Joint Commission finds improved hospital quality
Filed under: Conflicts of interest, Health data, Hospitals, Pharmaceuticals, Studies
The latest report from The Joint Commission, a hospital accrediting organization, finds that “overall, hospitals are following evidence-based standards for treatment of myocardial infarction, heart failure, and pneumonia,” as MedPage Today reports.
The report, which looks at 31 evidence-based measures, did find decreases in two areas: measuring oxygen in blood for pneumonia patients and administering antibiotics to pneumonia patients in the intensive care unit within 24 hours.
The report, “Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety 2009,” (PDF) and those from three previous years are available on the commission’s Web site. Among the key findings:
- Hospitals accredited by The Joint Commission have significantly improved the quality of care provided to heart attack, heart failure and pneumonia patients over a seven-year period.
- Hospitals have steadily improved on individual surgical care performance measures – as well as on additional individual heart attack and pneumonia care measures - over a two-, three- or four-year period.
- Hospital performance on two individual measures of quality relating to inpatient care for childhood asthma is excellent after only one year of measurement.
- Improvement is still needed.
- Where a patient receives care makes a difference.
As ProPublica’s Charles Ornstein explains in his tip sheet, The Joint Commission does routine inspections of participating hospitals to ensure they meet the standards required for accreditation. It compiles public reports on each hospital, which are available on the qualitycheck.org Web site. These reports include the hospital’s accreditation status, as well as some data on hospital outcomes and practices.
It does not release its detailed inspection reports to the public, and many states’ open records laws specifically exempt the reports from public disclosure. In the past, these inspections have not been surprises, and the group has been faulted for being slow to act against hospitals with problems Also, The Joint Commission rarely takes punitive steps against hospitals, preferring to work with them to improve.
Tip Sheets
A road map for covering your local hospital’s quality
Study: Hospital quality comparisons are inconsistent
News: Congress requires Joint Commission to re-apply for accreditation privileges (Sept. 17, 2008)
Hep C emerges from dormancy to hit baby boomers
Newsweek’s Sarah Kliff looked into hepatitis C, a virus which can be dormant for decades then emerge to cause liver fibrosis and cirrhosis. It affects between 2.7 million and 3.9 million Americans, two-thirds of them baby boomers.
The virus is transferred through contact with infected blood, typically through intravenous drug use or transplants or blood transfusions that occurred before 1992, the year when officials started screening blood for the disease. Because it can remain dormant for so long, many boomers who contracted the disease during their free and easy youth are just starting to show symptoms.
“Even though Boomers moved on with their lives, they could be living with an infection that happened many years ago,” says John W. Ward, division director for the Center for Disease Control’s Division of Viral Hepatitis. “Now, they’re aging into a period of their lives when Hepatitis C could become manifest through physical symptoms.” One study published last May estimates that, in the next 20 years, total medical costs for Hepatitis C patients will nearly triple, from $30 to $85 billion.
Many don’t even know they have the disease, and Kliff writes that general public awareness is lagging.
Despite affecting 1 percent of the population, hepatitis C remains a disease generally misunderstood by the general public with little in financial commitments from the federal government. The CDC’s National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention had a budget of almost $1 billion for 2008. Only 2 percent of that was allocated to hepatitis B and hepatitis C despite both viruses being five times more prevalent.
Because of the stigma associated with a virus often linked to drug use that causes symptoms (chronic liver disease) often associated with alcohol abuse, officials have found it tricky to convince now-affluent and settled boomers to come to terms with their wild past and acknowledge that they may have exposed themselves to the virus. To get past those barriers, officials have even considered comprehensive age-based screening requirements, Kliff writes.
The CDC is considering a blanket, age-based screening recommendation. “We’re launching studies to see if it’s feasible and makes sense,” says Ward, the CDC official. “Just like everyone over 50 should have a check for colon cancer, it might fit into an age-based checklist of preventative services.”
Related
From the Institute of Medicine: Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C (PDF)
FDA launches transparency site with help of tongue depressor
In the first step of a planned three-part transparency initiative, the U.S. Food and Drug Administration has rolled out FDA Basics, a tidy little Web portal aimed at helping the public understand exactly what the agency does. And that, according to the page’s centerpiece, is regulate tongue depressors. The goofiness of the example aside, the FDA does use the depressors to make a pretty solid point about device regulation, as you can see below.
All in all, the FDA manages to pack enough information into the site to educate and even intimidate curious consumers. In addition to the bit about devices, it has dedicated pages to each of its core regulatory missions, stuff like dietary supplements and cosmetics. It also has announced a series of topic-specific Webinars and given the site a hearty sprinkling of suggestion and question submission boxes, as well as contact information.
To announce the site the FDA hosted a Webinar on Tuesday to teach bloggers about the Basics site; a promised recording of the session has yet to materialize.
(Hat tip to Medical Marketing and Media)
Bush Institute program set to launch for PBS
Filed under: Health journalism, Hot Health Headline
The Dallas-based George W. Bush Institute, a think tank founded by the former president, is working on a new public television program (in cooperation with Grace Creek Media) that plans to focus on global health issues in addition to domestic policy and education. According to The Dallas Morning News‘ Lori Stahl, two episodes of “Ideas In Action with Jim Glassman” have already been taped, and the program will start airing on PBS and some cable stations in February.
Host Jim Glassman, who also heads Bush’s think tank, brings with him a solid, if somewhat partisan, resume. He hosted TechnoPolitics on PBS in the late ’90s, published The New Republic in the ’80s and has long written conservative-leaning columns in various media outlets, including The Washington Post and SHNS.
Stahl writes that PBS viewers have already begun to push back against what they fear will inevitably be idealogically motivated programming. Glassman’s response? The show will fall somewhere between neutral and “absurdly biased.”
Glassman said the new show will not try to promote a political viewpoint. Noting that he’s well-acquainted with PBS standards from a stint hosting the PBS series TechnoPolitics, Glassman said, “If you get something that’s absurdly biased, people aren’t going to watch it.”
At the same time, he acknowledged that the Bush Institute is looking for places to influence the course of civic action, not just generate more debate.
“We’re not going to shy away from the fact that we’ve built the Bush Institute on principles,” Glassman said, noting that other public television show hosts are not entirely neutral. He cited Bill Moyers, William Buckley and Tavis Smiley as examples.
Even pro wrestling has a wellness program
Wrestler Chris Jericho fights WWE colleague Eddie Fatu (aka “Umaga”). Fatu died at age 36 after a Dec. 4, 2009 heart attack. He had been kicked from the WWE for wellness program violations in June. Photo courtesy of the Wikimedia Commons.
Writing for Human Resource Executive Online, Jared Shelly explained World Wrestling Entertainment’s version of an employee wellness program. With at least 22 professional wrestlers (including a number of high-profile WWE stars) dying before their 45th birthday since 2003, the health challenges faced by the high-impact WWE aren’t exactly typical, and neither is their wellness program.
For starters, the wrestlers are technically independent contractors, not employees, and the wellness program is run by a third party contracted by WWE. The program itself, instituted in 2006, revolves around drug testing (both for the performance enhancing and recreational varieties) four times a year, with suspensions and testing escalating with every instance in which a particular wrestler tests positive.
Wrestlers’ contracts are terminated after their third violation of the policy, but they are still eligible for the Former Talent Rehabilitation Program, an anti-drug-addiction prorgam used by about 4 percent of former WWE wrestlers.
Third-party PubMed video tutorials in plain English
PubMed’s fantastic, but it can also be mighty frustrating. Maintained by the National Library of Medicine, it’s the interface through which folks can search or browse their way through NIH’s vast repository of health-related research articles.
Unfortunately, it’s also not quite like the user-friendly search engines most of us have come to know and love. That’s where third-party tutorials come in.
If you’re looking for a strong distillation of the basics, head straight for AHCJ’s tip sheet. If you prefer more technical info and less hands-on guidance, see Wikipedia. But if you’re looking for an in-depth, easy-to-follow introduction broken into easily digestible chunks, head for this nine-part video tutorial created by an Indiana University medical librarian.
She uses accessible language, analogies and well-paced demonstrations to peel back the layers of the labyrinth and help viewers understand the purpose and relevant applications of the interface’s features. Here’s the first installment:
Note that on Screenjelly webcasts, such as this one, you can click on the “full-screen” icon in the bottom-right corner of the player. Screenjelly looks much better in the full-screen mode than most players.
GAO looks at ‘extraordinary’ drug price hikes
Filed under: Government, Pharmaceuticals, Studies
In a new report (pdf), the Government Accountability Office looks into what caused hundreds of extraordinary increases in prescription drug prices during the past decade. The GAO defines an “extraordinary” price increase as a single hike that more than doubled a drug’s price, an event that occurred regularly throughout the past decade. In their summary of the report (pdf), the GAO summarizes the relevant numbers thus:
From 2000 to 2008, 416 brand-name drug products—different drug strengths and dosage forms of the same drug brands—had extraordinary price increases. These 416 brand-name drug products represented 321 different drug brands. The number of brand-name drug products that had these extraordinary price increases represents half of 1 percent of all brand-name drug products. The number of extraordinary price increases each year more than doubled from 2000 to 2008 and most of the extraordinary price increases ranged between 100 percent and 499 percent. Almost 90 percent of all brand-name drug products that had an extraordinary price increase sustained the new higher price—by either having another increase in price or remaining at the increased price.
More than half of the these extraordinary increases came in drugs in the central nervous system, anti-infective, and cardiovascular classes. According to the report, limited competition and a lack of equivalent drugs (either from generics or brand-name competitors) may be to blame for the price increases. Industry consolidation is also an issue, analysts said, as several drugs jumped in price after their parent company’s acquisition had been finalized.
Related: FDA approval causes drug price to skyrocket
Groups give Obama “A” for openness despite barriers between journalists, federal experts
Filed under: Government, Health journalism, Hot Health Headline, Public records
A coalition of reform groups, including Common Cause, Democracy 21, the League of Women Voters and U.S. PIRG, recently issued “A Report Card from Reform Groups on the Obama Administration’s Executive Branch Lobbying, Ethics and Transparency Reforms in 2009.” The administration gets high marks in a number of categories, including an “A” for open government. The report card, however, seems to overlook an issue of particular interest to health care journalists.
The groups praise the administration’s “unprecedented steps to implement Executive Branch transparency,” steps they said include the disclosure of official visits to the White House, the publication of stimulus and other government contracts online and the administration’s “presumption of disclosure” approach to FOIA requests. They also note a few shortcomings, including the administration’s reliance on Internet-only avenues of disclosure and time lags in the availability of some information.
According to AHCJ’s Right to Know Committee, there’s another shortcoming those reformers missed in their report card: Restricted access to federal employees. AHCJ has already requested that the administration reverse inherited policies that allow federal public information officers to restrict the access the public has to federal experts, and while committee representatives praised the administration’s move toward a more open government, they don’t think this particular obstructionist policy should be ignored.
By way of explanation, here’s an excerpt from a letter sent by Right to Known Committee Chair Felice Freyer and AHCJ President Charles Ornstein to the groups responsible for the report card.
… we wanted to make you aware of another issue the administration has yet to address: the continuing difficulty that journalists face in speaking with federal employees. Under policies that have intensified over the past 15 years, public information officers often block or delay our access to the people who have the facts needed to inform the public.
This is not just a matter of reporters looking to make their jobs easier. It’s a question of our ability to tell the public what federal employees are doing with taxpayers’ money and to report on important research and public health issues. Many times staff members are eager to talk with us, but they require permission from public information officers. The PIOs sometimes simply say “no.” Or they never call back. Or they tell the reporter to wait for the official news release. Many insist on listening in on interviews, ensuring that staff will stick to the “official story.”
AP looks at drug resistance worldwide
Filed under: Health policy, Hot Health Headline, Public health
The Associated Press has neatly wrapped up its wide-ranging look at drug resistance and the threat it poses to global health into a flash-based multimedia presentation. The presentation consists of stories, infographics, videos and a photo/audio slideshow.
The two videos explain drug-resistant strains of various infectious diseases. The first looks at the wide availability of powerful antibiotics without guidance or prescription, addresses the problem as it has emerged both in the United States and in locales like Mexico and the Philippines. The second, which is about the use of antibiotics in large-scale livestock operations, relies on just one source, Dr. Craig Rowles of Elite Pork Partnership.
The AP uses infographics to establish the spread and scope of the problem, relying heavily on various world maps. I particularly like the timeline that accompanies the malaria graphic (click “statistics” in the upper right, then “malaria”); it shows the span of time from when each malaria-fighting drug was introduced to the date at which a resistant strain emerged.
Finally, they drive the problem home with three strong anecdotes, including a Southeast Asian boy with drug-resistant malaria, a man fighting the drug-resistant tuberculosis that killed his HIV-positive partner, and a woman who lost an infant daughter to MRSA.
Stories in the series:
- New form of malaria threatens Thai-Cambodia border
- South African doctor sees drug-resistant HIV
- First case of highly drug-resistant TB found in US
- Solution to killer superbug found in Norway
The package is accompanied by this video.
California Watch serves up data, health stories
The new Center for Investigative Reporting-backed California Watch site is an ambitious and, by virtue of its commitment to providing resources for readers’ own investigations, a particularly reporter-friendly nonprofit news site. Unlike many of their peers, they’re looking toward a syndication-based funding model and seem ready to try just about anything.
This spirit of openness is evidenced by reporter Christina Jewett’s list of story ideas, which include meaty standards (hospital finance, aging population) and a slightly less-covered story (problems with the child welfare system), as well as the health subject page, where Jewett is fairly open about what she’s working on, as well as what she’s reading. All-in-all, the site uses a careful balance of self-promotion and transparency to create a compelling news destination.
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
