VHIG Digest: Volume 2, No. 7
By Kate Gurba, MSTP ’13
In the News…
1. Study finds drop in deadly V.A. hospital infections- 4/13/11
Two articles in the New England Journal of Medicine examined the clinical and financial efficacy of efforts to reduce hospital-acquired infections. Over a span of 32 months, Veterans Affairs hospitals nationwide reduced methicillin-resistant staphylococcus aureus (MRSA) infections by 62% in intensive care units and by 45% in other medical and surgical units. Veterans Affairs hospitals currently screen all patients for MRSA upon admission, isolate patients who test positive, mandate contact precautions for all personnel caring for those patients, and repeat screening before discharge. However, universal and repeated screening may not be cost-effective.
2. House GOP passes budget cut- 4/16/11
The House of Representatives passed a budget with significant spending cuts, many of which target healthcare outlays. The plan would replace current Medicare benefits with vouchers to help seniors purchase individual private health insurance. These changes would not be tied to inflation and would apply to people currently under 55 years of age. The budget also calls for major changes to Medicaid; it aims to cut $
771 billion from the program over the next 10 years by transforming it into a system of block grants to states. Each state would receive a limited amount of federal government money to spend on Medicaid, with fewer regulations than currently apply. http://online.wsj.com/article/SB10001424052748704495004576265013724755094.html?mod=WSJ_hp_LEFTTopStories
Study: Half of meat, poultry tainted by staph; 1 in 4 samples have drug-resistant kind –
A team from the Translational Genomics Research Institute in Arizona tested 136 samples of beef, chicken, pork, and turkey from grocery stores in major metropolitan areas throughout the country. Testing for foodborne pathogens revealed that half of all samples were contaminated with Staphylococcus aureus, and half of the contaminated samples contained multidrug-resistant S. aureus. Moreover, three samples contained methicillin-resistant S. aureus (MRSA). Two other studies in recent years have found staphylococci in at least 20% of meat. The new report will be published in the journal Clinical Infectious Diseases.
In the Literature…
1. Global Trigger Tool Shows that Adverse Events in Hospitals May Be Ten Times Greater than Previously Measured- 4/30/11
Most studies of hospital safety and adverse events use either hospital-specific voluntary reporting systems or the Agency for Healthcare Research and QualityÕs Patient Safety Indicators. A recent report in the journal Health Affairs compared the efficacy of those methods to the Global Trigger Tool, developed by the Institute for Healthcare Improvement. The Global Trigger Tool randomly selects patient chart numbers, removes identifying information, and refers charts to a team including both physicians and non-physicians, who reviewed charts for ÒtriggerÓ events. These events could include Òa medication stop order, an abnormal lab result, or use of an antidote medicationÓ. After finding a trigger event, the review team examined charts in greater depth to determine if a major adverse event had occurred in the course of the patientÕs stay. Results indicated that adverse events occurred in one-third of all hospital admissions, and 90% of those were not identified by either voluntary reporting systems or the Agency for Healthcare Research and QualityÕs Patient Safety Indicators.
2. Launching Accountable Care Organizations Ð The Proposed Rule for the Medicare Shared Savings Program- 3/31/11
On March 31, the Department of Health and Human Services (HHS) released proposed regulations for forming accountable care organizations (ACOs). These organizations of health care providers would take responsibility for all medical needs of at least 5000 Medicare beneficiaries. If an organization successfully delivers care at lower-than-expected costs, the providers would share in the savings. The HHS proposal outlines two business options for new ACOs. An organization may operate for two years without risk of loss; alternatively, it can assume risk from its inception, but retain the opportunity to keep more of its potential savings.