articles Weekend hospital admission, acute kidney injury, and mortality. J Am Soc Nephrol. 2010 May;21(5):845-51 Authors: James MT, Wald R, Bell CM, Tonelli M, Hemmelgarn BR, Waikar SS, Chertow GM Admission to the hospital on weekends is associated with increased mortality for several acute illnesses. We investigated whether patients admitted on a weekend with acute kidney injury (AKI) were more likely to die than those admitted on a weekday. Using the Nationwide Inpatient Sample, a large database of admissions to acute care, nonfederal hospitals in the United States, we identified 963,730 admissions with a diagn...
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