Patients with learning disabilities become ‘invisible’ in hospitals, says study
Patients with learning disabilities become ‘invisible’ in hospitals, says study.
From the 17th January 2014 ScienceDaily article
Hospital patients with learning disabilities face longer waits and mismanaged treatment due to a failure to understand them by nursing staff, says a new report.
In one case, a patient who had problems making herself understood was accused of being drunk by hard pressed hospital staff.
It is estimated that one in 50 people in England have some form of learning disabilities such as Down’s syndrome.
Dr Irene Tuffrey-Wijne, senior research fellow in nursing at St George’s, University of London and Kingston University, said: “People with learning disabilities are largely invisible within the hospitals, which meant that their additional needs are not recognised or understood by staff.
“Our study found many examples of good practice, but also many examples where the safety of people with learning disabilities in hospitals was at risk.”
Dr Tuffrey-Wijne, a co-author of the study who works at the Faculty of Health, Social Care and Education, a partnership between the two universities, added: “The most common safety issues were delays and omissions of care and treatment.
“Some examples come down to basic nursing care like providing enough nutrition but other serious consequences were also seen in our study.
…
It found that the main barrier to better and safer care was a lack of effective flagging systems, leading to a failure to identify patients with learning disabilities in the first place.
…
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New Database Reveals Thousands of Hospital Violation Reports New Database Reveals Thousands of Hospital Violation Reports
Hospital (Photo credit: Ralf Heß)
From the March 20, 2013 State Line article
Hospitals make mistakes, sometimes deadly mistakes. A patient may get the wrong medication or even undergo surgery intended for another person. When errors like these are reported, state and federal officials inspect the hospital in question and file a detailed report.
Now, for the first time, this vital information on the quality and safety of the nation’s hospitals has been made available to the public online.
A new website, www.hospitalinspections.org, includes detailed reports of hospital violations dating back to January 2011, searchable by city, state, name of the hospital and key word. Previously, these reports were filed with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid (CMS), and released only through a Freedom of Information Act request, an arduous, time-consuming process. Even then, the reports were provided in paper format only, making them cumbersome to analyze.
Release of this critical electronic information by CMS is the result of years of advocacy by the Association of Health Care Journalists, with funding from the Ethics and Excellence in Journalism Foundation. The new database makes full inspection reports for acute care hospitals and rural critical access hospitals instantly available to journalists and consumers interested in the quality of their local hospitals.
The database also reveals national trends in hospital errors. For example, key word searches yield the incidence of certain violations across all hospitals. A search on the word “abuse,” for example, yields 862 violations at 204 hospitals since 2011. …
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- Series on N.C. hospitals wins national award (charlotteobserver.com)
- Medical execs dispute hospital study (krqe.com)
- Govt. To Publish Data On What Drug & Device Makers Pay To Individual Doctors & Hospitals (consumerist.com)
- Time Magazine Study Reveals Hospitals Hiking up Medical Bills (counselheal.com)
Nurses’ Assessment of Hospital Quality Often On the Button
From the 8 October 2012 article at Science Daily
A new study from the University of Pennsylvania School of Nursing affirms a straightforward premise: Nurses are accurate barometers of hospital quality.
Perceptions from nurses — the healthcare providers most familiar with the patient experience — about hospital quality of care closely matches the quality indicated by patient outcomes and other long-standing measurements.
“For a complete picture of hospital performance, data from nurses is essential,” said lead author Matthew D. McHugh, a public health policy expert at Penn Nursing. “Their assessments of quality are built on more than an isolated encounter or single process — they are developed over time through a series of interactions and direct observations of care.”
Nurse-reported quality accurately correlated with outcome measures including death and life-threatening post-surgical complications, and patients’ reports of the care experience, wrote Dr. McHugh…
Related articles
- Overworked nurses report medical errors (cbc.ca)
- Hospital wards ‘neglected’ to due lack of staff and money (standard.co.uk)
- Patients being treated ‘like medical conditions, not people’ – Telegraph (telegraph.co.uk)
Hospital readmission rates linked to availability of care, socioeconomics
From the 11 May 2012 Eureka News Alert
American Heart Association meeting report – Abstract 12
Differences in regional hospital readmission rates for heart failure are more closely tied to the availability of care and socioeconomics than to hospital performance or patients’ degree of illness, according to research presented at the American Heart Association’s Quality of Care & Outcomes Research Scientific Sessions 2012.
U.S. regional readmission rates for heart failure vary widely ― from 10 percent to 32 percent ― researchers found. Communities with higher rates were likely to have more physicians and hospital beds and their populations were likely to be poor, black and relatively sicker. People 65 and older are also readmitted more frequently.
To cut costs, the Centers for Medicare and Medicaid Services plans to penalize hospitals with higher readmission rates related to heart failure, heart attack and pneumonia. Next year, hospitals with higher-than-average 30-day readmission rates will face reductions in Medicare payments.
But the penalties don’t address the supply and societal influences that can increase readmission rates, said Karen E. Joynt, M.D., lead author of the study and an instructor at Brigham and Women’s Hospital, Harvard Medical School and the Harvard School of Public Health in Boston, Mass….
Related articles
- Hospital Readmission Rates Linked to Availability of Care, Socioeconomics (newsroom.heart.org)
- Availability of Beds, Poverty Drive Costly Hospital Readmissions (news.health.com)
Hospital readmission rates misleading
Hospital readmission rates misleading
From the Healthcare Informatics blog item
Readmission rates, for instance, do not take into account the complexity of correcting problems involving the spine, which often call for two or more staged surgeries spaced out over several weeks, says Mummaneni. Publicly reported readmission rates do not always take into account scheduled follow-up surgeries and unplanned hospital readmissions, causing the calculated rates to be over-estimated. Additionally, he said, this problem may present surgeons with a tough choice between scheduling multiple surgeries, which may be better for the patients, and scheduling single surgeries, which would improve readmission rate calculations.
A US Navy general surgeon and an operating room nurse discuss proper procedures while performing a laparoscopic cholecystectomy surgery. (Photo credit: Wikipedia)
Related articles
- Readmission rate could be not as relevant as it seems in measuring hospital’s performance (philippehavinh.wordpress.com)
- Hospital readmission rates misleading (eurekalert.org)
- Spinal Surgeries Much More Successful Than Reflected In Public Reported Statistics (medicalnewstoday.com)
- New tool allows hospital performance comparisons (cbc.ca)
- Reducing Hospital Readmissions (fedmark.wordpress.com)
- New Metrics for Health Care Reform (3mhealthinformation.wordpress.com)
- Simple, but wrong, approach on readmissions (thehealthcareblog.com)
- Is the hospital readmission rate a measure of quality? (kevinmd.com)
- New Study Shows EHR Can Help Reduce Hospital Readmissions (jaysimmons.org)
- Most Triad hospitals again face Medicare penalties for readmission rates (bizjournals.com)
To Gauge Hospital Quality, Patients Deserve More Outcome Measures One Comment
From the 15 February 2012 Health Care Blog item
Patients, providers and the public have much to celebrate. This week, the Centers for Medicare and Medicaid Services’ Hospital Compare websiteadded central line-associated bloodstream infections in intensive care units to its list of publicly reported quality of care measures for individual hospitals.
Why is this so important? There is universal support for the idea that the U.S. health care system should pay for value rather than volume, for the results we achieve rather than efforts we make. Health care needs outcome measures for the thousands of procedures and diagnoses that patients encounter. Yet we have few such measures and instead must gauge quality by looking to other public data, such as process of care measures (whether patients received therapies shown to improve outcomes) and results of patient surveys rating their hospital experiences….
Related Resources
- Hospital Quality Compare (Centers for Medicare & Medicaid Services)- compares quality of care for certain medical conditions at more than 4,200 hospitals. The site also includes a checklist to help you choose a hospital
- Leapfrog Hospital Ratings – information on this site is derived from hospitals’ voluntary submissions of The Leapfrog Hospital Survey. More about the Leapfrog Group at their About Page
- AHRQ (US Agency for Health Care Research and Quality
- Medicare.gov includes
Related articles
- Doctor Rating Web Site Health Grades is a Time Magazine “Best 50″ – How Trustworthy Is the Content?? (jflahiff.wordpress.com)
- Georgia hospitals rated on infections (ajc.com)
- Hospital Reviews Reflect Data On Hospital Outcomes (medicalnewstoday.com)
- The Cost of Satisfaction: A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality (bespacific.com)
- Surgical Outcomes-Based Measures Developed: Approval Marks Latest Step In Path To National Implementation (medicalnewstoday.com)
- The Leapfrog Group names Children’s Memorial a top children’s hospital for patient safety (prweb.com)
- The Leapfrog Group Names Virginia Mason Top Hospital of the Decade (prweb.com)
- Roswell Park Named to Leapfrog Group’s Annual Top Hospitals List (prweb.com)
- How patient satisfaction can kill (kevinmd.com)
- American Health Care System Gets Positive Prognosis In “U.S. Health Care: The Good News” February 16, 2012 At 9 P.M. Est On PBS With Correspondent T.R. Reid (prweb.com)
- National Quality Forum endorses 2 American College of Surgeons NSQIP measures (eurekalert.org)
- Skeptical Scalpel: Patient satisfaction and reality (gruntdoc.com)
- Nurse Navigators Providing Patient Satisfaction at Medical Center (prweb.com)
- Hospital Caregivers use MagnaSnap Paper Clamps at Bedside to Improve Patient Satisfaction Scores (prweb.com)
- Requiring doctors to give orders on patients they have not seen (kevinmd.com)
Death rate measure used to judge hospital quality may be misleading
From the 3 January 2012 press release
Hospitals, health insurers and patients often rely on patient death rates in hospitals to compare hospital quality. Now a new study by researchers at Yale School of Medicine questions the accuracy of that widely used approach and supports measuring patient deaths over a period of 30 days from admission even after they have left the hospital….
…The study compared two widely used approaches to assessing hospital quality. One approach uses mortality rates of patients who die during their initial hospitalization, and the other uses rates of patients who die within 30 days, whether or not they have been discharged.
Drye and colleagues focused on mortality rates for patients with heart attack, heart failure, and pneumonia. For these conditions, one-third to one-half of deaths within 30 days occur after the patient leaves the hospital, but this proportion often varies by hospital.
“We were concerned that only counting deaths during the initial hospitalization can be misleading,” said Drye. “Because some hospitals keep their patients for less time than others due to patient transfers to other facilities or because they send patients home more quickly.”
Drye and her colleagues found that quality at many U.S. hospitals looked quite different using the two different accounting methods.
The team also found that measures looking only at deaths in the hospital favor hospitals that keep their patients for a shorter length of time.
“To assess current and future patient management strategies,” said Drye. “We should assess all patients for a standard time period, such as 30 days.”…
Citation: Annals of Internal Medicine 156:19-26. (January 3, 2012)
Related articles
- Judging Hospital Quality Via Death Rate May Be Misleading (medicalnewstoday.com)
- Death rate measure used to judge hospital quality may be misleading (eurekalert.org)
- Death rate measure used to judge hospital quality may be misleading (medicalxpress.com)
- Measuring In-Hospital Mortality Favors Hospitals with Short Stays (forbes.com)
Doctor Rating Web Site Health Grades is a Time Magazine “Best 50” – How Trustworthy Is the Content??
HealthGrades has been rating doctors, dentists, and hospitals on five star scales for over ten years. Ratings include communication skills, time spent, trust, and office environment. There are also links to board sanctions.
This past August Time Magazine rated Health Grades as one of the 50 best Websites of 2011.
Recently there was a lively discussion on this topic at the medical librarian listserv (Medlib-L).
Among the responses…
- Two people noted contact information for their doctors was not correct
- “The self selection process creates a huge bias. The people who are angry and disappointed are the ones motivated to write.”
- “patient rating is 4.5 stars out of 5, but he’s only had 4 patients comment on him. In skimming through other doctors in Fargo, very few have more than 4 patient comments and everyone has between 4 and 5 stars.”
- “My doctor is in private solo practice and when you look at the lists by highlighted or popularity they are very institutionally presented. The independents come at the end of the list so this is not a fair representation”
- “the physician she replaced upon his retirement in April 2008 is still listed (with one review), although he has been gone for almost 4 years”
Although these comments do not compromise an in depth critique of Health Grades they do raise questions about its currency, contact information correctness, and basis of comparison (basically unsolicited input from patients). It would be wise to use Health Grades in conjunction with other sources of information to make good decisions on choosing or evaluating a doctor, dentist, or hospital.
Some additional sources of information
- Leapfrog Group Hospital Quality and Safety Survey compares” hospitals’ performance on the national standards of safety, quality, and efficiency that are most relevant to consumers and purchasers of care”
- The CAHPS Hospital Survey -Centers for Medicare & Medicaid Services, programs and information.
- Hospital Compare – A quality tool provided by Medicare
- Comparing Health Care Quality: A National Directory (Robert J. Woods Foundation) -Web-based resources to help them choose a doctor or hospital in their town based on whether patients received recommended tests and treatment, the outcomes of their care, their experience with providers, or the overall cost of care. Not comprehensive, geared mostly to large urban areas.
- Choosing a Doctor or Health Care Service (Medline Plus) includes numerous resources on how to find a specific doctor and general guidelines
- State Medical Boards usually provide only the basics: contact information, specialties if any, and any formal actions
Related articles
- Patients’ Grades to Affect Hospitals’ Medicare Reimbursements (nytimes.com)
- Medicare launches ‘hospital compare’ (seattletimes.nwsource.com)
- Isn’t it time for a patient rating system for doctors? (kevinmd.com)
- HealthGrades to Merge with CPM Marketing – Will Their Data and Questionable Algorithms Will Be Improved For Consumers? (ducknetweb.blogspot.com)
- Social Media Physician Referrals – Whichdoc Recommends Doctors Using Facebook (TrendHunter.com) (trendhunter.com)
- Limits to the Active Health Care Consumer (josephineensign.wordpress.com)
Your consumer powers when choosing a hospital
From an August posting by at KevinMD.com
The casual attitude people demonstrate when choosing doctors incurs a steep price. Let’s direct our attention to your consumer powers when choosing a hospital.
The imperative ‘caveat emptor’ (let the buyer beware) carries the most consequence when you purchase health care. When it comes to hiring a hospital’s services, it’s more caveat empty than caveat emptor.
It’s time to impart the same lessons for hospitals as we did for doctors. All hospitals are not the same. Each is its own unique brand. We, a nation of shoppers, are obsessed with brand names that tout their distinctiveness. In reality, most consumer products in any given category are all but indistinguishable from each other. We think we can see the smallest pixel a human brain can process on a video display. We taste the figs and peaches in a $9 bottle of wine. We claim the sensory hyper-acuity possessed by dogs, dolphins and nocturnal predators….
Resources for comparing hospitals
- Hospital Quality Compare (Centers for Medicare & Medicaid Services)- compares quality of care for certain medical conditions at more than 4,200 hospitals. The site also includes a checklist to help you choose a hospital
- Leapfrog Hospital Ratings – information on this site is derived from hospitals’ voluntary submissions of The Leapfrog Hospital Survey. More about the Leapfrog Group at their About Page
Related articles
- Find the Best Hospital with Medicare’s Hospital Compare Tool [Health] (lifehacker.com)
- Smart Consumers Can Improve Health Care Quality. (victimrights.wordpress.com)
- CMS Updates Medicare.gov Portal With Added Searches and Comparison Information (ducknetweb.blogspot.com)
- New Tools And Initiatives Announced By The Centers For Medicare & Medicaid Services (medicalnewstoday.com)
CMS Launches Tools and Initiatives to Help Improve American Health Care Quality
The Centers for Medicare & Medicaid Services (CMS) announced a new tool for patients and caregivers, and other enhanced initiatives, to empower consumers to make informed choices about their health care, and to help improve the quality of care in America’s hospitals, nursing homes, physician offices, and other health care settings.
From the 5 August 2011 press release
“These tools are new ways CMS is making sure consumers have information about health care quality and important information they need to make the best decisions about where to receive high-quality care,” said Dr. Don Berwick, the CMS Administrator. “These efforts are designed to also encourage providers to deliver safe, patient-centered care that consumers can rely on and will motivate improvement across our health care system.”
The steps announced today include:
· A Quality Care Finder to provide consumers with one online destination to access all of Medicare’s Compare tools — comparison information on hospitals, nursing homes and plans: www.Medicare.gov/QualityCareFinder.
· An updated Hospital Compare website, which now includes data about how well hospitals protect outpatients from surgical infections and whether hospitals care for outpatients who are treated for suspected heart attacks with proven therapies that reduce death: www.hospitalcompare.hhs.gov
Related articles
- CMS Updates Medicare.gov Portal With Added Searches and Comparison Information (ducknetweb.blogspot.com)
- U.S. health care system fails to deliver – Same Story The World Over… (earlsview.com)
About
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner.
Do you have an informational question in the health/medical area?
Email me at jmflahiff@yahoo.com
I will reply within 48 hours.
This blog is a companion site to my Health and Medical News and Resources Web site with…
- Great places to start (locating health information)
- Links to help from others (as health care providers and support groups)
- Interactive tools (as health calculators and apps)
- Select related news sites and blogs
My professional work experience and education includes over 15 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news, I subscribe to the following to glean entries for this blog.
- Science Daily – Your source for the latest research news
- MedlinePlus email updates from the US National Institutes of Health
- Partners in Information Access for the Public Health Workforce – a collaboration of U.S. government agencies, public health organizations and health sciences libraries
- US Agency for Healthcare Research and Quality (AHRQ) news now with updates on the agency’s efforts to “improve the quality, safety, efficiency, and effectiveness of health care for all Americans”
- Research Buzz, “news about search engines, digital archives, online museums, databases, and other Internet information collections since 1998”
- Scout Report, a “weekly publication offering a selection of new and newly discovered Internet resources of interest to researchers and educators”
- KevinMD.com -“Social Media’s leading physician voice”
- EurekAlert-Medicine and Health
Health and Medical News and Resources 