CDC issues antibiotic stewardship tools for hospitals

The Centers for Disease Control and Prevention (CDC) recently issued new tools to help hospitals develop antibiotic stewardship programs to improve prescribing practices, with the goal of protecting patients from preventable complications and reducing the emergence of resistant organisms such as C. difficile that lead to serious life-threatening infections. The tools include a checklist and guidance for implementing a stewardship program that dedicates the necessary human, financial and information technology resources; appoints a single leader responsible for program outcomes and a single pharmacist leader to support improved prescribing; takes at least one prescribing improvement action; tracks and regularly reports to clinicians on prescribing and antibiotic resistance patterns; and offers education on how to improve them. According to a CDC Vital Signs report, physicians in some hospitals prescribe three times as many antibiotics as their colleagues in other hospitals, suggesting the potential to improve prescribing practices in certain clinical scenarios. According to the report, a 30% reduction in the antibiotics most likely to cause C. difficile infections could reduce these infections by more than 25%. AHA Senior Vice President John Combes, MD, who participated in a recent CDC briefing on the report, noted that AHA recently addressed this issue in its white paper on “Appropriate Use of Medical Resources,” which recommends that hospitals maintain an antibiotic stewardship program along with four other interventions to reduce non-beneficial medical services. A toolkit for the development of an antibiotic stewardship program, including the new CDC resources, will be available to hospitals in the coming months.

ACGME, AOA, AACOM commit to a single GME accreditation system

The Accreditation Council for Graduate Medical Education (ACGME), the American Osteopathic Association (AOA), and the American Association of Colleges of Osteopathic Medicine (AACOM) have agreed to a single accreditation system for graduate medical education (GME) programs in the United States. The single accreditation system will allow graduates of allopathic and osteopathic medical schools to complete their residency and/or fellowship education in ACGME-accredited programs and demonstrate achievement of common milestones and competencies. Currently, the ACGME and AOA maintain separate accreditation systems for allopathic and osteopathic educational programs.

 

Under the single accreditation system:

Two-midnight bill introduced in the Senate

Sens. Robert Menendez (D-NJ) and Deb Fischer (R-NE) have introduced the Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082), to delay enforcement of the Medicare inpatient admission and review criteria (the Centers for Medicare & Medicaid Services’ two-midnight policy). During this delay, CMS should convene a meeting with affected stakeholders to develop alternate policy solutions that would address the related issues this policy has created for hospitals, physicians and patients. S. 2082 directs CMS to implement a new criterion that will both address this trend and adequately provide for the intense, inpatient-level services currently provided by hospitals to Medicare beneficiaries that are reasonable and necessary but do not appear on the inpatient-only list and are not expected to span two midnights.

AHA surveying hospitals about physician relationship models

The American Hospital Association (AHA) is surveying hospitals through March 14 to learn more about how they engage with physicians. The survey was mailed recently to all hospital CEOs for their chief medical officer to complete. The results will help AHA develop resources and information to strengthen the bond between physicians and hospitals, and report on the state of physician-hospital relationships that improve health care quality and efficiency. For more on the survey, contact AHA survey support staff at (800) 530-9092 or [email protected].

Hospitalist field continues to grow

A recent article from the Wharton School at the University of Pennsylvania discusses the continued rise of hospitalists. According to the article, over the last decade the number of hospitalists has risen from 500 to 44,000. The article says hospitalists can bring financial value to the health care system and cites several studies proving this point. The biggest benefit of hospitalists is that they’re always there and able to take care of patients around-the-clock, which allows for efficiencies that were not possible before. Hospitalists can reduce lengths of stay by up to 30% and hospital costs by up to 20%, according to the Society for Hospital Medicine. The article says there’s a growing trend for hospitalists to be employed by academic medical centers, mostly due to the limits put on how many hours residents can work. The article notes that hiring doctors isn’t cheap, and hospitals will need to continue to justify the expense by showing a return on the investment.

U.S. doctors continue shift to salaried positions

Physicians continue to seek salaried jobs from hospitals, according to a recent article from the New York Times. Last year, 64% of job offers filled through Merritt Hawkins, one of the nation’s leading physician placement firms, involved hospital employment, compared with only 11% in 2004. The firm anticipates a rise to 75% in the next two years. The article says when hospitals gather the right mix of salaried front-line doctors and specialists under one roof, it can yield cost-efficient and coordinated patient care, like the Kaiser system in California and Intermountain Healthcare in Utah. In addition to primary care doctors, specialists are also moving toward hospital employment. According to the American College of Cardiology, cardiologists employed by hospitals rose to 35% in 2012, up from 11% just five years earlier.

Majority of osteopathic medical students match into primary care residency slots

The majority of osteopathic medical students and recent graduates matched into primary care residency programs, according to new data released by the National Matching Services, Inc., about the American Osteopathic Association match. Among primary care specialties, family medicine is the largest matched specialty with 519 positions filled, a 10% increase from last year. Family medicine also was the largest matched specialty in 2013 with 472 positions filled. Other osteopathic match trends include:

Hospital medicine groups the focus of next PLF webinar

What makes a hospital medicine group (HMG) effective? How can your hospitalists improve their performance? For the first time ever, new guidelines from the experts in the field can help hospital executives and HMGs evaluate their performance.

 

With the continuing growth of the specialty of hospital medicine, the capabilities and performance of HMGs varies significantly. In February, the Society for Hospital Medicine (SHM) published The Key Principles and Characteristics of an Effective HMG as a guide for HMG self-improvement in the Journal of Hospital Medicine.

 

This webinar will review the published principles and characteristics and offer practical applications to hospital leaders. The Key Principles and Characteristics of an Effective HMG have been designed to be aspirational, helping to “raise the bar” for the hospital medicine specialty. These principles and characteristics provide a framework for HMGs seeking to conduct self-assessments, outlining a pathway for improvement, and better defining the central role of hospitalists in coordinating team-based, patient-centered care in the acute care setting.

Dates/Times:

Conference to explore the dynamics of the physician/practice executive team

The Medical Group Management Association (MGMA) will hold its 2014 Business of Care Delivery Conference March 23-25 in Orlando, Fla. The conference will explore why the physician/practice executive team is the linchpin of practice success and growth, as well as help practices transition to new models of care, create and implement strategic plans and staffing models and empower practices to take on the challenges ahead as they focus on the business of care delivery.

 

Featured sessions include:

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