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		<title>Joint Commission Benchmark</title>
		<link>http://www.jcrinc.com</link>
		<description>Blog</description>
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					<title>Learn About Accountability Measures </title> 
					<link>http://www.jcrinc.com/Blog/2011/9/16/Learn-About-Accountability-Measures/</link> 
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								In June 2010, The Joint Commission ushered in a new era of performance measurement with the development of accountability measures. Although in the past The Joint Commission has emphasized the need for measures that are tied to a health care organization’s performance, the accountability measures initiative takes this concept to a new level by requiring hospitals to attain and sustain a specific level of performance. Beginning January 1, 2012, hospitals will be required to comply with a new standard and element of performance that requires them to 
								achieve a composite performance rate of at least 85% on the ORYX accountability measures transmitted to The Joint Commission.
								
										
										
										
								
						
				
		
		
				
						
								 
						
				
		
		
				
						
								The September/October issue of Benchmark is dedicated entirely to helping you learn about accountability measures, the new standard, the various programs to support this initiative, as well as to help you meet the new accreditation requirements. And the following resources provide supplementary information to help you learn more about accountability measures and its various components. 
						
				
		
		
		
		
				
						
								We’d love to hear from you if you have any questions or comments about accountability measures, and please share any success stories your organization has had with improving their performance on these measures.• Chassin M., et al.: Accountability Measures: Using Measurement to Promote Quality Improvement. New England Journal of Medicine 363:683–688, August 12, 2010. Available at http://www.nejm.org/doi/full/10.1056/NEJMsb1002320• Joint Commission Online: Focus on accountability measures: Helping hospitals meet future performance measurement expectations. Available at http://www.jointcommission.org/assets/1/18/jconline_June_23_10_SI.pdf• Joint Commission Online: New hospital standard establishes 85 percent compliance rate for accountability measures. Available at http://www.jointcommission.org/assets/1/18/jconline_June_29_1111.PDF• Joint Commission Online: Additional accountability measures for 2011; four non-accountability measures to be retired. Available at http://www.jointcommission.org/assets/1/18/jconline_Aug_17_11.pdf• The Joint Commission: Facts about accountability measures. Available at http://www.jointcommission.org/assets/1/18/Accountability_measures_7_1_111.PDF• The Joint Commission: Joint Commission FAQ Page. Available at http://www.jointcommission.org/about/JointCommissionFaqs.aspx?CategoryId=31#188• The Joint Commission: Core measure changes that impact accountability measures. http://www.jointcommission.org/assets/1/6/Core_measure_changes_1_1_2012__2_.pdf• The Joint Commission: List of accountability measures. http://www.jointcommission.org/assets/1/6/ACCOUNTABILITY_MEASURES_August_2011_rev.pdf• The Joint Commission: Helping Hospitals Improve with The Joint Commission Accountability Measures: Joint Commission Changes How Core Measures Are Classified. Joint Commission Perspectives 30:1–9, Aug. 2010. Available for purchase at: http://www.ingentaconnect.com/content/jcaho/jcp/2010/00000030/00000008/art00001• The Joint Commission: New Hospital Standard Sets Performance Expectations for ORYX Accountability Measures. Joint Commission Perspectives 31:3–5, Aug. 2011. Available for purchase at: http://www.ingentaconnect.com/content/jcaho/jcp/2011/00000031/00000008/art00003• The Joint Commission: The Joint Commission Helps Hospitals Meet Future Performance Measure Expectations. The Joint Commission Benchmark 12:1, 11, Sep./Oct. 2010. Available for purchase at: http://www.ingentaconnect.com/content/jcaho/jcb/2010/00000012/00000005/art00001• The Joint Commission Accountability Measures Conference Call transcript. Jun. 30, 2010. Available at http://www.jointcommission.org/assets/1/18/Accountability_Measures_6.30.10.pdf
						
				
		
		
				
						
						
				 
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					<pubDate>Fri, 16 Sep 2011 17:49:23 GMT</pubDate>
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					<title>2011 Ambulatory Breakfast Briefings Webinar/Audio Conference Series</title> 
					<link>http://www.jcrinc.com/Blog/2011/7/7/2011-Ambulatory-Breakfast-Briefings-Webinar/Audio-Conference-Series/</link> 
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		The nine-week 2011 Ambulatory Breakfast Briefings Webinar/Audio Conference Series begins September 7, 2011. Each week, Joint Commission experts will cover the Comprehensive Accreditation Manual for Ambulatory Care one chapter at a time, providing both a formal presentation and a moderated Q&A session. Performance measurement professionals may be particularly interested in the discussion of the “Performance Improvement (PI)” chapter. Choose a live connection or access the recorded web conferences, depending on your schedule and needs. Find out more about the 2011 Ambulatory Breakfast Briefings Webinar/Audio Conference Series
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					<pubDate>Thu, 07 Jul 2011 16:20:57 GMT</pubDate>
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					<title>The July/August issue of Benchmark is now available</title> 
					<link>http://www.jcrinc.com/Blog/2011/6/22/The-July/August-issue-of-Benchmark-is-now-available/</link> 
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				Contents
		
		
				Health Reform News
				
						
								National Quality Strategy: Setting the Agenda for Health Care Reform
						
				The National Strategy for Quality Improvement in Health Care was released in March 2011 with the goal of establishing national aims and priorities to improve the quality of health care in the United States. The strategy outlines three broad goals for the health care system (better care, healthy people and communities, and affordable care) and discusses six priorities (make care safer, individuals are partners in their care, promote effective communication, promote best practices, enable healthy living in the community, make care more affordable). The strategy also presents sample quantitative goals and measures to evaluate progress toward the aims and priority areas.
		
				
				Core Measure Case Study
				
						
								University of Kansas Improves Compliance with the SCIP Infection Antibiotic Core Measures
						
				The University of Kansas Hospital conducted a multiyear, multidisciplinary research project to improve its perioperative prophylactic administration process. A surgical antibiotic prophylaxis order set was developed to standardize the administration process. Implementing the order set allowed the hospital to improve compliance with two SCIP core measures: SCIP INF-1 (prophylactic antibiotic received within one hour) and SCIP INF-2 (prophylactic antibiotic selection for surgical patients). The project also streamlined the antibiotic selection process, which in turn saved the hospital thousands in pharmacy costs. 
		
				
				National Performance Measurement Report
				
						
								AHRQ: Core Measure Data Provide Snapshot of Health Care Quality in the United States
						
				The Agency for Healthcare Research and Quality released two reports in February 2011 that benchmark the state of health care quality and health care access in the United States. The 2010 National Healthcare Quality Report provides data on trends in health care quality, and the National Healthcare Disparities Report provides information on disparities in health care delivery. The article discusses how data were collected and analyzed for inclusion in the reports and summarizes the highlights and major findings from the reports. 
		
				
				FAQ CornerPerinatal Care Core Measure SetThe Specifications Manual for Joint Commission National Quality Core Measures describes the Perinatal Care (PC) core measure set. This article presents answers to questions addressed to The Joint Commission’s Division of Healthcare Quality Evaluation staff pertaining to the PC core measure set, including PC-01, PC-02, PC-03, and PC-05.
		
				Access the July/August issue of 
				
						Benchmark
				
		
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					<pubDate>Wed, 22 Jun 2011 22:30:12 GMT</pubDate>
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					<title>Don’t Miss the Joint Commission Annual Conference on Quality and Patient Safety</title> 
					<link>http://www.jcrinc.com/Blog/2011/5/20/Don’t-Miss-the-Joint-Commission-Annual-Conference-on-Quality-and-Patient-Safety/</link> 
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		You can still register for the Joint Commission Annual Conference on Quality and Patient Safety, “Come Together – A Gathering of Leading Ideas in Quality and Safety,” which will be held June 8–10 in Chicago. Faculty will provide best practices, solutions, obstacles for overcoming challenges, and tools for implementing solutions in all areas of health care, including performance measurement. Presentations of interest for PM professionals include the following:• Supporting Patient Safety and Controlling Losses with Active Data Mining Stephen Pavkovic, RN, MPH, JD, Risk Manager, Northwestern Memorial HealthCare, Chicago, IL • The Core Measure Solution Exchange: What Are Organizations Like Mine Doing to Improve Core Measure Performance? Scott Williams, PsyD, Associate Director, Division of Healthcare Quality Evaluation, The Joint Commission
		
				Registration at an early bird rate is still available—until May 31, 2011. I hope to be able to meet you there; you can ask for me at the registration booth. Click here for more information, including registration: http://www.jcrinc.com/Conferences-and-Seminars/Annual-Conference-on-Quality-and-Patient-Safety/2903/ 
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					<pubDate>Fri, 20 May 2011 21:42:46 GMT</pubDate>
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					<title>A New Benchmark</title> 
					<link>http://www.jcrinc.com/Blog/2011/3/8/A-New-Benchmark/</link> 
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		The world of health care performance measurement is experiencing a period of great transformation, innovation, and evolution. The stakes are enormous—high-quality, safe patient care that is grounded on scientific evidence, rigorously tested and evaluated using consensus-driven performance measures, based on performance improvement principles, and delivered in an efficient and value-driven fashion isn’t a goal, it’s an expectation. 
		And The Joint Commission Benchmark® is raising its expectations, too.
		As Benchmark’s editor, my goal is to help you and your health care organization meet new performance measurement challenges head-on by providing the authoritative resource on critical performance measurement issues affecting your organization.  To achieve this objective, Benchmark has added or revised the following features for 2011:• Accountability Measures Update: The latest, most authoritative news on The Joint Commission’s Accountability Measures, including tracking their development into standards. Once the Measures are implemented, Benchmark will provide organizations with tips and strategies to comply with the new requirements, including case studies.• Health Reform News: The most current information on important health care reform legislation and policies and the impact these initiatives will have on performance measurement activities.• National Performance Measurement Report: Details and analysis of programs and reports from some of the nation’s leading performance measurement and improvement organizations, such as the National Quality Forum, the Agency for Healthcare Research and Quality, the National Quality Measures Clearinghouse, and the Hospital Quality Alliance.• Case Studies: Best practices from organizations that are successful at meeting core measure and other performance measurement requirements and details on how those efforts have helped improve performance and patient safety.  • Joint Commission Focus: Joint Commission projects related to performance measurement—including ORYX®, the Strategic Surveillance System (S3), Core Measures (including the Core Measure Solution Exchange), the Hospital Recognition Program, and the Center for Transforming Health Care—will be explored in depth. • FAQ Corner: The most frequently asked questions of Joint Commission staff concerning performance measurement standards and core measure set requirements, with answers from Joint Commission decision makers. • Technology Bytes: Reports on technological advancements to assist performance measurement professionals collect, analyze, or present data. Changes to performance measurement that result from the transition to Electronic Health Records will also be discussed.• Data Corner: Strategies to assist performance measurement professionals to improve their data collection, analysis, presentation, and management techniques. 
		Look also for a greater emphasis on the link between Joint Commission accreditation requirements— standards and National Patient Safety Goals—and performance measurement activities. In this issue and others going forward, Benchmark will give readers a clear nexus between standards compliance and performance measurement.
		The print and electronic versions of Benchmark will become linked more closely with the Benchmark blog (available at http://www.jcrinc.com/Blogs-All-By-Category/benchmark-Blog). The newsletter will contain callouts to the blog to point readers to supplemental materials, solicit reader feedback, and pose questions related to topics featured in the articles.
		Finally, we are developing a new look for Benchmark that we expect to unveil later in 2011. Please let us know if you have any feedback that might help us present our content in the way you want to see it. 
		We hope you enjoy Benchmark’s new focus and that it will continue to be an indispensable source of information on the critical performance measurement issues affecting your health care organization. Contact me at maviles@jcrinc.com with any questions, thoughts, or feedback.
		Mary AvilesEditor, The Joint Commission Benchmark
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					<pubDate>Tue, 08 Mar 2011 16:04:32 GMT</pubDate>
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					<title>Welcome Back to Benchmark!</title> 
					<link>http://www.jcrinc.com/Blog/2010/11/22/Welcome-Back-to-Benchmark/</link> 
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		Welcome back to the Benchmark blog! After a brief hiatus, the blog will be returning to its normal bi-weekly schedule to bring you the latest and greatest in the world of performance measurement.
		My name is Mary Aviles, and I am the new editor for Benchmark. I am pleased to be able to bring you the most-up-to-date and important news and information you need to meet your performance measurement needs. In addition to a change in editorship, there will be many new and exciting changes on the horizon for Benchmark. 
		As all of you are aware, there are many changes regarding performance measurement that have recently occurred and that are yet to come. New government regulations and requirements such as pay-for-performance, value-added purchasing, and mandatory reporting requirements are providing the impetus for health care organizations to use performance measurement to drive improvement in new and novel ways. A second force of change is The Joint Commission’s new accountability measures, which will lead to new accreditation requirements tied to performance measures. And payers and other stakeholders are also demanding that organizations demonstrate their compliance with regulations through performance indicators. My goal is to make Benchmark your one-stop source for the latest information on these requirements and other topics important for performance measurement professionals.
		One of the first changes is to seek input from our readers in various facets of performance measurement, and this is your first opportunity. The Joint Commission is seeking public comment on its Sudden Cardiac Arrest Initiative. Sudden cardiac arrest takes the lives of approximately 350,000 individuals in the United States every year. At present, there are no guidelines that are evidence-based or standardized; therefore, The Joint Commission has developed inpatient measures to prevent and treat sudden cardiac arrest. The nine draft measures are as follows:•  SCA-01: Timeliness of First Defibrillation Attempt•  SCA-02: Confirmation of Correct Endotracheal Tube Placement•  SCA-03: Initiation of Therapeutic Hypothermia•  SCA-04: Assessment of Thermoregulation in Therapeutic Hypothermia•  SCA-05: Survival to Discharge, Adult•  SCA-06: Survival to Discharge, Pediatric•  SCA-07: Patient Transition Record•  SCA-08: Provider Transition Record•  SCA-09: Advance Directive
		This is your opportunity to provide comments and feedback regarding these measures. Simply follow http://www.surveymonkey.com/s/KFPNWHD, and take the 40-minute survey, which will be available until December 3, 2010.
		 
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					<pubDate>Mon, 22 Nov 2010 22:29:48 GMT</pubDate>
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					<title>The Changing of the Guard</title> 
					<link>http://www.jcrinc.com/Blog/2010/9/23/The-Changing-of-the-Guard/</link> 
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				Not all of us like change, but change is imminent nonetheless. For the past three years it has been my pleasure to serve as senior editor for The Joint Commission Benchmark. Now I am transitioning to a new role as executive editor for The Joint Commission Perspectives and must hand my Benchmark duties to someone new. Don’t worry; I’m leaving you in very capable hands.Your new senior editor will be Mary Aviles. Mary has been with Joint Commission Resources for a little over two years and is very eager to take on this new challenge. I believe you’ll find her as approachable and talented as I do. It has been a great honor to serve as your editor, and I hope you will join me in welcoming Mary to her new role. 
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					<pubDate>Fri, 24 Sep 2010 04:54:59 GMT</pubDate>
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					<title>Center for Transforming Healthcare Releases Targeted Solutions Tool </title> 
					<link>http://www.jcrinc.com/Blog/2010/8/31/Center-for-Transforming-Healthcare-Releases-Targeted-Solutions-Tool/</link> 
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		How can Six Sigma help to stop the spread of health-care associated infections? If you have heard about The Joint Commission Center for Transforming Healthcare, you may also have heard that the Center is doing some interesting and innovative things using Lean, Six Sigma, and Robust Process Improvement ideologies. These performance improvement methods can be used to help solve some of health care’s most persistent quality and safety problems—including the spread of health-care associated infections. 
		For example, in mid-September, Joint Commission–accredited hospitals will have access, via their Joint Commission Connect™ extranet site, to an application called The Targeted Solutions Tool™ (TST), which delivers solutions for  difficult and pressing safety and quality problems. While the TST initially contains information on hand hygiene compliance, content will be expanded to include contributing factors, root causes, and solutions to other Center projects. These include increasing the effectiveness of hand-off communications, reducing the risk of wrong-site surgery, and addressing surgical site infections. 
		The TST guides health care teams through a step-by-step process to do the following:• Measure their organization’s actual performance• Identify barriers to excellent performance• Identify proven, tested, and targeted solutions. The advanced process improvement methods used by organizations participating in the Center’s pilot program on increasing hand hygiene compliance have been simplified by the TST and are now available to all Joint Commission–accredited organizations. Organizations do not need statistical data analysis capability or specialized performance improvement expertise to use the TST; the Center designed the self-paced tool to be clearly understood and used by an organization’s staff so that no new resources are required to implement it. Even better, TST is available at no cost and the entire process is confidential. 
		Will you make use of the TST in your organization? I’d love to know how it goes.
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					<pubDate>Tue, 31 Aug 2010 07:22:22 GMT</pubDate>
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					<title>Study Finds Medical Errors Cost United States Billions </title> 
					<link>http://www.jcrinc.com/Blog/2010/8/25/Study-Finds-Medical-Errors-Cost-United-States-Billions/</link> 
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		Medical errors cost the United States billions of dollars in 2008 according to a new study commissioned by the Society of Actuaries (SOA).  The study’s findings, based on claims data, estimate that medical errors cost the U.S. economy $19.5 billion in both direct costs paid out as insurance claims, and indirect costs, such as lost worker productivity. 
		In addition, of the approximately $80 billion in medical injury costs, about 25% were the result of avoidable medical errors. The study concluded that approximately 55% of the total medical error costs resulted from the following five common errors:
		1. Pressure ulcers2. Postoperative infections3. Mechanical complications of devices, implants, or grafts4. Postlaminectomy syndrome5. Hemorrhages complicating a procedure
		Other key findings from the study include the following:• There were 6.3 million measureable medical injuries in the United States in 2008; of the 6.3 million injuries, the SOA estimates that 1.5 million were associated with a medical error.• The average total cost per error was approximately $13,000.• In an inpatient setting, 7% of admissions are estimated to result in some type of medical injury.• The measurable medical errors resulted in more than 2,500 avoidable deaths and more than 10 million work days missed due to short-term disability.
		
				The study’s findings were based on an analysis of an extensive database. 
		
				Do you believe this study to be accurate? What role do you see medical errors playing in your organizations? 
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					<pubDate>Thu, 26 Aug 2010 03:00:05 GMT</pubDate>
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					<title>One State Takes Steps to Improve Surgical Care</title> 
					<link>http://www.jcrinc.com/Blog/2010/8/18/One-State-Takes-Steps-to-Improve-Surgical-Care/</link> 
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		Several Florida hospitals have helped launch an initiative to improve patient safety and the quality of surgical care while reducing costs throughout the state. The Florida Surgical Care Initiative (FSCI), a joint venture of the Florida Hospital Association, the American College of Surgeons (ACS), and the ACS Florida chapter, is a statewide collaboration focusing on reducing surgical complications and improving the quality of care in participating hospitals. 
		To date, 71 hospitals have lined up to join the program. The goal is to recruit at least 100 hospitals to the program, which will officially launch in October. 
		
				A critical issue being addressed is regional variations in the quality and cost of care. The FSCI will focus on the following four key areas: 1. Surgical site infections 2. Urinary tract infections 3. Colorectal surgery outcomes 4. Elderly surgery outcomes 
		
				The initiative was developed based on the ACS National Surgical Quality Improvement Program (NSQIP), a program that uses risk-adjusted, 30-day clinical outcomes data to review and assess outcomes and complications related to surgical care. The use of ACS NSQIP has been shown to significantly reduce complications and deaths in participating hospitals and to help hospitals save money by preventing costly complications. 
		
				Do you believe other states should follow Florida’s lead and create initiatives like this one? Is this something in which you’d like your organization to participate? I’d love to hear your thoughts. 
		 
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					<pubDate>Thu, 19 Aug 2010 04:04:16 GMT</pubDate>
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					<title>ACOG Issues Less Restrictive VBAC Guidelines </title> 
					<link>http://www.jcrinc.com/Blog/2010/8/10/ACOG-Issues-Less-Restrictive-VBAC-Guidelines/</link> 
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		Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery—including for some women who have had two previous cesareans—according to guidelines released by The American College of Obstetricians and Gynecologists (ACOG). Note: The Joint Commission’s Perinatal Care Core Measure Set, part of the National Quality Core Measures, includes the following measures:• Elective delivery • Cesarean section • Antenatal steroids • Health care–associated bloodstream infections in newborns • Exclusive breast milk feeding• This measure set is now available for selection for hospitals beginning with April 1, 2010, discharges.ACOG states that, in keeping with past recommendations, most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered a trial of labor after cesarean (TOLAC). In addition, ACOG guidelines now say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC. Both repeat cesarean and a TOLAC carry risks including maternal hemorrhage, infection, operative injury, blood clots, hysterectomy, and death. Most maternal injury that occurs during a TOLAC happens when a repeat cesarean becomes necessary after the TOLAC fails. A successful VBAC has fewer complications than an elective repeat cesarean while a failed TOLAC has more complications than an elective repeat cesarean. According to ACOG, the risk of uterine rupture during a TOLAC is low—between 0.5% and 0.9%—but if it occurs, it is an emergency situation. A uterine rupture can cause serious injury to a mother and her baby. ACOG maintains that a TOLAC is most safely undertaken where staff can immediately provide an emergency cesarean, but recognizes that such resources may not be universally available. Women and their physicians may still make a plan for a TOLAC in situations where there may not be immediately available staff to handle emergencies, but it requires a thorough discussion of the local health care system, the available resources, and the potential for incremental risk.ACOG states that restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will if, for example, a woman in labor presents for care and declines a repeat cesarean delivery at a center that does not support TOLAC. On the other hand, if, during prenatal care, a physician is uncomfortable with a patient's desire to undergo VBAC, it is appropriate to refer her to another physician or center. Practice Bulletin #115, "Vaginal Birth after Previous Cesarean Delivery," is published in the August 2010 issue of Obstetrics & Gynecology. 
		 
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					<pubDate>Wed, 11 Aug 2010 03:20:00 GMT</pubDate>
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					<title>Pediatric ICU Eliminates Central-Line Infections for Entire Year</title> 
					<link>http://www.jcrinc.com/Blog/2010/7/30/ICU-Eliminates-Central-Line-Infections-for-Entire-Year/</link> 
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		When it comes to performance improvement, you can’t get much better than bringing a count to zero. The Steven and Alexandra Cohen Children’s Medical Center (formerly Schneider Children’s Hospital of North Shore) in New York has done just that by going an entire year without a central-line infection in its pediatric intensive care unit, as reported by Quality Digest.After various studies and measurements, the Center reported that the key to combating infections in pediatric populations is focusing on maintenance procedures. Improvements made included a lengthy scrub of the catheter port with a special cleansing solution for each entry into the catheter (to either administer a medication or to sample blood), frequent changes of the catheter tubing, and a new protocol for changing the catheter dressing.  Additionally, the necessity of the catheter itself has become a topic for discussion on daily rounds; and an open conversation between the team of nurses and physicians caring for the patient has become a must at the first warning sign of an infection. To implement these last two aspects, a culture shift away from the more traditional hierarchical medical model is necessary. The organization instituted an “if you see something wrong, say something” policy.The results of the culture shift speak for themselves: From July 7, 2009, to July 7, 2010, Cohen Children’s Medical Center reported zero infections for 2,574 central-line days. The national average is 2.9 infections per 1,000 central-line days. Has your organization done something to boast about? Let me know. E-mail benchmark@jcrinc.com and tell me about it.
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					<pubDate>Sat, 31 Jul 2010 03:36:15 GMT</pubDate>
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					<title>Final Rules Supporting ‘Meaningful Use’ of Electronic Health Records Announced</title> 
					<link>http://www.jcrinc.com/Blog/2010/7/23/Final-Rules-Supporting-‘Meaningful-Use’-of-Electronic-Health-Records-Announced/</link> 
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		Over a series of five articles (see articles in the January/February, March/April, May/June, July/August, and September/October 2010 issues) Benchmark has discussed electronic health records (EHRs) and their “meaningful use.” This week, the U.S. Department of Health and Human Services announced final rules to help improve Americans’ health, increase safety and reduce health care costs through expanded use of EHRs.Under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives. One of the two new regulations defines the “meaningful use” objectives that providers must meet to qualify for the bonus payments, and the other regulation identifies the technical capabilities required for certified-EHR technology. Announcement of these regulations marks the completion of multiple steps laying the groundwork for the incentive payments program. With “meaningful use” definitions in place, EHR system vendors can ensure that their systems deliver the required capabilities, providers can be assured that the system they acquire will support achievement of “meaningful use” objectives, and a concentrated five-year national initiative to adopt and use electronic records in health care can begin.Requirements for meaningful use incentive payments will be implemented over a multi-year period, phasing in additional requirements that will raise the bar for performance on IT and quality objectives in later years. The final CMS rule specifies initial criteria that eligible professionals (EPs) and eligible hospitals, including critical access hospitals (CAHs), must meet. The rule also includes the formula for the calculation of the incentive payment amounts; a schedule for payment adjustments under Medicare for covered professional services and inpatient hospital services provided by EPs, eligible hospitals and CAHs that fail to demonstrate meaningful use of certified EHR technology by 2015; and other program participation requirements.What are your reactions to the final rule? How is your organization going about participating in the expanded use of EHRs?
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					<pubDate>Fri, 23 Jul 2010 10:53:06 GMT</pubDate>
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					<title>New AHRQ tool to help hospitals better display quality data </title> 
					<link>http://www.jcrinc.com/Blog/2010/7/16/New-AHRQ-tool-to-help-hospitals-better-display-quality-data/</link> 
					<description><![CDATA[
		The Agency for Healthcare Research and Quality's (AHRQ) has released a new tool for hospital administrative or claims data. MONAHRQ (My Own Network, Powered by AHRQ) is a free software program built to allow organizations to analyze data and/or create their own Web sites.
		The AHRQ released MONAHRQ in early June in hopes that organizations, including individual hospitals, hospital associations, and regional health initiatives, would take advantage of the ability to analyze and display data at no cost.
		A Web site created using MONAHRQ will provide information in the following four areas:• Quality of care for specific hospitals—provides information about patient safety, patient deaths in the hospital    and other quality-related • Provision of services by hospital for health conditions and procedures—provides information about the number    of patient discharges, charges, costs and length of hospitalizations for specific hospitals • Potentially avoidable hospitalizations—creates maps of county-by-county rates for potentially avoidable    hospitalizations • Rates of health conditions and procedures—provides information about the prevalence of diseases or    medical procedures through maps of county-by-county rates for selected conditions and procedures While they both provide information to the public on hospital quality, the Web sites generated by MONAHRQ users differ from The Department of Health and Human Service’s Hospital Compare Web site because of the information reported. For example, MONAHRQ users provide information on elements of care that are not offered by Hospital Compare, including outcome measures of quality by individual hospital, such as patient safety events and deaths; data on which high-volume procedures are associated with better outcomes; and preventable hospitalizations by county on conditions for which good outpatient care could avert the need for a hospital stay.MONAHRQ also is a completely different way of generating the information. Using the MONAHRQ software, users generate a custom Web site on hospital quality using a step-by-step approach to analyzing the data and generate a Web site that they can then host. Look for an article in a future issue of Benchmark on this new initiative.Has your organization had the opportunity to check out MONAHRQ? Would you, or do you, find it to be a useful tool? What are your thoughts on using the data to generate a custom Web site? 
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					<pubDate>Fri, 16 Jul 2010 09:32:22 GMT</pubDate>
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					<title>Want to Be in Benchmark?</title> 
					<link>http://www.jcrinc.com/Blog/2010/7/12/Want-to-Be-in-Benchmark/</link> 
					<description><![CDATA[
		Would you like to see your organization featured in Benchmark newsletter? The planning for 2011 has begun and we would love to read your case studies. If your organization has conducted a study or been part of a performance measurement project that led to significant improvements, let us know. E-mail us at benchmark@jcrinc.com and tell us about your organization’s successes. 
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					<pubDate>Tue, 13 Jul 2010 02:44:52 GMT</pubDate>
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					<title>The Race is on for the Baldrige Award</title> 
					<link>http://www.jcrinc.com/Blog/2010/7/1/The-Race-is-on-for-the-Baldrige-Award/</link> 
					<description><![CDATA[
		Eighty-three organizations (including 54 health care organizations) are competing for the 2010 Malcolm Baldrige National Quality Award, the United States’ highest recognition for organizational performance excellence through innovation and improvement. The number of applicants is up 20% over 2009 and marks the fifth consecutive year that there have been 70 or more organizations seeking the award. Additionally, the 54 health care applicants represent the largest number in that category since it was established in 1999. The 2010 applicants will be evaluated rigorously by an independent board of examiners in the following seven areas: 1. Leadership2. Strategic planning3. Customer focus4. Measurement, analysis, and knowledge management5. Work-force focus6. Process management7. ResultsThe winners are expected to be announced in late November. The Joint Commission includes Baldrige Award information in its Quality Check Web site to further illustrate the quality of a given organization. Do you believe including quality award data is useful for consumers when choosing a health care organization? What have been your experiences with quality awards, particularly the Baldrige Award? 
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					<pubDate>Fri, 02 Jul 2010 04:05:20 GMT</pubDate>
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					<title>Joint Commission Helps Hospitals Meet Future Performance Measurement Expectations</title> 
					<link>http://www.jcrinc.com/Blog/2010/6/25/Joint-Commission-Helps-Hospitals-Meet-Future-Performance-Measurement-Expectations/</link> 
					<description><![CDATA[
		To help hospitals prepare for performance measurement in the new health care environment, The Joint Commission is categorizing its performance measures into accountability and non-accountability measures. This approach places more emphasis on an organization’s performance on accountability measures – quality measures that meet four criteria designed to identify measures that produce the greatest positive impact on patient outcomes when hospitals demonstrate improvement. Non-accountability measures (for example, providing smoking cessation advice) are more suitable for secondary uses, such as exploration or learning within individual health care organizations, and are good advice in terms of appropriate patient care. The majority of The Joint Commission’s core measures are accountability measures; there are six non-accountability measures. 
		Increasingly, performance measure data are being used for many purposes and, moving forward, will be the basis for much of Medicare’s Value-Based Purchasing program and for public reporting purposes. The Joint Commission’s new approach will help hospitals prepare for the increasing reliance on attaining high performance on quality measures. 
		Currently, Joint Commission–accredited hospitals deliver evidence-based treatment of heart attack 96% of the time and they are making similar—and greater—gains in evidence-based treatment of heart failure, pneumonia, and in surgery. The need to “raise the bar” and advance performance measures that truly improve patient outcomes has been top-of-mind for accredited hospitals and The Joint Commission for some time. To learn more about accountability measures, read the June 23, 2010 online issue of the New England Journal of Medicine that features an article, “Accountability Measures: Using Measurement to Promote Quality Improvement,” for which Mark R. Chassin, M.D., M.P.P, M.P.H., president of The Joint Commission, was the lead author.What are your thoughts on The Joint Commission’s new categorizations? Do you feel this will help organizations? 
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					<pubDate>Fri, 25 Jun 2010 08:42:03 GMT</pubDate>
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					<title>A Closer Look at Health Care Reform</title> 
					<link>http://www.jcrinc.com/Blog/2010/6/18/A-Closer-Look-at-Health-Care-Reform/</link> 
					<description><![CDATA[
		Health care reform is just picking up momentum but some caregivers are still in the dark regarding what it means specifically for their organizations, especially when it comes to quality- and performance-improvement matters.  
		Princeton, New Jersey–based Mathematica Policy Research has developed an informative six-part series of briefs focusing on federal and state efforts to establish medical homes and notes considerations for policymakers seeking to improve access to services and the quality of care. Of particular interest to Benchmark readers would be the three briefs, “Basing Health Care on Empirical Evidence,” “How Does Insurance Coverage Improve Health Care Outcomes?” and “Medical Homes: Will They Improve Primary Care?”
		What changes have you made in your organizations since health care reform passed? Are there any areas that you are still unsure of in the health care reform act? How do you think health reform will affect the quality of care you provide and any quality-improvement initiatives you have or plan to have in place? 
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					<pubDate>Fri, 18 Jun 2010 06:24:28 GMT</pubDate>
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					<title>Improving Safety Processes to Prevent Violence in Health Care Organizations</title> 
					<link>http://www.jcrinc.com/Blog/2010/6/10/Improving-Safety-Processes-to-Prevent-Violence-in-Health-Care-Organizations/</link> 
					<description><![CDATA[
		Health care organizations should be a place of healing, not violence, and The Joint Commission has issued a warning calling for process improvements to keep patients and staff safer. The newest Joint Commission Sentinel Event Alert warns that health care organizations today are being confronted with steadily increasing rates of crime, including assault, rape and murder.
		To improve safety in health care organizations, the Alert urges greater attention to the issue of violence and to controlling access to facilities to protect patients, staff and visitors. The Alert cautions that the actual number of violent incidents is significantly under-reported and advises organizations to mandate the reporting of all real or perceived threats.
		To prevent violence in health care facilities, The Joint Commission suggests that facilities take a series of steps, including the following:• Evaluate the facility’s risk for violence examining the campus, reviewing crime rates and surveying employees   about their perceptions of risk.• Take extra security precautions in the emergency department, especially if the facility is in an area with a high    crime rate or gang activity. Precautions might include uniformed security guards, scanning people entering    the building for weapons, and inspecting bags.• Conduct thorough background checks of prospective employees and staff.• Report crime to law enforcement.
		
				In addition to the specific recommendations contained in the Alert, The Joint Commission urges hospitals to comply with the requirements described in its accreditation standards to prevent violence. The standards require accredited health care facilities to have a security plan as well as conduct violence risk assessments, develop strategies to prevent violence and have a response plan when a violent episode occurs. The Joint Commission’s standards also are clear that patients have a right to be free from neglect, exploitation, and verbal, mental, physical and sexual abuse.  Have you seen incidences of violence increase in your health care organizations? What are some protocols your organizations have in place to deal with violence? 
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					<pubDate>Fri, 11 Jun 2010 02:37:36 GMT</pubDate>
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					<title>New Analysis Predicts Decreases in Uninsured, Federal Government Covering Costs</title> 
					<link>http://www.jcrinc.com/Blog/2010/6/7/New-Analysis-Predicts-Decreases-in-Uninsured-Federal-Government-Covering-Costs/</link> 
					<description><![CDATA[
		The expansion of Medicaid under the new health reform law will significantly increase the number of people covered by the program and markedly reduce the uninsured in states across the country, with the federal government picking up the majority of the cost, according to a state-by-state analysis released by the Washington, D.C.-based Kaiser Family Foundation's Commission on Medicaid and the Uninsured.The analysis is among the first to show the distribution of new Medicaid enrollees and costs for all 50 states and the District of Columbia, as well as the impact that health reform will have on the uninsured. Health reform offers Medicaid coverage to millions of low-income adults for the first time and helps establish a national floor for Medicaid eligibility that contrasts sharply with the wide variation in eligibility across current state Medicaid programs.States with large uninsured populations currently are expected to see the biggest increases in the numbers of people who obtain health coverage through Medicaid. California and Texas—for example, two states with considerable numbers of uninsured residents—are each projected to see 1.4 million fewer uninsured adults in 2019 due to the Medicaid expansion, with the federal government covering 95% of the cost in Texas and 94% in California. Nationally, the analysis projects that Medicaid enrollment will climb by 15.9 million more people by 2019 than it otherwise would have, and that the number of uninsured will fall by more than 11 million persons. The cost of the Medicaid expansion between 2014 and 2019 would be jointly financed, with the federal government paying $443.5 billion (or 95.4 % of the total cost) and the states contributing $21.2 billion.  It is difficult to predict the impact of the new Medicaid outreach and enrollment efforts under health reform, as well has how states will respond.  So the analysis contemplates two scenarios and applies a uniform rate of enrollment (participation rate) among those eligible for Medicaid.  Both scenarios examine the coverage and cost impact of the Medicaid expansion for adults with annual incomes at or below 133% of the federal poverty level (FPL), which is $14,404 for an individual under current poverty guidelines. The scenarios do not account for the impact of reform for children or state savings related to reductions in uncompensated care costs or reductions in Medicaid coverage for adults currently covered above 133% FPL. Nor do they factor in other changes in Medicaid in health reform related to provider payment rates, changes to the drug rebates or new options related to payment reform.  How do you see these changes effecting your organizations? Are you currently doing anything differently to prepare for the expected increase in insured patient? 
		 
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					<pubDate>Tue, 08 Jun 2010 04:31:21 GMT</pubDate>
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					<title>AHRQ: Bar-code eMAR Reduces Medication Use, Transcription Errors</title> 
					<link>http://www.jcrinc.com/Blog/2010/5/21/AHRQ-Bar-code-eMAR-Reduces-Medication-Use-Transcription-Errors/</link> 
					<description><![CDATA[
		 
		Using bar-code technology with an electronic medication administration record (eMAR) substantially reduces transcription and medication administration errors, as well as potential drug-related adverse events, says a new study funded by the Department of Health & Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ). The study was published in the May 6 issue of the New England Journal of Medicine. Bar-code eMAR is a combination of technologies that ensures that the correct medication is administered in the correct dose at the correct time to the correct patient. When nurses use this combination of technologies, medication orders appear electronically in a patient's chart after pharmacist approval. Alerts are sent to nurses electronically if a patient's medication is overdue. Before administering medication, nurses are required to scan the bar codes on the patient's wristband and then on the medication. If the two don't match the approved medication order, or it is not time for the patient's next dose, the system issues a warning. Researchers at Brigham and Women's Hospital in Boston compared 6,723 medication administrations on hospital units before bar-code eMAR was introduced with 7,318 medication administrations after bar-code eMAR was introduced. Having bar-code eMAR technologies in place was associated with reductions in errors related to the timing of medications, such as giving a medicine at the wrong time, and nontiming medication administration, such as giving a patient the wrong dose. The researchers documented a 41-percent reduction in nontiming administration errors and a 51-percent reduction in potential drug-related adverse events associated with this type of error. Errors in the timing of medication administration, meaning a patient was given medication an hour or more off schedule, fell by 27 percent. No transcription errors or potential drug-related adverse events related to this type of error occurred. "Medication errors in hospitals are a very serious issue and can often lead to patient harm," says AHRQ director Carolyn M. Clancy, M.D. "The good news from this study is that using bar-code technology and an electronic medication administration record together can be an important intervention to help achieve medication safety." The findings have important implications because bar-code eMAR technology is being considered as a 2013 criterion for meaningful use of health information technology under the American Recovery and Reinvestment Act of 2009. "Our study shows that this combination of technologies can make the delivery of hospital care safer. However, hospitals need the right set of resources and human talent to deploy these technologies successfully, so more research is needed to identify ways to implement them in the most cost-effective way," says lead study author Eric G. Poon, M.D., of Brigham and Women's Hospital. AHRQ's health information technology initiative is part of the Nation's strategy to use health information technology to improve health care. Since 2004, AHRQ has invested more than $300 million in contracts and grants to more than 150 communities, hospitals, providers, and health care systems in 48 states to develop knowledge about and encourage the adoption of health IT practices that improve quality and safety. 
		
				
				
						Performance Improvement on the Go
				
				Sometimes you don’t have time to sit down and read an entire book and with e-Readers and electronic formats these days, you don’t have to. Even when you’re on the move, you still need to keep in touch with The Joint Commission and with performance measurement and improvement news with Joint Commission Resources’s (JCRs) new e-Books. Most JCR books are available as e-Books, which are PDFs that can be accessed on demand. Benchmark articles can also be accessed on demand by clicking here. 
		
				E-books have a plethora of benefits some of which include the following: • Immediate access¬a convenient way to get the information you need quickly• Searchable--find key words or topics throughout the book• Cost-effective--specially priced plus no additional shipping and handling charges
		
				Find titles like the following:• A Guide for Addressing RFIs After Your Joint Commission Survey• Advanced Lean Thinking• Doing More With Less• And many more helpful guides. 
		
				 Did you know that many of JCRs e-Books feature free online extras, including tools, forms and other helpful information? Look for this logo next to the e-Book description on the JCR Web site.
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					<pubDate>Fri, 21 May 2010 07:11:09 GMT</pubDate>
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					<title>ASQ Asks: “H1N1: What Have We Learned?”</title> 
					<link>http://www.jcrinc.com/Blog/2010/5/17/ASQ-Asks-“H1N1-What-Have-We-Learned”/</link> 
					<description><![CDATA[
		Amid H1N1 concerns and shrinking budgets, U.S. public health departments face tough challenges. At the top of the list are fewer resources to ensure that residents get vaccinations and other services in a timely fashion. But more agencies are finding a prescription for improved efficiency and public safety with the help of process improvement methods, according to the Milwaukee-based American Society for Quality’s Report, “H1N1 Influenza and Quality Tools: What Have We Learned?”The report notes the experiences of several public health agencies, which with the help of quality professionals and organizations such as the Public Health Foundation and the National Network of Public Health Institutes, are integrating continuous improvement tools and techniques. Results include the following:• Improved vaccine distribution• Waste elimination• More client satisfaction with vaccination services• Strengthened communications to ensure a smooth flow of informationThe Northern Kentucky Health Department, for instance, has come up with a novel idea—incorporating customer satisfaction surveys in H1N1 mass vaccination clinics. Doing this enabled the health department to capture valuable feedback about its immunization process. Interviews of clinic clients and staff helped determine what the clinic was doing well and where problems lurked. This enabled the department to make changes resulting in reduced waiting times while providing friendly, efficient service. Also, according to the report, quality tools are becoming an important way for public health agencies to improve emergency preparedness as well as communication processes for the Kansas Department of Health and Environment. The Shawnee County health agency in Kansas developed a Plan-Do-Study-Act report for implementing a process to monitor vaccination doses, the procedures for providing vaccines to public sites, and coordinating distribution to private vaccination sites. This exercise supported real-time inventory control and facilitated timely and accurate data on vaccine doses throughout all of the mass vaccination clinics. Quality tools are also being used to help monitor and improve issues such as staffing, equipment setup, training, and communications. Has your organization done any type of analysis to find out what you can learn from your H1N1 experiences? We would love you share your experience with our readers. 
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					<pubDate>Tue, 18 May 2010 02:51:06 GMT</pubDate>
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					<title>Patient Safety in the United States Still Needs Improvement</title> 
					<link>http://www.jcrinc.com/Blog/2010/5/7/Patient-Safety-in-the-United-States-Still-Needs-Improvement/</link> 
					<description><![CDATA[
		Improvements in patient safety continue to move slowly, according to the Agency for Healthcare Research and Quality’s (AHRQ)2009 National Healthcare Quality Report and the 2009 National Healthcare Disparities Report.
		The Quality Report states that little progress has been made on eliminating health care-associated infections (HAIs). For example, of the five types of HAIs in adult patients who are tracked in the reports the following was found: • Rates of postoperative sepsis, or bloodstream infections, increased by 8%. • Postoperative catheter-associated urinary tract infections increased by 3.6%. • Rates of selected infections due to medical care increased by 1.6%. 
		The Congressionally mandated AHRQ annual quality and disparities reports show trends by measuring health care quality for the nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in the following four areas of quality: 1. Effectiveness2. Patient safety3. Timeliness4. Patient-centeredness 
		The 2009 reports include a new section on lifestyle modifications, because preventing or reducing obesity is a crucial goal for many Americans and an important task for health care providers. The reports found the following:• One-third of obese adults have never received advice from their physician about exercise. • Obese adults who are African American, Hispanic, poor, or have less than a high school education are less likely to receive diet advice from their physician. • Most overweight children and one-third of obese adults report that they have not been told by their physician that they are overweight. • Most American children have never received counseling from their health care provider about exercise, and almost half have never received counseling about healthy eating. 
		
				The reports indicate that the lack of health insurance slows improvement in health care quality and reduction of disparities. For many services, not having insurance is the single strongest predictor of poor quality care, exceeding the effects of race, ethnicity, income, or education. The reports state that Americans with no insurance are much less likely than those with private insurance to obtain recommended care, especially preventive services and management for diabetes. While differences between African Americans and Caucasians in the rates of lack of insurance have narrowed in the past decade, disparities related to ethnicity, income, and education remain large. What do you think about this report? Have you seen examples of these trends in your organizations? How have your organizations worked to combat these trends? 
		 
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					<pubDate>Sat, 08 May 2010 05:11:25 GMT</pubDate>
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					<title>Is the United States Facing a Physician Shortage?</title> 
					<link>http://www.jcrinc.com/Blog/2010/4/29/Is-the-United-States-Facing-a-Physician-Shortage/</link> 
					<description><![CDATA[
		A recent article in The Wall Street Journal warns that due to the health care law passed in March, there won’t be enough physicians to cover the newly insured. The article also reports that the United States could face a shortage of as many as 150,000 physicians in the next 15 years, according to the Association of American Medical Colleges (AAMA). This shortfall is expected despite teaching hospitals and medical schools doing their best to boost the number of U.S. physicians, which now totals nearly 954,000. 
		The article goes on to explain that the greatest demand will be for primary care physicians who now total approximately 352,908. However, AAMA says that 45,000 more physicians will be needed by 2020. What does this do for performance improvement? Not much. In fact, a shortage of primary care and other physicians may mean limited access to health care and longer wait times – all bad news for patients and a step back for performance improvement. 
		Some medical schools are hoping to combat this possibility by increasing class sizes. But AAMC says that won’t help much due to a shortage of medical resident positions. In 1997, Congress imposed a cap on funding for medical residencies and many hospitals have cited this as hurting their ability to expand the number of resident positions. It was hoped that the new health care law would provide provisions that would increase the number of funded residency slots, but that provision didn’t make it into the final bill. However, because some residency slots to go unfilled each year, the law will pool the funding for unused slots and redistribute it to other institutions, with the majority of these spaces going to primary care or general surgery residencies. According to the Centers for Medicare & Medicaid Services, this redistribution will create additional residencies because previously unfilled positions will now be used. 
		What do you think the solution is? Do you believe there will be a shortage of physicians? How do you think this will impact patient care and performance improvement?  
		
				It's a Can't Miss Opportunity
				Don't miss The Joint Commission Annual Conference on Quality and Patient Safety, June 23-25. This conference is for chief executive officers, patient safety officers, risk managers, chief compliance officers, chief nursing officers, chief medical officers, administrators, Joint Commission coordinators, staff nurses and physicians and all others involved in direct patient care or survey compliance. Click here for more details!
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					<pubDate>Fri, 30 Apr 2010 04:58:04 GMT</pubDate>
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					<title>Joint Commission to Offer Monograph on Tdap Vaccinations</title> 
					<link>http://www.jcrinc.com/Blog/2010/4/21/Joint-Commission-to-Offer-Monograph-on-Tdap-Vaccinations/</link> 
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		In an effort to help health care organizations implement or improve tetanus, diphtheria and acellular pertussis (Tdap) vaccination programs for patients and health care workers, The Joint Commission will release a monograph in late 2010 that will include information on the following: • Discussion of the impact of pertussis, especially on infants and young children • A review of the morbidity and costs associated with pertussis outbreaks in health care organizations, including    personnel absenteeism and furloughs, investigation of exposed persons, antimicrobial prophylaxis, and    laboratory evaluations • Background on, and recommendations for Tdap vaccinations for adolescents, adults, and health care workers• A compilation of practices and effective strategies for implementing or enhancing Tdap vaccination programs for    adolescents, adults, and health care workers“Increasing Tdap vaccination rates requires leadership support, education, creative strategies for vaccine delivery and a shift in organizational culture to sustain improvement over time,” says Jerod M. Loeb, Ph.D., executive vice president, Division of Quality Measurement and Research, The Joint Commission. “This project offers opportunities to share front-line practices that are making a difference.”When finalized, the monograph will be available for free download on The Joint Commission’s public Web site, http://www.jointcommission.org. 
		
				
				It’s a Can’t Miss Opportunity
				Don’t miss The Joint Commission Annual Conference on Quality and Patient Safety, June 23-25. This conference is for chief executive officers, patient safety officers, risk managers, chief compliance officers, chief nursing officers, chief medical officers, administrators, Joint Commission coordinators, staff nurses and physicians and all others involved in direct patient care or survey compliance. Click here for more details! 
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					<pubDate>Thu, 22 Apr 2010 03:24:24 GMT</pubDate>
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					<title>U.S. Agencies Plan to Share More Performance Measurement Data</title> 
					<link>http://www.jcrinc.com/Blog/2010/4/16/US-Agencies-Plan-to-Share-More-Performance-Measurement-Data/</link> 
					<description><![CDATA[
		Data transparency is finally having its day. The Centers of Medicare & Medicaid Services (CMS) launched a public Web site tracking its spending on hospital Medicare patients for the most-treated illnesses and conditions. It is one of the efforts by the Health and Human Services (HHS) Department to become more transparent and publish some of its data for public view and analysis. 
		HHS detailed several online programs it plans as part of its Open Government directive to make governmental operations and performance more accessible. For instance, the release of the CMS site provides statistics from its Inpatient Prospective Payment System data based on medical claims the agency paid—including  by volume and hospitals paid—in a dashboard format. The data cover information from inpatient discharges from January 2006 to December 2009 and will be updated monthly. The Open Government plan also cites the importance of the nationwide health information network (NHIN), a set of standards and services designed to secure the exchange of health information via the Internet, and its recently announced streamlined version, called NHIN Direct. HHS said it will protect the confidentiality of individually identifiable information that may be contained in data sets that it releases publicly. 
		Another of HHS’ projects will share national-, state-, regional-, and potentially county-level data on Medicare prevalence of disease, quality, and costs. The data stream is part of the department’s Community Health Data initiative, an effort to help Americans understand health care performance in their communities compared with others and to help spur improvements. 
		Among other planned efforts, the Office of the National Coordinator for Health IT is developing a performance measurement system and Web site that demonstrates the status of its programs, such as monitoring its many grant awardees in advancing the adoption of electronic health records. The initial version of its performance dashboard is expected before year end. 
		CMS is currently accepting public feedback on its dashboard using this form. What would you like to see included on the dashboard? What do you like or dislike about the data that  are shared and how CMS is sharing them?
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					<pubDate>Fri, 16 Apr 2010 08:55:19 GMT</pubDate>
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					<title>Joint Commission Calls for Performance Measures on Sudden Cardiac Arrest</title> 
					<link>http://www.jcrinc.com/Blog/2010/3/31/Joint-Commission-Calls-for-Performance-Measures-on-Sudden-Cardiac-Arrest/</link> 
					<description><![CDATA[
		Want to share your performance measures on sudden cardiac arrest with other organizations? The Joint Commission has initiated a project to identify, develop, and test a set of standardized performance measures to assess inpatient and emergency department care of patients with sudden cardiac arrest.  The Joint Commission is soliciting candidate performance measures for review and evaluation by its Technical Advisory Panel for potential inclusion in the set of performance measures for sudden cardiac arrest. Candidate submissions can be structure, process, or outcome measures and must be submitted no later than April 30, 2010. Any measure(s) adopted or adapted for inclusion in the measure set must reside in the public domain. For more information on how to submit your organization’s performance measures, click here.The Joint Commission is also soliciting abstracts describing effective community-based programs, program implementation methods, or practices related to prevention or treatment of sudden cardiac arrest for possible inclusion in an educational monograph of effective community-based practices. Authors of abstracts selected will be contacted in late summer, 2010.
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					<pubDate>Thu, 01 Apr 2010 05:16:51 GMT</pubDate>
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					<title>Call for Submissions for the John M. Eisenberg Patient Safety and Quality Award</title> 
					<link>http://www.jcrinc.com/Blog/2010/3/18/Call-for-Submissions-for-the-John-M-Eisenberg-Patient-Safety-and-Quality-Award/</link> 
					<description><![CDATA[
		
				
						Showcase your important patient safety and quality work—whether it’s related to performance measurement and improvement or not—by applying for a 2010 John M. Eisenberg Patient Safety and Quality Award. The Eisenberg Award recognizes major achievements of individuals and organizations in improving patient safety and health care quality. Annual awards are given in the following categories:• Individual achievement (domestic and international combined) • Domestic system innovation in patient safety and/or health care quality at the national level • Domestic system innovation in patient safety and/or health care quality at the local level • Domestic research • International research or system innovation in patient safety and/or health care quality
				
				
						 
				
		
		More information and application forms are available on The Joint Commission and the National Quality Forum Web sites. The award program will again include the opportunity for international submissions. Applications are due to The Joint Commission by April 12, 2010.
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					<pubDate>Fri, 19 Mar 2010 03:10:29 GMT</pubDate>
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					<title>A Voice from the Field</title> 
					<link>http://www.jcrinc.com/Blog/2010/3/11/A-Voice-from-the-Field/</link> 
					<description><![CDATA[
		
				I try as much as I can in Benchmark to include columns from those in The Joint Commission who know the real scoop on performance measurement and improvement. In the May/June issue, I will include a column from Jerod M. Loeb, Ph.D., executive vice president, Division of Quality Measurement and Research. It’s called “Performance Measurement: The Good, Bad, and The Ugly,” so you know he’s got some good stuff to say. Here’s a sample of what’s to come: 
		
		
				
						
								The reality that most of us appreciate in health care today is that we tend to live in a culture of low expectations. Data have repeatedly shown that, in the United States, about 40 cents of each health care dollar spent is wasted. Even when available, health care organizations fail to use technology to empower themselves and their patients. There is only limited use of electronic health records, little interoperability among extant automated systems (that is, administrative, pharmacy and clinical decision support come to mind here) and workarounds are developed for inefficient processes, rather than redesigning the process. And, we live in an environment in which many toxic processes often defy logic. Changing the oil on a 747 aircraft at 35,000 feet is probably easier than changing existing systems and processes in health care today.
						
				
		
		
				
				
						
								With these obstacles in mind, it is interesting to consider the various barriers to implementing evidence-based quality and safety practices that need to be overcome. While this list is certainly not exhaustive, what comes to mind are the following:• Absence of organizational culture focusing on quality and patient safety• Lack of knowledge and experience in systems-thinking including systems analysis and process redesign• Lack of availability of practical tools and solutions to guide implementation of specific practices• Lack of effective methods for creating a behavior change among health care professionals • Tendency to add specific evidence-based practices to existing chassis rather than redesign the process
								
						
				
		
		
				You won’t want to miss reading this issue. Along with Dr. Loeb’s column, I’ll have articles on electronic health records, human error reduction, the patient-centered medical home, and more. Be sure to check it out when it arrives in mid-April. 
		
		
				
				If you don’t have a Benchmark subscription, click 
				
						here
				
				. To read the current issue, click 
				
						here
				
				. 
		
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					<pubDate>Fri, 12 Mar 2010 03:28:42 GMT</pubDate>
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					<title>Professional Interpreters Increase Patient Satisfaction</title> 
					<link>http://www.jcrinc.com/Blog/2010/3/6/Professional-Interpreters-Increase-Patient-Satisfaction/</link> 
					<description><![CDATA[
		Mathematica Policy Researchers asked the question, “Does using professionally trained interpreters in the emergency department (ED) increase patient satisfaction?” Up until now, research on this topic has been sparse, so Mathematica conducted its own study using random assignment to compare the reported satisfaction of patients and providers during 424 ED visits, roughly half of which included interpreter services from a professionally trained medical interpreter and roughly half of which relied on the ED’s usual language services—that is, a telephone language line or ad hoc interpreter services.
		The study found that use of professional interpreter services dramatically increased satisfaction with patient-provider communication during the ED visit, not only for patients but for all types of providers—including triage nurses, doctors, and discharge nurses. That’s a big win for performance improvement. 
		What do you do in your organizations? Do you use a trained medical interpreter or another service? What has your experience been with patient satisfaction and the type of service your organization provides? 
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					<pubDate>Sat, 06 Mar 2010 07:21:47 GMT</pubDate>
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					<title>Does Pay For Performance Impact Low Performing Physicians? </title> 
					<link>http://www.jcrinc.com/Blog/2010/2/25/Does-Pay-For-Performance-Impact-Low-Performing-Physicians/</link> 
					<description><![CDATA[
		Most of us have heard of pay-for-performance (P4P) programs and are familiar with their impact on high-performing physicians – they are obviously recognized for their hard work. But do these programs help motivate low-performing physicians? The short answer is yes. A number of studies have come out recently stating that P4P works to boost low-performing physicians and turn their performance around. This was true especially for selected quality measures, such as mammography, cervical cancer screening, and childhood immunization measures. Good news all around.What has been your experience with P4P? Does your organization use a P4P program? If so, for how long? What quality improvements have you seen?
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					<pubDate>Thu, 25 Feb 2010 08:18:42 GMT</pubDate>
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					<title>Tell Us Your Success Stories</title> 
					<link>http://www.jcrinc.com/Blog/2010/2/18/Tell-Us-Your-Success-Stories/</link> 
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		In each issue of The Joint Commission Benchmark, I try to highlight organizations that have success stories in the areas of performance improvement and measurement. Have you had success with The Joint Commission’s S3 system? Have you made improvements in your organization because of a measurement you used? Is there anything you’re doing in your organization that you think can be replicated in another organization (click here for an example)? Let us know. E-mail benchmark@jcrinc.com and tell us your story. Your organization could be highlighted in the next issue. 
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					<pubDate>Fri, 19 Feb 2010 03:19:24 GMT</pubDate>
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					<title>What Does Health Care Reform Mean for You? </title> 
					<link>http://www.jcrinc.com/Blog/2010/2/11/What-Does-Health-Care-Reform-Mean-for-You/</link> 
					<description><![CDATA[
		I read an interesting article on the Quality Digest Web site titled “What Will Health Care Reform Mean for the Health Care Quality Professional?” The article was structured in a question–and-answer format, with the American Hospital Association’s (AHA) Maulik Joshi, M.D., president of AHA’s Health Research & Educational Trust and Nancy Foster, AHA’s vice president of quality and patient safety policy, answering questions posed by Quality Digest’s editor.
		I found it remarkable that both health care experts pointed out that the U.S. health care reform bills, as passed by the House and Senate, have a keen eye on quality; in other words, legislators have recognized that reforms are needed to not only make health care accessible to everyone, but to make health care better as well. Quality leaders have been working toward this goal for years. We’ve already seen the Center for Medicare & Medicaid Services issue a list of “never events” for which they will no longer reimburse organizations, along with the advent of electronic health records, and the medical home. These and other steps currently being taken will go a long way in making sure patients are receiving quality care at a fair price.
		What do you think health care reform will mean for your organization? What changes have you made so far to ensure your organization is reimbursed at the highest level possible?
		 
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					<pubDate>Thu, 11 Feb 2010 15:22:05 GMT</pubDate>
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					<title>Preventing Deaths During and After Pregnancy</title> 
					<link>http://www.jcrinc.com/Blog/2010/2/4/Preventing-Deaths-During-and-After-Pregnancy/</link> 
					<description><![CDATA[
		
				
						
								A new Sentinel Event Alert from The Joint Commission reminds us that women and infants dying during childbirth is still a significant patient safety issue that deserves our attention.The Alert comes as federal and state governments are increasing efforts to identify causes and prevent maternal deaths. The current statistics from the Centers for Disease Control and Prevention show that there are 13.3 maternal deaths per 100,000 live births, well over the target of 3.3 maternal deaths per 100,000 live births set as part of the U.S. government’s Healthy People 2010 initiative. Common preventable causes that lead to maternal deaths include uncontrolled high blood pressure, undiagnosed fluid build-up in the lungs of women with pre-eclampsia, failure to pay attention to vital signs after a Cesarean section, and hemorrhage following a Cesarean section.To prevent pregnancy-related deaths and severe illness, The Joint Commission’s Sentinel Event Alert suggests that hospitals take a series of six specific steps, including the following:• Educate physicians and other caregivers about underlying conditions such as high blood pressure, diabetes or morbid    obesity that may put women at risk if they become pregnant. • Use specific protocols to treat pregnant women who have, for example, experienced a change in vital signs, hemorrhage or   
								pre-eclampsia. • Train emergency room staff to consider whether female patients may be pregnant or recently pregnant. Pregnancy can affect    the diagnostic process or change a woman’s response to treatment.
						
				
				
						
								
								For women who are identified as being at high risk because of existing conditions such as high blood pressure, diabetes or morbid obesity, the Alert calls for referrals to experienced prenatal care providers who can provide specialized services. In order to avoid pulmonary embolism, The Joint Commission recommends hospitals make pneumatic compression devices available to high-risk patients undergoing a Cesarean section. Finally, hospitals are urged to evaluate whether pregnant women who are at high risk for dangerous blood clots (thromboembolism) should receive a special dosage of blood thinner after giving birth.
								
								
								This is in connection with a new set of perinatal core measures from The Joint Commission. This measure set reflects the following:• Elective delivery • Cesarean section • Antenatal steroids • Health care–associated bloodstream infections in newborns • Exclusive breast milk feedingFor more information on these measures, see the March/April issue of The Joint Commission Benchmark. What are your organization’s measures saying about instances in childbirth? Are there any specific interventions your organization takes to ensure a healthy mother and child for every birth?
						
				
		
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					<pubDate>Thu, 04 Feb 2010 20:55:53 GMT</pubDate>
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					<title>Take Two Aspirin and Go Away</title> 
					<link>http://www.jcrinc.com/Blog/2010/1/21/Take-Two-Aspirin-and-Go-Away/</link> 
					<description><![CDATA[
		In 2007,  I edited a book for Joint Commission Resources titled, Defusing Disruptive Behavior: A Workbook for Leaders. The book focused on physicians behaving badly and treating those around them poorly. Some interesting studies were cited regarding how physicians behaved and how that might affect patient care. A new study along those lines done by researchers at Israel’s Ben-Gurion University of the Negev suggests that physicians’ moods affect the number of prescriptions, referrals, and lab tests ordered, as well as the amount of time they spend with their patients. The findings of the study “Communicating with Patients, Prescribing Medications and Referring to Tests and Specialists: Associations with Physician Burnout and Moods” were presented at the 14th International Conference of the Israel National Institute for Health Policy.  More than 180 primary physicians in Israel were surveyed to determine whether physicians changed their professional behavior on good mood days, as well as days when they felt stressed, tired, or anxious. Physicians’ burnout levels were also assessed. The study asked physicians to rank how their mood affected the extent they talked with patients, prescribed medications, sent patients to lab or diagnostic tests, and referred patients to a specialist.  The study’s findings showed that a good or bad mood affected all five physician behaviors. On days the physicians felt positively, they spoke more to patients, wrote fewer prescriptions, ordered fewer tests, and issued fewer referrals. However, when physicians were in a bad mood, they did the opposite. Additionally, if the physicians’ burnout level was higher, their moods more strongly impacted their behaviors. Have you seen this in action? Do you believe that mood could have an impact on patient care? 
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					<pubDate>Thu, 21 Jan 2010 15:04:17 GMT</pubDate>
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					<title>Welcome to the Future</title> 
					<link>http://www.jcrinc.com/Blog/2010/1/5/Welcome-to-the-Future/</link> 
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		Welcome to 2010. Another year brings a new set of challenges and adventures. And with those challenges comes electronic health record (EHR) reform. It reminds me of playing hide-and-seek as a child, ready or not, here they come. And some organizations report they aren’t yet ready.
		A small survey of 58 various-sized hospitals conducted by Computer Sciences Corporation (CSC), Falls Church, VA, reportedly shows they are not ready for meaningful use of EHR requirements.
		Two-thirds of surveyed hospitals identified gaps in their current systems to meet meaningful use requirements but only one-quarter met at least 70% of the readiness criteria within the survey. Hospitals generally had the highest scores for privacy and security and the lowest for use of required EHR capabilities.
		Fifty-four percent of surveyed hospitals have the latest version of their EHR software, which CSC suggests indicates upgrading to meet meaningful use requirements might be required. While 89% of respondents report on core quality measures, only half capture most required data from their EHR.
		Full survey results are available here.
		Is your organization ready? If not, what are you doing to prepare? 
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					<pubDate>Tue, 05 Jan 2010 15:18:36 GMT</pubDate>
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					<title>Data Mining or Snooping for Cash?</title> 
					<link>http://www.jcrinc.com/Blog/2009/12/21/Data-Mining-or-Snooping-for-Cash/</link> 
					<description><![CDATA[
		I read an interesting article in the LA Times this week. In this blog, I’ve spoken about Web sites and companies using data to plot flu outbreaks and epidemics, using data to plot health care trends, and so on. However, this story in the Times brings about some interesting legal (and maybe even ethical) dilemmas. 
		
				Pharmaceutical companies are now using prescription data to find out what physicians are prescribing the most and to what demographic and, consequently, learning how to better market their products. While these companies can’t know exactly who is being prescribed the medications (due to patient confidentiality), they can use this data to target the public and physicians in marketing campaigns, and they may even be using these campaigns to promote higher-priced and newer drugs. 
		Pharmaceutical companies state that mining this data from pharmacies and drug companies helps them to improve their products and keep their fingers on the pulse of what the public needs. Critics are saying the data really just helps the companies sell more expensive drugs. Now state legislature is getting involved and trying to regulate what data the pharmaceutical companies have access to and can use. 
		What are your thoughts? Do you think pharmaceutical companies should have access to this information? How should they be able to use it? 
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					<pubDate>Mon, 21 Dec 2009 21:59:53 GMT</pubDate>
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					<title>Electronic Health Records: What’s Your Opinion?</title> 
					<link>http://www.jcrinc.com/Blog/2009/12/4/Electronic-Health-Records-What’s-Your-Opinion/</link> 
					<description><![CDATA[
		I’m beginning research on a book set to publish in mid-2010 on electronic health records (or EHRs). I’m learning all kinds of interesting information about their impact on performance improvement, patient safety, and so on. Having EHRs sounds like a fantastic idea, and I happen to have a physician who is part of a health care system that uses them (which makes being a patient there quite easy).
		Does your organization use EHRs? How long have you used them? Did you have any implementation difficulties? What have you found to be the impact on patient safety? 
		Now that the government has created a stimulus package for health care organizations who are using EHRs, let’s learn from each other how to implement and use them well, for the greater good.
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					<pubDate>Fri, 04 Dec 2009 16:40:06 GMT</pubDate>
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					<title>Don&amp;quot;t Forget Employee Morale</title> 
					<link>http://www.jcrinc.com/Blog/2009/11/20/Dont-Forget-Employee-Morale/</link> 
					<description><![CDATA[
		
				My husband is a video game fanatic. The other day, the sequel to his favorite video game was released, and the game store opened at midnight in order to give customers a chance to pick up their copies. It was something interesting to see. The store opened and while the employees might not have been excited to be working at midnight, the company made it worth their while. The store had a full-blown party. There was pizza, soda, snacks, music, games, and so on. It was a celebration that the employees seemed excited to be a part of. These are tough economic times. Employees are dealing with cutbacks on salaries, perks, and the like. It’s difficult, and it doesn’t seem to be getting better any time soon. Small tokens of appreciation can go a long way to improve performance and morale. These tokens need not be costly. They could come in the form of free coffee in the morning, a short break in the afternoon, or even a message of a job well done.   What are some things you do in your organizations to show your employees your appreciation? How do you improve performance and morale?
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					<pubDate>Fri, 20 Nov 2009 17:46:20 GMT</pubDate>
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					<title>The State of Health Care Quality</title> 
					<link>http://www.jcrinc.com/Blog/2009/11/13/The-State-of-Health-Care-Quality/</link> 
					<description><![CDATA[
		
				The State of Health Care Quality 2009, an annual report provided by the National Committee for Quality Assurance, finds that the quality of U.S. health care was nearly stagnant in 2008. This was seen as a slow down after a decade of improvements. The down turning trend was seen in care provided both to people with private insurance coverage as well as with Medicare and Medicaid. The report also examined the link between higher health care spending and quality and found virtually no connection between the two, a finding said to have significant implications for health care reform efforts. You can find a copy of the report here. There was a good news when it came to the use of beta-blocker drugs for heart attack care and the delivery of flu shots. The big disappointments were in several measures related to mental health, diabetes care, the overuse of imaging for low back pain, and breast cancer screening. This being said, what have you seen as major strengths and weaknesses in health care during the last year? What would you like to see happen differently in 2010? Editor’s note: Staying current with this blog is easier now than ever with our new RSS feed. Click here to find out more.
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					<pubDate>Fri, 13 Nov 2009 15:00:42 GMT</pubDate>
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					<title>Measuring Performance: Count the Ways</title> 
					<link>http://www.jcrinc.com/Blog/2009/11/5/Measuring-Performance-Count-the-Ways/</link> 
					<description><![CDATA[
		We all know performance measurement is a must. The challenge is finding new and inventive ways to collect data. I recently was solicited for two surveys: one was a regular paper survey mailed to me from a hospital regarding my recent stay and the other was a telephone survey regarding an appliance I had delivered to my home. I participated in the hospital survey because I understand their need to collect the information; however, in speaking to some of my acquaintances, the consensus seems to be that most of these types of surveys end up in the recycling bin. I also participated in the appliance survey because it was interesting. Like I said, the hospital survey was a paper survey asking for a rating from 1 to 5 on various services and appearances. The phone survey was completely automated and asked for basically the same information. However, the phone survey was much shorter and didn’t require me to sit down with a pen and a stamp and do things “the old fashioned way.”  It also gave you the option of opting out of questions and choosing on which services you’d like to give feedback. I’m wondering this: In what different ways do you collect data? Do you use the old paper method? Do you employ telemarketing surveyors or use an automated system? Is there anything new or innovative about offering a public survey? 
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					<pubDate>Thu, 05 Nov 2009 16:35:49 GMT</pubDate>
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					<title>The Importance of High-Quality Care</title> 
					<link>http://www.jcrinc.com/Blog/2009/10/29/The-Importance-of-High-Quality-Care/</link> 
					<description><![CDATA[
		You might have noticed my hiatus from this blog for a few weeks. I wish I could say I was on a European vacation but the truth is, I broke one ankle and sprained the other with a “graceful” fall in my garage. This landed me in the surgical suite of a local hospital. The care at this hospital could not have been better. The nurses were extremely attentive and there was no waiting for days to have help to the bathroom after pushing the nurse call button. The surgical team made me feel at ease before the procedure, and the food was even pretty good. What really grabbed my attention was the way the new nurses knew my situation and how that communication had happened before the nurses came into my room, no matter the shift. I don’t know what the hospital’s handoff processes were, but they were effective. And there was one nice touch added with my discharge paperwork—the surgical team and my nurses gave me a get-well card that was personally signed. It even included little details of my stay.  It made me feel like more than just another patient.For me, it’s the personal details that make me feel like I’ve been provided with high-quality care. This is where I think we can learn from each other. What are some of the touches you’ve experienced, either as a patient or an employee? What are some of your ideas of quality care? Maybe in sharing experiences new ideas will spark.
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					<pubDate>Thu, 29 Oct 2009 16:17:49 GMT</pubDate>
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					<title>AHRQ Researches E-Prescribing Practices</title> 
					<link>http://www.jcrinc.com/Blog/2009/10/14/AHRQ-Researches-E-Prescribing-Practices/</link> 
					<description><![CDATA[
		The Agency for Healthcare Research and Quality (AHRQ) plans to collect information from physicians and pharmacies that electronically transmit prescriptions in the hope of identifying what helps and what hinders the adoption of e-prescribing. 
		AHRQ will interview physicians, medical directors, information technology administrators, pharmacists, and others at 110 organizations over two years, according to a notice in the September 1 Federal Register. 
		In addition to gaining physician and pharmacy perspectives on e-prescribing, AHRQ will look at how physicians use data regarding the list of accepted drugs from the patient’s health plan and how pharmacies feel about changes in communication with physician practices regarding accepted drugs with e-prescribing.
		The study will help the Health and Human Services Department, state and local government, and private health care organizations design ways to promote the adoption and effective use of e-prescribing.
		Do any of you use e-prescribing in your organization? How has it worked? Have you received any feedback from pharmacists regarding e-prescribing? Let us know what your experience has been thus far. 
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					<pubDate>Wed, 14 Oct 2009 15:33:56 GMT</pubDate>
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					<title>Yep, There’s an App for That</title> 
					<link>http://www.jcrinc.com/Blog/2009/9/22/Yep-There’s-an-App-for-That/</link> 
					<description><![CDATA[
		I guess you can file this under measurement (or just plain cool). 
		There’s a new application for the ever-popular iPhone that will tell you exactly where there is a disease outbreak near you, according to an article on Wired’s Web site. To read the full article, click here.Outbreaks Near Me is an application for the iPhone based on the free HealthMap epidemiological Web service, which allows users to access disease-outbreak information. However, this mobile version offers warnings that public health trouble is coming in what the creators are calling “participatory epidemiology.”How this works is if you are a clinician who sees a trend in the people you’re caring for, you upload that information into the program. Whether clinicians will actually do this is anyone’s guess, but I hear the creators have made the submission process as simple as possible for encouragement. Of course there are all kinds of technical details that I won’t get into here and this is obviously only one way to identify pockets of suspicion, but it’s an interesting one. 
		Do you think people will use this application? Could you see any additional uses for something like this? Drop me a line. 
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					<pubDate>Tue, 22 Sep 2009 21:14:07 GMT</pubDate>
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					<title>Go Ahead, Convenient Care is Nothing to Fear</title> 
					<link>http://www.jcrinc.com/Blog/2009/9/10/Go-Ahead-Convenient-Care-is-Nothing-to-Fear/</link> 
					<description><![CDATA[
		I’ve never actually been to a retail medical clinic but I’ve driven past many. They are becoming quite common these days. The clinics are becoming popular due to their prices and convenience and can provide care comparable to that offered in physicians' offices, urgent care centers, or emergency departments, according to two studies in the September issue of Annals of Internal Medicine.However, since the first clinic of this kind opened its doors, physician organizations have voiced concerns regarding the quality of care that these clinics deliver. These organizations’ leaders are worried that patients visiting one of these clinics could be overlooking unforeseen complications and preventive care. To evaluate these concerns, researchers analyzed claims data from a health plan that has been providing coverage for its members at retail clinics for more than five years. Researchers compared the cost, quality of care, and the delivery of preventive services for more than 2,000 patients who received care for the following three conditions commonly treated in retail clinics:1. Fluid in the middle ear (with or without ear infection)2. Sore throat3. Urinary tract infectionThese episodes were matched with other episodes in which these illnesses were treated first in physician offices, urgent care centers, or emergency departments. The researchers found that •    the quality of care in retail clinics was similar to that provided in physician offices and urgent care centers and slightly superior       to that of emergency departments; •    rates of preventive care received at the initial visit through the subsequent three months were similar for retail clinics and       physician offices; and•    for patients who visit a retail clinic, preventive care was typically delivered in a physician's office, which suggests that the       clinics were not disrupting opportunities for preventive services.I would be interested to hear what you think of these studies. Have you visited a retail clinic? How would you compare the quality of care you received to that you’ve received in a physician’s office or emergency department? 
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					<pubDate>Thu, 10 Sep 2009 19:51:46 GMT</pubDate>
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					<title>NQF Endorses Measures to Improve Medication Safety and Quality</title> 
					<link>http://www.jcrinc.com/Blog/2009/9/3/NQF-Endorses-Measures-to-Improve-Medication-Safety-and-Quality/</link> 
					<description><![CDATA[
		To improve the quality and safety of medication use in the United States, the National Quality Forum (NQF) endorsed 18 measures for managing over-the-counter and prescription medications. The 18 measures assess prescribing and use of appropriate medications and medication adherence, reconciliation, and monitoring.  The measures are among the first to be endorsed for medication management and help to highlight gaps in measurement and quality improvement for medication use and adherence. The NQF-endorsed measures focus on measuring and improving adherence and management of medication for a range of conditions where medication nonadherance is prevalent and results in severe adverse outcomes. These conditions include diabetes, asthma, coronary artery disease, kidney disease, chronic obstructive pulmonary disease, and schizophrenia.The endorsed measures focus on areas such as adherence of antipsychotics among patients with schizophrenia, and medication possession for statin therapy for patients with coronary artery disease. Other measures focus on medication reconciliation and review by measuring the percentage of adults over age 65 who had a medication review, or the percentage of discharged patients over age 65 whose medications were reconciled.  The endorsed measures include the following: •    MM-001-08: Proportion of Days Covered (PDC): 5 Rates by Therapeutic Category*•    MM-003-08: Adherence to Chronic Medications*•    MM-004-08: Coronary Artery Disease and Medication Possession Ratio for Statin Therapy*•    MM-005-08: Use and Adherence to Antipsychotics Among Members with Schizophrenia*•    MM-006-08: Diabetes Mellitus and Medication Possession Ratio (MPR) for Chronic Medications*•    MM-010-08: Diabetes and Medication Possession Ratio for Statin Therapy*•    MM-014-08: Chronic Kidney Disease, Diabetes Mellitus, Hypertension, and Medication Possession Ratio for ACEI/ARB       Therapy*•    MM-017-08: Ace Inhibitor/Angiotensin Receptor Blocker Use and Persistence Among Members with Coronary Artery Disease      at High Risk for Coronary Events*•    MM-008-08: Diabetes Suboptimal Treatment Regimen (SUB) •    MM-011-08: Suboptimal Asthma Control (SAC)  and Absence of Controller Therapy (ACT) •    MM-013-08: Pharmacotherapy Management of COPD Exacerbation (PCE): Two rates are reported •    MM-022-08: HBIPS-4: Patients Discharged on Multiple Antipsychotic Medications and HBIPS-5 Patients Discharged on       Multiple Antipsychotic Medications with Appropriate Justification (paired measure) •    MM-026-08: Care for Older Adults — Medication Review (COA) •    MM-028-08: Medication Reconciliation Post-Discharge (MRP) •    MM-030-08: Monthly INR Monitoring for Beneficiaries on Warfarin •    MM-031-08: INR for Beneficiaries Taking Warfarin and Interacting Anti-Infective Medications •    MM-034-08: HBIPS-6 Post-Discharge Continuing Care Plan Created •    MM-035-08: HBIPS-7 Post-Discharge Continuing Care Plan Transmitted to Next Level of Care Provider upon Discharge What are your thoughts on these endorsements? Do you think they will do the job to promote safety and quality? I’m interested in any feedback you might share. 
		
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					<pubDate>Thu, 03 Sep 2009 15:24:24 GMT</pubDate>
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					<title>Smoke-Free Hospital Campuses: What’s the Performance Improvement Link?</title> 
					<link>http://www.jcrinc.com/Blog/2009/8/27/Smoke-Free-Hospital-Campuses-What’s-the-Performance-Improvement-Link/</link> 
					<description><![CDATA[
		“The Adoption of Smoke-Free Hospital Campuses in the United States,” a new study by The Joint Commission, projects that the majority of U.S. hospitals will have smoke-free campuses by the end of 2009. By February 2008, more than 45% of U.S. hospitals had adopted a smoke-free campus policy and an additional 15% of hospitals reported actively pursuing the adoption of  smoke-free campus policies. The study reveals that nonteaching and nonprofit hospitals were more likely to have smoke-free campus policies, and private, nonprofit hospitals were three times as likely as for-profits to have smoke-free campus policies.  More than 1,900 Joint Commission–accredited hospitals responded to a survey assessing current smoking policies and future plans. To date, little is known about smoke-free policy prevalence and its impact. For more information, view the study’s abstract.This study led me to wonder, where there is a link between performance improvement and smoke-free campuses. A couple of performance-improvement possibilities spring to mind: Fewer staff outside smoking means more staff on the floor responding to patient needs; fewer staff suffering from smoking-related illnesses means more staff working on a given shift and fewer short-handed days (leading to less medical staff stress, less stress-related sick days, and so on). So what do you think? Are there other areas where being smoke free could have a positive impact on performance and patient care? Have any of your organizations done studies on this topic? What did you find out? I’d be interested to hear from you. 
		
				
		
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					<pubDate>Thu, 27 Aug 2009 15:47:16 GMT</pubDate>
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					<title>How Do You Choose A Health Care Provider?</title> 
					<link>http://www.jcrinc.com/Blog/2009/8/21/How-Do-You-Choose-A-Health-Care-Provider/</link> 
					<description><![CDATA[I read an interesting column the other day called “You Can Lead Patients to Quality Data, But Will They Use It” discussing how, despite the wealth of data out there regarding physicians, hospitals, and other health care organizations, most people still rely on referrals from family, friends, or physicians when choosing a new provider. I admit I’m sometimes guilty of this myself. Obviously, those of us in the health care field know many ways to find out about the quality of an organization. I often use The Joint Commission’s Quality Check™ and encourage my family and friends to do the same. How do you choose a health care provider? Do you do research or rely on colleagues or loved ones for referrals? Do you let your primary care physician rrecommend a specialist or do you find one yourself? Would you instruct a loved one to listen to his or her physician or to do extra research on his or her own? I look forward to hearing from you.]]></description> 
					<pubDate>Fri, 21 Aug 2009 16:44:34 GMT</pubDate>
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					<title>New Report Gives Examples of Pathways for Translating Results into Action</title> 
					<link>http://www.jcrinc.com/Blog/2009/8/12/New-Report-Gives-Examples-of-Pathways-for-Translating-Results-into-Action/</link> 
					<description><![CDATA[Findings from well-conducted health research may help policymakers improve health care delivery, control costs, and enhance quality of care. However, few studies examine how this occurs and the processes involved. A recently released report from Mathematica Policy Research in Washington, D.C., presents seven case studies illustrating examples of various ways research findings have been moved to policy and practice.  The case studies were part of an evaluation Mathematica conducted for the Agency for Healthcare Research and Quality to review its grant-funded research on health care costs, productivity, organization, and market forces.  Key lessons from the case studies include the importance of the following: •    Developing relationships with potential users•    Understanding how results might be used for different policy decisions and the timing of these decisions•    Fitting individual projects within a broader scope of research conducted by the investigator and       contributing to a broader body of research conducted by other investigators•    Developing investigators’ expertise—and reputation for expertise—to enhance the quality and visibility of       the research among policymakers  The seven case studies were the following: 1.    “The Effect of Clinic Payment and Structure on Costs” (University of Minnesota)2.    “Rural Response to Medicare+Choice: Change and its Impact” (University of Nebraska Medical Center)3.    “Prescription Drug Cost-Sharing: Affordability/Safety” (Kaiser Foundation Research Institute)4.    “Asthma Quality in Varying Managed Medicaid Plans” (Harvard Pilgrim Health Care)5.    “Quality Measures and Managed Care Markets” (University of California San Francisco)6.    “Structuring Markets and Competition in Health” (Harvard Medical School)7.    “Quality of Care for Children with Special Needs in Managed Care” (University of Florida) One of the studies, “Strategies for Translating Health Services Research to Policy and Practice: Selected Case Studies of Investigator-Initiated Research Funded by AHRQ” is available here.How does your organization turn research into action? What procedures do you find important? Do you often learn from the example of other organizations? ]]></description> 
					<pubDate>Wed, 12 Aug 2009 16:24:24 GMT</pubDate>
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					<title>A Penny for Your Thoughts</title> 
					<link>http://www.jcrinc.com/Blog/2009/8/6/A-Penny-for-Your-Thoughts/</link> 
					<description><![CDATA[
		Here in the publishing world, I’m beginning to plan Benchmark’s issues for 2010 (I know, it seems far away for most of you but for me it’s just around the corner). 
		While I plan what you’ll read in the coming year, I’d like to have your input. What have we done a good job of reporting? What would you like to see more of? Let me know what’s on your mind. All suggestions and comments are welcome. I want to make sure Benchmark is a valuable resource to its readers. 
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					<pubDate>Thu, 06 Aug 2009 15:44:09 GMT</pubDate>
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					<title>States Still Inconsistent with Health Care Quality</title> 
					<link>http://www.jcrinc.com/Blog/2009/7/28/States-Still-Inconsistent-with-Health-Care-Quality/</link> 
					<description><![CDATA[The Agency for Healthcare Research and Quality's (AHRQ) annual release of state-by-state quality data continues to give mixed reviews for the quality of care that states provide. AHRQ's 2008 State Snapshots show that no state does well or poorly on all quality measures. The U.S. Department of Health and Human Services (HHS) is also releasing state-by-state reports on the health care status quo. The 2008 State Snapshots provide state-specific health care quality information, including strengths, weaknesses, and areas for improvement. The state-level information used to create the specific snapshots is drawn from the National Healthcare Quality Report 2008, which was released in March 2009 by HHS and the AHRQ. The 2008 State Snapshots summarize health care quality in the following three dimensions:1.    Type of care: Preventive, acute, and chronic care 2.    Setting of care: Hospitals, ambulatory, nursing homes, and home health care 3.    Clinical areas: Cancer, diabetes, heart disease, maternal and child health, and respiratory disease The snapshots—compiled from more than 30 sources, including government surveys and health care organizations—allow users to explore whether a state has improved or worsened compared with other states in several areas of health care delivery. New features in the 2008 Snapshots provide more ways to analyze the quality of health care for each state compared with all states, as well as with states in the same region. Have you taken a look at how your state performed in the snapshots? In what ways could organizations use these data to improve? ]]></description> 
					<pubDate>Tue, 28 Jul 2009 15:16:50 GMT</pubDate>
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					<title>NQF Endorses New Practices for Labs</title> 
					<link>http://www.jcrinc.com/Blog/2009/7/16/NQF-Endorses-New-Practices-for-Labs/</link> 
					<description><![CDATA[To improve the safety of laboratory medicine, the National Quality Forum (NQF) has endorsed six preferred practices for measuring and reporting patient safety and communication in laboratory medicine. The practices focus specifically on improving quality within pre- and posttesting services and address the following:•    Laboratory leadership•    Patient specimen identification•    Sample acceptability•    Test order accuracy•    Verbal communication•    Critical value and result reportingThe pre- and postanalytic phases of laboratory testing are especially critical points on which to focus patient safety improvements. Evidence indicates that errors occur in those windows at an uncommonly high rate, with preanalytic error rates as high as 75% and postanalytic error rates as high as 31%, according to NQF. These errors pose a direct threat to patient safety and to consumer confidence. If significant improvements are to occur in patient safety and communication processes, NQF notes that a more standardized approach for test orders and critical value and result reporting must be adopted. What do you do at your organizations to improve laboratory testing and ensure accuracy? Would anyone like to share some best practices? I would love to hear from you and share some of your success stories.]]></description> 
					<pubDate>Thu, 16 Jul 2009 14:53:22 GMT</pubDate>
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					<title>Electronic Medical Records and Your Organization</title> 
					<link>http://www.jcrinc.com/Blog/2009/7/9/Electronic-Medical-Records-and-Your-Organization/</link> 
					<description><![CDATA[		Under President Obama’s American Recovery and Reinvestment Act,  federal stimulus funds won’t become available for Electronic Medical Records (EMRs) until 2011, and specific guidelines for determining what constitutes a “qualified” system are as yet undertermined. What is your organization doing to adopt EMRs? Is there anyone out working completely from EMRs? What are some things you see critical to safe adoption of new technologies?]]></description> 
					<pubDate>Thu, 09 Jul 2009 18:50:55 GMT</pubDate>
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					<title>Come On Now, Get Those Flu Vaccinations</title> 
					<link>http://www.jcrinc.com/Blog/2009/7/2/Come-On-Now-Get-Those-Flu-Vaccinations/</link> 
					<description><![CDATA[When I worked for a health care organization in a former life, all employees had to be vaccinated for the flu. No questions asked. I didn’t like it, but that was the policy. Apparently, that isn’t the case everywhere.Last week, The Joint Commission released “Providing a Safer Environment for Health Care Personnel and Patients through Influenza Vaccination:  Strategies from Research and Practice,” to help health care organizations improve seasonal influenza vaccination rates in their staff.  The monograph includes information about seasonal influenza and the influenza vaccine, barriers to successful programs and strategies for overcoming them, and examples of successful initiatives organizations have used to improve their influenza vaccination rates. It also incorporates evidence-based guidelines and published literature to highlight practical strategies and tools submitted by health care organizations.  Jerod M. Loeb, Ph.D., executive vice president, Division of Quality Measurement and Research, The Joint Commission says, “Health care worker flu vaccination rates have been less than optimal for years and the vaccination rate is still below 50%. Organizations are eager to find ways to encourage their employees to get vaccinated. The monograph includes strategies that organizations can employ and provides a foundation to improve vaccination rates.” Have any of you read the monograph? I’d be interested to know your thoughts. If you’d like to share any processes you have for tackling this issue at your organizations, feel free to do that as well. We’d all be interested in learning from your successes. ]]></description> 
					<pubDate>Thu, 02 Jul 2009 15:08:43 GMT</pubDate>
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					<title>White Paper Seeks Change in Behavioral Health Care</title> 
					<link>http://www.jcrinc.com/Blog/2009/6/24/White-Paper-Seeks-Change-in-Behavioral-Health-Care/</link> 
					<description><![CDATA[
		 
		I just read a white paper called Consumer-Driven Outcomes Management: A New Paradigm for Quality and Efficiency Improvement in Behavioral health released by Danya International, Inc. in Silver Spring, Maryland. The paper said nothing but positive things about consumer outcomes management for behavioral health care.  Among the statistics that stood out was that total program costs were reduced by 10& to 35% while outcomes and satisfaction were improved. Length of stays and cancellations were also down. Would any of you in the behavioral health care field like to share your thoughts on the paper? Do you see the same in your organizations? 
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					<pubDate>Wed, 24 Jun 2009 15:50:28 GMT</pubDate>
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					<title>ORYX: Animal or Performance Measurement Initiative?</title> 
					<link>http://www.jcrinc.com/Blog/2009/6/19/ORYX-Animal-or-Performance-Measurement-Initiative/</link> 
					<description><![CDATA[Most of you are familiar with The Joint Commission’s ORYX® initiative. The ORYX initiative integrates outcomes and other performance measurement data into the accreditation process. ORYX measurement requirements are intended to support Joint Commission-accredited organizations in their quality improvement efforts. As part of The Joint Commission’s accreditation process, Joint Commission surveyors assess how health care organizations have integrated and used ORYX performance measurement data in their performance improvement activities. On the other hand…The oryx (from Latin origin according to Webster’s) is an antelope of the genus Oryx, of Africa and southwestern Asia, having long, straight or arching horns.  But the question in your minds (at least it’s in mine) is what does ORYX the initiative have to do with oryx the animal? I’m glad you asked. In speaking with Linda Hanold, director of quality measurement at The Joint Commission, I found out that initially (before its launch in 1997) the initiative was called “OPUS.” Before that name became known publicly, however, it was determined that OPUS was a protected trademark and couldn’t be used. So, former Joint Commission President, Dr. Dennis O’Leary, directed Chief Communications Officer Cathy Barry-Ipema, and Joint Commission Resources President, Karen Timmons, to find another “o” word with four letters. The word “oryx” was chosen out of the dictionary because it fit the requirements. The word appealed to O’Leary because of the animal’s speed and strength, says Hanold.“ORYX is not an acronym,” Hanold reminds, “although many have tried to force it to be an acronym, using, for example, Outcomes Research Yields Excellence.”Consider yourself acquainted with a little Joint Commission history (or trivia). For more information on the ORYX initiative, click here.   What are your thoughts on ORYX? Share your successes, failures, or questions. Although ORYX isn’t an acronym, what does it stand for in your organization? ]]></description> 
					<pubDate>Fri, 19 Jun 2009 16:05:45 GMT</pubDate>
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					<title>Measuring Racial and Ethnic Disparities: How Could this Data Be Used to Improve Care?</title> 
					<link>http://www.jcrinc.com/Blog/2009/6/15/Measuring-Racial-and-Ethnic-Disparities-How-Could-this-Data-Be-Used-to-Improve-Care/</link> 
					<description><![CDATA[At what price do we collect data? And for what benefit?That’s what I wondered after seeing “Measuring Racial and Ethnic Disparities in Health Care: Efforts to Improve Data Collection,” a new policy brief from Mathematica Policy Research, Inc. The brief examines recent federal and state activities aimed at strengthening the collection of health-related data on race, ethnicity, and primary language. The brief highlights three states—Massachusetts, California, and New Jersey—that implemented laws or regulations guiding data collection activities by hospitals, health plans, and government agencies to draw lessons for other states interested in addressing disparities. Massachusetts has been a front runner in establishing laws and regulations mandating and standardizing race and ethnicity data collection. Its Health Care Quality and Cost Council sets standards for collection of data by health plans, and enacted laws requiring hospitals to collect race and ethnicity data from patients. The state’s new Office of Health Equity will monitor data collection across state agencies. These data will be used to report on measures of health care quality and costs, stratified by race and ethnicity. California also requires health plans to collect race and ethnicity data. However, health plans have encountered technical and financial difficulties in doing so. Many plans have modified their information technology systems to accommodate new data fields; others find that members are unwilling to provide race and ethnicity information in surveys. Some plans have turned to indirect data collection methods, such as geocoding (coding by geographic location) and surname analysis, due to low response rates using direct methods. In New Jersey, the state government and New Jersey Hospital Association (NJHA) have collaborated to improve race, ethnicity, and language data collection in hospitals and government agencies. NJHA is working with hospitals, state agencies, and academic institutions to standardize data collection; it also has developed patient education materials, staff training sessions, and a toolkit to facilitate implementation. There are numerous times when filling out paperwork that we are asked to disclose race or ethnicity, but these fields are usually optional. I can think of some instances in which this information could improve health care, mostly in ways having to do with cultural preferences. Yet, I wonder what some of the other ramifications of disclosing this type of information might be. What are the positives and negatives? Do you have any thoughts on if this type of data will improve care or is it data collection for data collection’s sake? I’d like to hear from you. On a side note:The National Quality released a draft of the Health Information Technology Expert Panel Report: Health IT Enablement of Quality Measurement – the Quality Data Set and Dataflow for public review and comment. All comments must be submitted online via the NQF Web site by Tuesday, June 30, 2009, 6:00 pm, ET. Learn more about the project and access the draft report here.]]></description> 
					<pubDate>Mon, 15 Jun 2009 15:44:59 GMT</pubDate>
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					<title>The Future is (Almost) Here</title> 
					<link>http://www.jcrinc.com/Blog/2009/5/28/The-Future-is-Almost-Here/</link> 
					<description><![CDATA[
		Mayo Clinic has unveiled an interesting new online tool called The Mayo Clinic Health Manager for health care consumers to store their personal medical record information free of charge. Based on Microsoft's HealthVault system, the service lets anyone--not just Mayo patients--store medical histories, test results, immunization records, appointment records, data from heart rate monitors and other devices, and so on. Perhaps most importantly, users can selectively share pieces of that information with approved health care providers. The Health Manager also offers health recommendations and guidance based on data entered by users; for instance, the system might suggest a wellness visit, mammogram, blood pressure check, or additional reading. (I should mention that Google also has a health management system called Google Health. If you are a member of Blue Cross Blue Shield, they offer a portal as well.)This brings to mind my blog regarding Google’s tool to predict flu outbreaks. Imagine the possibilities that Mayo has at its fingers. With these type of data, a host of patterns and trends could be realized. Of course, there would be ethical considerations; however, if this data could be manipulated in any way and used for the good of humanity, what would you like to see done with it? Could we better trend (and therefore better handle) outbreaks like the recent swine flu and even AIDS? 
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					<pubDate>Thu, 28 May 2009 15:57:42 GMT</pubDate>
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					<title>Quality Recommendations Sent to Congress</title> 
					<link>http://www.jcrinc.com/Blog/2009/5/14/Quality-Recommendations-Sent-to-Congress/</link> 
					<description><![CDATA[Stand for Quality, a coalition of more than 165 organizations from across the health care spectrum, recently announced a framework to improve the quality and affordability of health care for all patients through a public-private partnership described in six key recommendations. These recommendations were a nudge to Congress as part of President Obama’s health care reform.The six recommendations are as follows:1. Set national priorities and provide coordination for quality improvement2. Endorse and maintain nationally standardized measures3. Develop measures to fill gaps in priority areas4. Ensure that providers and other stakeholders have a role in developing policies on use of measures5. Collect, analyze, and make performance information available and actionable6. Support a sustainable infrastructure for quality improvementThe recommendations representing a path to safe, efficient, patient-centered health care are outlined in Stand for Quality’s Building a Foundation for High Quality, Affordable Health Care: Linking Performance Measurement to Health Reform. They build on existing improvement efforts and aim to harness the energies of the public and private sectors to strengthen health care quality.To support and catalyze these efforts, Stand for Quality identifies distinct roles for the public and private sectors to work in partnership to measure quality and to use those results to drive continuous improvement. The coalition also recognizes that standardized measures and public reporting create a strong foundation to share what works, along with informing care delivery that is patient-centered, safe, and effective. What are your thoughts on the six recommendations? Do they go far enough or too far? What would your recommendations to Congress entail? ]]></description> 
					<pubDate>Thu, 14 May 2009 21:34:07 GMT</pubDate>
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					<title>What Happens to the Keywords You Just Typed in That Search Engine?</title> 
					<link>http://www.jcrinc.com/Blog/2009/4/30/What-Happens-to-the-Keywords-You-Just-Typed-in-That-Search-Engine/</link> 
					<description><![CDATA[
		When is the last time you used an online search engine to research a topic? Maybe your child had a rash and you searched for an idea of what could be causing it. Maybe you wanted to know what the weather is like in Kentucky. Have you ever searched for health information online? As Benchmark readers interested in all things data related, did you ever wonder what could be done with all that search data? Google has figured it out. 
		Google, one of the best-known search engines on the Web, has launched a new site that tracks the trends of those searching for flu-related information to gather data on where flu outbreaks might occur in the United States. 
		
				So how does this work? According to the Web site, Google “[has] found a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms.” While not every person who searches for "flu" is actually sick, “a pattern emerges when all the flu-related search queries from each state and region are added together.” 
		Google compared its query counts with data from a surveillance system managed by the Centers for Disease Control and Prevention and found that some search queries tend to be popular exactly when flu season is happening. By counting how often Google sees these search queries, the site can estimate how much flu is circulating in various regions of the United States. Google’s results were published in the February 2009 issue of Nature.
		Of course the new site has its critics, but I have to admit, it’s an interesting concept. Along with charts highlighting the trends of flu searches, Google also offers downloadable raw data. In published reports, Google says it has found that it can spot outbreaks, on average, two weeks earlier than traditional surveillance systems. Do you think this is a viable option for tracking outbreaks of flu and other diseases within the United States?
		In a related side note, another interesting Web tool for researching illness trends is WhoIsSick.org. This site is broader in scope, asking individuals to describe their symptoms and plot their locations on a map. Summary analytics show sickness trends and outbreaks. But how reliable is this data? Are these Web sites the new wave in tracking outbreaks? I suppose time, and the evolution of technology, will tell. 
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					<pubDate>Thu, 30 Apr 2009 18:48:02 GMT</pubDate>
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					<title>New Quality Indicators and You</title> 
					<link>http://www.jcrinc.com/Blog/2009/4/14/New-Quality-Indicators-and-You/</link> 
					<description><![CDATA[
		Last month, the Centers for Medicare & Medicaid Services (CMS) conducted a “dry run” of reporting data for nine of the most recent Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators and Inpatient Quality Indicators (read more here, including the full list of the indicators)The goal of the exercise was to familiarize hospitals with the AHRQ measures and their organization’s performance on them before information was made public on the Hospital Compare Web site. Participating hospitals were given 30 days to look over and comment on the report. The dry run and comment period are over and the results have not yet been made public but I’m interested to know: • What do you think about these most recent indicators? • On which of these indicators will your organization consider reporting?• What about these reports is most useful to organizations? • Would you be interested in commenting on the indicators for an article in an upcoming issue of Benchmark?I look forward to hearing from you.
]]></description> 
					<pubDate>Tue, 14 Apr 2009 22:17:21 GMT</pubDate>
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					<title>So, What About Hospitalists? </title> 
					<link>http://www.jcrinc.com/Blog/2009/4/2/So-What-About-Hospitalists/</link> 
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		I’ve been working on a project with the Society of Hospital Medicine, so hospitalists have been on my mind quite a bit lately. As you probably know, physicians, physician assistants, and nurse practitioners who focus primarily on hospital medicine are called hospitalists. The term "hospitalist" was coined by Robert Wachter, M.D., in 1996. (He also has a great blog on all things medicine). Hospital medicine, like emergency medicine, is a specialty organized around a site of care, rather than an organ, a disease, or a patient’s age.I was forwarded an interesting article from the New England Journal of Medicine regarding the growth of hospitalists. I already knew that hospitalists are a fast growing group, but it was interesting to read that the percentage of hospitalists practicing in the United States has increased from 5.9% in 1995 to 19.0% in 2006. The percentage of all Medicare claims for inpatient evaluation-and-management by hospitalists increased from 9.1% to 37.1% during that same period. Clearly, this is a rapidly growing group. So, I wondered…what influence do they have on patient outcomes and quality measures? Surely, they must have some. After doing some research I found an interesting article from Mayo Clinic Proceedings regarding a literature review that asked the question, “Are there differences in cost or quality of inpatient medical care provided to adults by hospitalists versus nonhospitalists?” My inkling was that there was probably a slightly better quality of care with hospitalists due to the nature of their specialty. The article states that most of the data found pointed to a general agreement that hospitalist care leads to shorter length of stay and lower costs per stay. Reports studied also showed the following:
		- Improvement in outcomes for orthopedic surgery patients who had hospitalist consultation or comanagement- Improvement in markers of quality of care for patients with pneumonia- Improvement in aspects of heart failure managementWhy do you think these differences in care exist? Do you think improvements might be generalized to other physicians? The author of this study, Michael C. Peterson, M.D., suggests that other studies should seek to answer these questions and others. 
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					<pubDate>Thu, 02 Apr 2009 14:59:31 GMT</pubDate>
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					<title>Improving the Quality of Your Care</title> 
					<link>http://www.jcrinc.com/Blog/2009/3/17/Improving-the-Quality-of-Your-Care/</link> 
					<description><![CDATA[While reading ABCNews.com the other day I came across an article titled, “Five Ways to Get Your Doctor to Listen to You.” This caught my attention because I just finished editing a book for Joint Commission Resources called Putting the CARE in Health Care. I also recently visited my family physician and (with the topic fresh in my brain) noticed what a great job he did of listening to my concerns and not making me feel rushed. I’ve always been fortunate to have physicians who have taken time with me; however, obviously many people are not that fortunate. In a video clip accompanying the article, Diane Sawyer of Good Morning America said the average person is lucky to get 20 minutes with his or her physician on a given visit. And from what I’ve read in my research, 20 minutes is on the long side. That doesn’t leave much time to have your complaints heard (and if you’re like me, you save up a list of them before seeing the physician in the first place). Much is said in Joint Commission Benchmark® about performance improvement, and one major element of performance improvement is patient-centered care. In fact, Beverley Johnson of the Institute for Family-Centered Care in Bethesda, M.D., writes in the foreword of Putting the CARE in Health Care, “In 1996, the Institute of Medicine launched a concerted effort focused on assessing and improving the nation’s quality of care. A key element of this effort was the 2001 publication of Crossing the Quality Chasm: A New Health System for the 21st Century. The Quality Chasm report described broad quality issues and proposed six aims: Care should be safe, effective, patient centered, timely, efficient, and equitable.” That sounds reasonable to me. Having said all that, I’m interested to know: What do you do in your organization to ensure quality, patient-centered care? How do you measure your efforts? How does your organization balance listening to patients and their concerns with the number of patients to see that day?]]></description> 
					<pubDate>Tue, 17 Mar 2009 16:42:07 GMT</pubDate>
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					<title>It&amp;quot;s award time again</title> 
					<link>http://www.jcrinc.com/Blog/2009/3/11/Its-award-time-again/</link> 
					<description><![CDATA[The Joint Commission recently issued a request for nominations for the 2009 Eisenberg Awards. Here’s your chance to get your organization recognized for its quality and patient safety efforts. The John M. Eisenberg Patient Safety and Quality Awards were established in 2002 by the National Quality Forum (NQF) and The Joint Commission in memory of John M. Eisenberg, M.D. Eisenberg was the former director of the Agency for Healthcare Research and Quality, a member of the founding board of directors of NQF, and an impassioned advocate for health care quality improvement during his lifetime. These annual awards recognize the achievements of individuals who have made significant and lasting contributions to improving patient safety and health care quality. They also recognize individuals and organizations that have made an important contribution to patient safety and health care quality in the areas of research or system innovation.Annual awards are given in the following categories:• Individual achievement (domestic and international combined) • Domestic system innovation in patient safety and/or health care quality at the national level • Domestic system innovation in patient safety and/or health care quality at the local level • Domestic research • International research or system innovation in patient safety and/or health care qualityThe 2009 awards will be presented in conjunction with NQF’s Annual National Policy Conference on Quality October 14-16 in Washington, D.C. The accomplishments of award nominees/applicants should be clearly linked to the principles that Eisenberg promoted throughout his career. These include a dedication to improving the quality of health care and patient safety, leadership in advancing methods for measuring and reporting health care quality, expanding the public’s capacity to evaluate the quality and safety of health care, and promoting health care choices based upon information about safety and quality.  Self nominations are welcome.An awards panel comprised of patient safety and health care quality experts identified by The Joint Commission and NQF will evaluate all submissions. The decisions of the awards panel are final.  All materials become the property of The Joint Commission and NQF and will not be returned. The awards panel will not consider incomplete nominations/applications.  Award submissions will be due at The Joint Commission by close of business April 20, 2009. More information can be found at The Joint Commission’s Web site. In 2008 and 2009 Benchmark began running case studies featuring Eisenberg Award applicants who may have not taken the ultimate prize but were deserving of honorable mention. Would you like to see these case studies as part of a regular column in Benchmark? Do you often apply principles learned from other organizations into your organization’s daily routine? What do the Eisenberg Awards mean to you, in the field? ]]></description> 
					<pubDate>Wed, 11 Mar 2009 21:44:14 GMT</pubDate>
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					<title>Another Year, Another Resource</title> 
					<link>http://www.jcrinc.com/Blog/2009/3/5/Another-Year-Another-Resource/</link> 
					<description><![CDATA[
		
		
		Greetings! 
		I’m Audrie Bretl, senior editor of The Joint Commission Benchmark. I’ve been waiting for a way to reach out to Benchmark’s readers and this New Year has given me an opportunity — this new blog. I’m hoping this will be the perfect way for you and me to get to know each other and share ideas regarding performance measurement and improvement. I also hope you’ll let me know what you think of the newsletter –  what you like and what you don’t. I want both the newsletter and the blog to be useful and indispensable resources for you, so please let me know what you’d like to see more of in the coming year (or for that matter, what you’d like to see less of). 
		My professional background is in advertising and magazine journalism. Before becoming an editor at Joint Commission Resources a little more than two years ago, I wrote for two national magazines, covering safety and health issues. I also did a stint writing for the corporate communications department of a major health system. 
		I look forward to another year of serving you, our readers. Keep in touch. 
		Until next time,Audrie Bretl
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					<pubDate>Thu, 05 Mar 2009 20:47:36 GMT</pubDate>
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