iLoveBenefits: Industry News Blog

Communication With Health Providers

Among adults who reported having poor communication with their health providers in 2012, Hispanics had the highest percentage (11 percent) followed by blacks (10 percent) and whites (7 percent). (Source: Agency for Healthcare Research and Quality, 2014 National Healthcare Quality and Disparities Report, Chartbook for Hispanic Health Care.)

Hosptial Nurse Staffing Linked to Reduced Adverse Events and Lower LOS

Increases in hospital nurse staffing levels are associated with reductions in adverse events and lengths of stay and do not lead to increased costs, a longitudinal study by AHRQ concluded. Researchers also found that increasing the number of registered nurses, as opposed to other nursing positions, led to reduced costs. The authors linked hospital nurse staffing data to AHRQ’s Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from California, Maryland and Nevada between 2008 and 2011 to estimate the causal relationship between nurse staffing (level and skill mix), quality (adverse events as measured by nurse-sensitive patient safety indicators), lengths of stay and cost. The findings suggest that increased staffing of registered nurses can improve patient outcomes and efficiency. “Examining the Value of Inpatient Nurse Staffing: An Assessment of Quality and Patient Care Costs” and the abstract appeared in the November issue of Medical Care. Authors included AHRQ’s H. Joanna Jiang, Ph.D., and Carol Stocks, Ph.D., R.N.

Meaningful Use is Having an Impact on Health Care Practice

According to a recent study at 47 ambulatory practices in an integrated delivery system:

  • 28.4% of physicians, compared to 47.1% of advanced-practice providers and. 42.6% of nursing staff, have strong confidence in their department’s ability to solve Meaningful Use implementation problems
  • 57.9% of physicians, compared to 83.3% of advanced-practice providers and. 82.0% of nursing staff, report strong willingness to change their work practices for Meaningful Use

Source: “Stage 1 of the meaningful use incentive program for electronic health records: a study of readiness for change in ambulatory practice settings in one integrated delivery system,” BMC Medical Informatics & Decision Making, December 14, 2014, http://www.biomedcentral.com/1472-6947/14/119

Clinic delivery of health care is taking hold

According to a recent study of Walgreens retail clinics:

  • Patient visits for preventive services, screening and chronic health services (combined) rose from 4% in 2007 to 17% in 2013
  • Return patient visits to the retail clinics rose from 15% in 2007 to more than 50% in 2013
  • For patients age 17 and under, visits for both preventive services and vaccinations rose by 180%
  • For patients ages 18 to 64, visits for health testing rose by 90%, and preventive service visits rose 66%
  • Acute care visits rose 84% for patients age 65 and older

Source: “More Patients Turning to Retail Clinics for Chronic Care and Preventive Services, New Walgreens Study Shows,” Walgreens Press Release, July 17, 2014, http://news.walgreens.com/article_display.cfm?article_id=5882

Changing the paradigm and reach of the traditional office practice

Nurse-led protocol tied to better chronic disease managementAn analysis found nurse-led outpatient disease management protocols were associated with significant improvements in HbA1C, systolic blood pressure and lipid levels in patients with diabetes, hypertension and hyperlipidemia. The nurses followed a protocol for medication titration, according to the study reported in the Annals of Internal Medicine. Renal and Urology News (7/18)

Doctors agree that PAs, NPs improve care, productivityA Jackson Healthcare survey revealed about 75% of doctors who employed advance-practice professionals such as physician assistants and nurse practitioners said doing so helped improve patient care and practice efficiency, while two-thirds reported that PAs and NPs are handling tasks that formerly were handled by doctors. Sixty percent of respondents perceived the increasing role of PAs and NPs positively, researchers said. Nurse.com (7/17)

Enlarging the definition of the Primary Care Workforce is Critical

Geographic Distribution of Primary Care Workforce

Nurse practitioners Physician assistants Family physicians/GPs General internal medicine General pediatrics U.S. population
Urban 72.20% 75.10% 77.50% 89.80% 91.20% 80%
Large rural 11.00% 11.70% 11.10% 6.70% 6.20% 10%
Small rural 7.70% 6.90% 7.20% 2.40% 1.80% 5%
Remote rural 9.10% 6.30% 4.20% 1.10% 0.80% 5%

Source: Agency for Healthcare Research and Quality

Providing a written plan. . . of care

Most cancer patients enter survivorship with little direction from oncologists or primary care providers, according to a national survey.

Two-thirds of 1,130 oncologists said they always or almost always discuss survivorship with patients, but only a third told patients where to seek cancer-related or other care. Fewer than 5% of oncology respondents provided patients with a written plan for survivorship care.

Read more here: Of 1,020 primary care providers surveyed, 12% reported regular discussions about recommendations for survivorship care or provider responsibility, as reported online in the Journal of Clinical Oncology.

Most who follow me know that I have a vision for how health care will evolve. The next two big things that need to occur are transparency of pricing – what patients are expected to pay for the services they receive – estimates if not actual prices based on the insurance they have and the current terms of that insurance. And not necessarily in this order a plan of care.

Let me explain what is meant by a plan of care. It goes well beyond the story in the Journal of Clincal Oncology. That is just one example.

It is a plan that every person should have. It is the equivalent of a financial plan. It is something that the patient has the key to access, a portal and a document through which to view and understand their medical condition and the actions that they or their caregivers need to take to optimize the outcomes that patient is seeking. It is something that the patient enables others including their providers and caregives to view and to add to with their special knowledge and information. It spans every episode of care. Whether that is a prevention episode, a wellness episode, an acute episode, a chronic episode, even a secondary prevention episode.

It enables hospital discharge instructions to be cleanly handed off to family caregivers, rehabilitation caregivers, other physcians or nurses caring for the patient. It enables the primary care physician to view what all other parts of the health system are contributing to the health of the patient. It provides a means of communicating with the patient while in the office and to be sure that the instructions are clear when they leave the office. It helps turn the office visit into a counselling session rather than simply a visit and script.

It links physician to nurse, pharmacy to physician, hospital to rehab or nursing facility. It helps turn siloed health care services into a system of organized and informed health processes focused on the patient.

Nursing experience may play significant role in length of stay

Nurse experience, tenure may influence quality of hospital care
Hospital units with a greater number of registered nurses and licensed practical nurses had shorter patient length of stay than units with more unlicensed assistive personnel, a report showed. Every additional year in nurse tenure was associated with a 1.3% decline in duration of hospital stay. Allowing full-time nurses to work overtime when an experienced nurse is away from work also yielded better outcomes than hiring contractors, researchers wrote in the American Economic Journal: Applied Economics. BeckersHospitalReview.com (4/14), Modern Healthcare (free registration)/Vital Signs blog (4/14)

April 16, 2014 | Categories: healthcare,hospitals,Nurse | Tags: , , | Comments (0)

Hospitals that invest in the nursing work environment. . .

Magnet-designated
hospitals have better nurse-reported quality of care

In an analysis involving
more than 500 hospitals across the U.S., researchers explored why hospitals
with Magnet recognition, a designation tied to excellence and innovation in
nursing, had better nurse-reported quality of care than non-Magnet hospitals and
found that positive work environments were significantly associated with higher
quality of care. The findings, published in the Journal of Nursing
Administration, suggest that “hospitals that invest in improving the
nursing work environment have the potential to benefit from increased quality
of care for their patients and families,” researchers said. Nurse.com (3/13)

Keys to better health: Knowing who engages patients in the clinical setting

PAs, NPs more likely to provide routine chronic disease health education
Research published in the CDC’s Preventing Chronic Disease journal suggests health care providers do not routinely offer health education to patients with chronic diseases such as hypertension, diabetes, obesity and chronic obstructive pulmonary disease. Physician assistants and nurse practitioners were more likely than doctors to provide information to patients for all conditions measured. PhysiciansBriefing.com/HealthDay News (3/13)

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