Healthcare benchmarks最新文献

KEY POINTS Despite an explosion in the number of cardiac catheterizations being performed today, patients who rely on public assistance may have to wait for an angiogram if they are unable to pay on their own. A Texas study of patients in a state-owned hospital reports that after two weeks on a waiting list for angiography, the risk of cardiac events and hospitalization rises. When patients are placed on a waiting list, priority should be given to those who have strongly positive stress tests or who take two or three different medications for ischemic heart disease.

Key points At the departmental level, a "buddy system" can pay dividends in teaching and reinforcing correct housekeeping infection control techniques. Computer programs can be useful training tools. Keep the principles of adult learning in mind when devising training programs.

Hospitalists: How do they fit in? The hospitalist model of care is expanding in the United States. The model gets "tweaked" to suit the needs of the systems in which it takes hold. Cost and efficiency data notwithstanding, some hospitals implementing a hospitalist model are motivated solely by patient care quality concerns. A hospitalist service can be an amenity for physicians offered by a hospital. Potential hospitalists need to be carefully screened for what is a very demanding job.

Key points. A study sponsored by U.S. Agency for Health Care Policy and Research showed that physician report cards (physician profiles) for diabetes were unable to reliably detect true practice differences among doctors at three types of medical practices studied. The difficulty in using outcomes to evaluate physician performance in this study was due, in large part, to the relatively small number of diabetics managed by each doctor. A major problem with the current method of profiling individual doctors is the process can backfire if linked to powerful incentives not to have patients whose conditions are hard to manage and/or incur high costs.

Hospitalists: Do they improve care? Hospitalists are physicians dedicated to the care of hospitalized patients. The use of hospitalists is growing rapidly nationwide, primarily in markets marked by competitive managed care environments. When hospitalists are used, length of stay and costs are cut about 20%. The "handoff" of the patient from primary physician to hospitalist upon admission is seen by many as a weak, and possibly fatal, characteristic of the hospitalist model. The key to making the hospitalist model work in today's health care system is to make the "handoff at the hospital" voluntary, thereby garnering vital primary physician support.

Key points. Change agents are members of the organization through whom the organization figures out how to improve itself. Change agents can provide the focused attention that is required to develop "organizational horsepower." Change agents should be selected from the very best people in the organization. Change agents can come from all areas and all levels of the organization.

Key points. The federal Food and Drug Administration (FDA) has developed a list of types of medical devices that have the potential for the most serious consequences for patients should they fail because of Y2K-related problems. This list of computer-controlled potentially high-risk devices can provide a guide to health care facilities regarding the types of devices that should receive priority in their assessment and remediation of medical devices. The list may change as the FDA receives comments on the types of devices included in the list.

Key points. A viable strategic plan includes well-defined performance measures and targets. Kaplan & Norton's "Balanced Scorecard" is a useful (but not widely used) tool to help hospitals in the strategic planning process. A viable strategic plan requires input from all of a hospital's "stakeholders." Make the planning process fun, visual, and interactive.

There is a variety of good reasons for hospitals to consider setting up their own intranets. The most common motivations are the needs to reduce paperwork and have ready access to data. Careful attention to design standards will make it easier for users to make the most of their intranet. A consistent "look" makes pages more user-friendly, as well as providing for easy navigation. Intranet content can very with the hospital. Some see problems with putting individual patient data on the intranet. Setup costs can vary with the hospital. For some, the costs may be minimal.