SGR bill passes the Senate, president signs into law

The Senate this week approved and the president signed into law a bill that staves off scheduled cuts to Medicare physician payments through April 1, 2015. Medicare physician payments were scheduled to be cut by 24% on March 31 without congressional action. Among other provisions, the bill extends the Medicare-dependent Hospital Program, low-volume adjustment and ambulance add-on payments through April 1, 2015; extends the delay in enforcement of the Centers for Medicare & Medicaid Services’ two-midnight policy for an additional six months, through March 31, 2015; and prohibits recovery audit contractors from auditing inpatient claims spanning less than two midnights for the six-month period. It also delays implementation of ICD-10 for one year, until Oct. 1, 2015; delays the start of the Medicaid Disproportionate Share Hospital cuts for one year, until 2017; and extends the DSH cuts for an additional year through 2024. American Hospital Association members received a Special Bulletin last week with more information on the bill’s hospital-related provisions.

AHA urges FDA to increase U.S. supply of saline, other IV solutions

The American Hospital Association is urging the Food and Drug Administration to vigorously pursue additional supplies and suppliers of normal saline and other intravenous fluids that are fundamental to patient care in hospitals to ease the severe, long-standing shortage of these products and prevent future shortages. "The current shortages of IV fluid are unacceptable and must be resolved quickly to prevent a negative impact on patient care," wrote AHA Executive Vice President Rick Pollack. "Currently, hospitals are scrambling to manage the shortfall and have employed strategies including using smaller IV bags, switching patients to appropriate alternatives and prioritizing patients based on clinical factors. While these strategies have somewhat mitigated the problem to date, the AHA is concerned that patients could face harm in the future if these shortages are not resolved quickly." In a March 20 Quality Advisory, the AHA shared with members practical strategies that hospitals might consider adopting in order to better manage their supply of IV fluids during the current shortage. The list was created by the Drug Information Service of the University of Utah, in collaboration with the American Society of Health-System Pharmacists.

AABB announces new patient blood management standards

AABB is announcing a new comprehensive resource that focuses on maintaining and enhancing the quality of care for patients who may require transfusion. Standards for a Patient Blood Management Program, or PBM Standards, are founded on a general quality framework with program-specific requirements. The PBM Program Standards include a number of notable requirements, such as:

The PBM Program Standards describe a three-level approach for accreditation based on the complexity of the hospital in which the PBM program is housed. These activity levels are designed to capture the differences that exist among hospitals and the range of clinical services that they offer.

 

“The goal of the PBM Program Standards is to help facilities create and maintain programs that will foster the appropriate use of blood products to optimize patient health and safety,” said Jonathan Waters, M.D., medical director for the Patient Blood Management Program at the University of Pittsburgh Medical Services, who serves on AABB’s Board of Directors and on AABB’s Patient Blood Management Standards Program Unit. “Patient blood management is a burgeoning, critical area of medicine, and through these Standards, AABB is playing a significant role in advancing adoption among hospitals.”

Save the date: Patient blood management webinar May 1

In the November 2013 white paper, "Appropriate Use of Medical Resources," the Physician Leadership Forum of the American Hospital Association (AHA) identified a “top five” list of hospital-based procedures or interventions that warrant deeper review and discussion by patients and physicians. The first area of focus is “appropriate blood management in inpatient services.” This joint AHA/AABB webinar will provide an overview of the initiative, address the benefits of implementing a hospital-based, cross-functional patient blood management (PBM) program and review the resources that will be made available in support of the initiative. Speakers include Dr. John R. Combes, senior vice president, AHA; Miriam A. Markowitz, CEO, AABB; and Dr. Mark Ereth, PBM pioneer and thought leader. This webinar, which will be held on May 1 at 2 p.m. ET, will be offered at no charge and participants can receive CME/CEU credit. Please watch your email next week for the registration link to sign up for this important session.

Congressional physicians helping to shape national health care policy

A recent blog post from Health Affairs discusses the rise in the number of physicians in Congress and debates whether this will lead to better health policy. From 1960 to 2004, only 25 physicians served in Congress. Currently, there are 20 physicians serving in Congress. According to the authors, physicians have two characteristics that uniquely position them to guide national health policy – health care expertise and broad public credibility. Physician-representatives have the ability to contribute policy ideas that are more sensitive to these realities, and better grasp the incentives created during national health reforms the authors say. This can lead to legislation that draws on the most effective levers for reform and is more warmly embraced by the medical community.

Medical school seniors, others matched to residency slots

A total of 16,399 U.S. medical school seniors were matched to first-year residency positions recently through the National Resident Matching Program. Other applicants for the 29,671 first- and second-year positions, 500 more than last year, include past medical school graduates, graduates of osteopathic schools, and students and graduates of international medical schools. More than half of this year’s additional positions were in primary care specialties. The most competitive specialties this year were neurological surgery, orthopedic surgery, otolaryngology, plastic surgery and radiation-oncology. Darrell Kirch, M.D., president and CEO of the Association of American Medical Colleges, said “it appears that several hundred U.S. medical students did not match to a first-year residency training program. As a result, with a serious physician shortage looming closer, we remain concerned that the 17-year cap on federal support of new doctor training will impede the necessary growth in residency positions that must occur to ensure that our growing and aging population will receive the care it needs.” AHA continues to recommend that the 1996 cap on residency slots be lifted.

Social networks for physicians on the rise

Social networks specifically geared toward physicians are on the rise, according to a recent article from The DO, the American Osteopathic Association’s magazine. Two of the most popular ones are Doximity (more than 250,000 members) and Sermo (more than 200,000 members). According to the article, both networks are free for physicians and closed to the public. Sermo caters just to physicians while Doximity allows other medical professionals such as students, nurse practitioners and physician assistants to join the network. Physicians see these social networks as a place where they can converse more freely and talk with other physicians in confidence. In addition, physicians like the consultation, discussion, and networking features associated with these networks, the article says.

Helping physicians re-engage with their noble purpose

A recent article from H&HN Daily details how health care leaders can re-engage physicians around their noble purpose. Improving the patient experience begins with health care leaders partnering with physicians, the article says. At their core, physicians are deeply caring, and it is from that place of caring that they are connected to the intrinsic nobility of their daily work. This caring and nobility is the portal to physician engagement. The article presents a three-pronged strategy for physician engagement that can work well for most health care organizations. This strategic approach includes:

By re-engaging physicians to connect with their original devotion to medicine, the article says it will strengthen their individual commitment to the whole.

Seeking applicants for AHA-NPSF Comprehensive Patient Safety Leadership Fellowship

Applications are still being accepted for the 2014-2015 AHA-NPSF Comprehensive Patient Safety Leadership Fellowship, co-sponsored by the American Hospital Association (AHA) and the National Patient Safety Foundation (NPSF).

The Fellowship is a year-long program for clinical teams and strategic leaders dedicated to improving quality and patient safety results. Through a highly participatory learning experience, fellows gain competency in advanced patient safety concepts and are able to utilize those concepts through an Action Learning Project.

The deadline to apply has been extended through May 1. For program details and key benefits, visit www.ahafellowships.org.

AHA town-hall webcast to discuss appropriate use of medical resources

Tune in to the next American Hospital Association (AHA) members-only Town Hall Webcast on Thursday, April 10, at 4:00 p.m. ET to hear about AHA’s work on the "Appropriate Use of Medical Resources." Released in November, the report identifies five areas where hospitals, along with clinical staff and patients, can look to reduce non-beneficial care.

 

AHA President and CEO Rich Umbdenstock will host several guest speakers to discuss the "Appropriate Use of Medical Resources" report, as well as the toolkits the AHA’s Physician Leadership Forum will be releasing for each of the five areas. The first two toolkits, Patient Blood Management and Antimicrobial Stewardship, will be highlighted during the program.

Featured speakers include:

Tom Nickels, AHA senior vice president of federal relations, will also join the webcast to provide a Washington update.

 

Click here for more information.

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:

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