Source: Melanie Evans, Modern Healthcare, Vol. 37 no. 41, October 15, 2007
One of healthcare’s biggest nurses unions squared off against more than a dozen California hospitals last week, the latest example of labor’s push to exercise its clout across the healthcare industry.
Source: National Association of County and City Health Officials (NACCHO), August 2007
Federal funding received by local health departments for all-hazards emergency preparedness fell 20 percent last year, according to a new report by the National Association of County and City Health Officials (NACCHO). The report says that continued cuts in funding provided through the Centers for Disease Control and Prevention (CDC) threaten important, hard-won advances made in recent years in response planning to natural disasters, bio-terrorism events, emerging infectious diseases, and other public health emergencies.
National Preparedness Month
Source: Ayse P. Gurses, Pascale Carayon, Nursing Research, Volume 56, Issue 3, May/June 2007
From a summary:
A hospital intensive care unit (ICU) is typically an emotionally intense, loud, cramped, and stressful environment. ICU nurses face numerous obstacles to providing care to their critically ill patients, according to a new study of 217 nurses from 17 ICUs at 7 Wisconsin hospitals.
Source: Geri Scott and Randall Wilson, Jobs for the Future, April 2006
Community health workers are essential to the U.S. public health system. They work in diverse settings and under myriad titles to improve access to health care for underserved populations using culturally appropriate methods. Despite their importance, community health workers are often not well rewarded, and their job tenure is unstable. Well-defined career paths are lacking, as are systematic skills sets and credentials recognized across work settings and usable for higher education. With funding from the Robert Wood Johnson Foundation, SkillWorks asked JFF to recommend adaptations of the initiative’s Workforce Partnership model in order to apply that approach to career advancement for community health workers. As the basis for these recommendations, JFF conducted research on the challenges to and national best practices for the advancement of community health workers.
Source: Cynthia A. Bascetta, testimony before the Subcommittee on Government Management, Organization, and Procurement, Committee on Oversight and Government Reform, House of Representatives, United States Government Accountability Office, GAO-07-1229T, September 10, 2007
Six years after the attack on the World Trade Center (WTC), concerns persist about health effects experienced by WTC responders and the availability of health care services for those affected. Several federally funded programs provide screening, monitoring, or treatment services to responders. GAO has previously reported on the progress made and implementation problems faced by these WTC health programs.
Source: Diane L. Elliot, Kerry S. Kuehl, International Association of Fire Chiefs (IAFC) and the United States, Fire Administration (USFA), Oregon Health & Science University, June 2007
From the summary:
This new report, The Effects of Sleep Deprivation on Fire Fighters and EMS Responders, along with its accompanying computer-based educational program, presents background information on normal sleep physiology and the health and performance effects of sleep deprivation. Countermeasures for sleep deprivation are reviewed, which relate to identifying those particularly susceptible to risks of sleep deprivation, individual mitigating strategies and work-related issues. The project was supported by a cooperative agreement between the IAFC and the United States Fire Administration (USFA), with assistance from the faculty of Oregon Health & Science University.
Source: Christine T. Kovner,Carol S. Brewer, Susan Fairchild, Shakthi Poornima, Hongsoo Kim, Maja Djukic, American Journal of Nursing, Vol. 107 no. 9, September 1, 2007
From a summary:
In this article, researchers presented findings from the first wave of a three-year panel study on the work experience of newly licensed nurses. A randomly selected sample of 3,266 newly licensed RNs from 60 sites across the country participated in the study. RNs completed a multipage survey that addressed several aspects of their current employment.
Source: PricewaterhouseCoopers’ Health Research Institute, 2007
Many nurses and physicians are among the baby boomers who will start to retire in the next three to five years. The federal government is predicting that by 2020, nurse and physician retirements will contribute to a shortage of approximately 24,000 doctors and nearly 1 million nurses. While hospital leaders voice much of the concern over possible shortages, the implications extend throughout the labor-intensive, trillion-dollar United States health system. It’s expensive to educate new nurses and doctors. Taxpayer-funded Medicare spends $8 billion a year for residence training of physicians alone.
While the U.S. has more physicians and nurses today than ever before, they are not distributed or deployed efficiently. Shortage projections tend to be built around today’s often dysfunctional system, which makes them problematic. However, while future shortages are certainly worrisome, the bigger issue for health industry leaders today lies in orchestrating care in an increasingly complex and converging healthcare labor market.
Source: Rutgers College of Nursing, Press Release, August 15, 2007
From press release:
(NEWARK, N.J., Aug. 14, 2007) – Rutgers College of Nursing faculty member Linda Flynn is conducting a study to explore the effects of nurse staffing, work environment and safety technology on the frequency of non-intercepted medication errors in 17 New Jersey hospitals.
Funded by a two-year $308,254 grant from the Robert Wood Johnson Foundation, the study’s focus is to determine the best practices for reducing non-intercepted medication errors.
Source: PricewaterhouseCoopers’ Health Research Institute, 2007
It is impossible to improve what cannot be measured or to measure what hasn’t been defined. Take, for example, the topic of healthcare quality. Everyone wants quality, but everyone’s keeping score differently. This conundrum was described in some detail in The Quality Conundrum, a book developed and distributed in 2007 by PricewaterhouseCoopers’ Health Research Institute (HRI). It explores practical approaches to improving the quality of patient care from the perspective of patients, physicians, payers, and employers.
One of these approaches is pay-for-performance (P4P), which attempts to define, measure, and reward quality. This represents a radical departure from traditional payment methods, which pay providers the same regardless of differences in quality. P4P has gained traction, largely because the Centers for Medicare and Medicaid Services (CMS) has told hospitals and physicians that future increases in payment will be linked to improvements in clinical performance. Commercial health plans are also responding to employers’ demands for quality improvement by developing “scorecards” that use quality metrics to grade care provided by hospitals and physicians. By tying providers’ scores to financial payments, non-financial rewards, and public reporting, both private and public payers intend to incent improvements in quality of care and outcomes.
The most mature P4P programs are more than 10 years old. However, among payers interviewed for this report, P4P programs are still evolving. As they’ve blossomed, providers have faced a host of new and varied reporting requirements-what some call a “virtual soup of different metrics.” This has caused some to question the value of P4P and whether the results are worth the administrative burden.
Pay-for-Performance: Will the Latest Payment Trend Improve Care?
Source: Meredith B. Rosenthal, R. Adams Dudley, JAMA: Journal of the American Medical Association, Vol. 297 No. 7, February 21, 2007 (subscription required)