Friday, April 09, 2010

Poster presentations at Hospital Medicine 2010

Here are a few I found interesting:

Profiling hospitalists for utilization and outcome metrics
If you group has significant hand offs, such as shift work or several-days-on-several-days-off schedules, you can’t accurately profile individual hospitalists. It doesn’t work because patient care is spread out among multiple providers.

Poster 12 by Ansari, et. al., Loyola.

Another study showing no impact of RRTs
---even when the team rounded proactively on all patients transferred out of the ICU.

Poster 28, Butcher, et al, UCSF.

Press-Ganey surveys meaningless
P-G patient satisfaction surveys are attributed to the discharging physician (regardless of who really took care of the patient) and are mailed to the patient for completion days or weeks after discharge. Forth, et al, at Northwestern University, (poster 54) attempted to validate P-G surveys with an instrument used in real time during hospitalization, confirming that the patient knew the identity of the treating doctor. The result? Not validated. No correlation. R values ~ 0.2.

Patients who leave AMA are at higher risk
---for mortality and just about everything else. This was a huge database and apparently the first study of its kind. Should we target the AMA patients for special post discharge intervention as the authors suggest?

Poster 57, Glasgow, et al, Iowa City.

Poor survey perceptions among hospital workers about the patient safety culture
---were strongly associated with higher readmission rates for CHF and AMI in a survey reported by Hansen, et al, Northwestern University and Harvard School of Public Health. Poster 60.

Non-evidence based use of PPIs
---was rampant in a chart review by Rizvi, et al, UTHSCSA (poster 125). Most were started in the hospital for bundle compliance and for a variety or weak and sloppy indications. Many of the PPI prescriptions were continued following discharge with no reason documented. This is in part an adverse consequence of a performance measure.

Patient falls a never event---NOT
Despite a vigorous initiative using a multidisciplinary team, only a dent was made in the rate of patient falls, from 3.07 to 2.42 falls per 1000 patient-days in a study from Northwestern University by Shah et al (poster 192).


Anonymous said...

I am an internist struggling with my hospital administration against Press Ganey. I have much to comment on Press Ganey. How may I contact you?

Anonymous said...

I'm sorry, I should have given you an email address: