Recent highly publicized outbreaks of infections linked to improper reprocessing of flexible endoscopes have raised concerns about infection prevention in gastrointestinal endoscopy procedures. Because of the headlines, legislatures are hearing from their constituents that they are fearful of being exposed to infections, and legislatures are getting involved. The Society of…

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The Centers for Medicare & Medicaid Services (CMS) on April 30 issued its proposed rule that would update FY 2015 Medicare payment polices and rates for inpatient stays at general acute care and long-term care hospitals. The proposed rule will increase the payment rate to general acute care hospitals by…

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Obstructive sleep apnea is a major clinical and economic challenge in the postoperative period, affecting up to one-fourth of patients undergoing elective surgical procedures. The prevalence among orthopedic patients having joint arthroplasty may be especially high because obesity is a widespread comorbidity in this patient population. Obesity is 1 of…

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Much work needed to make hospitals highly reliable To achieve a goal of zero patient harm, hospitals must adopt lessons from high-risk industries, finds a Joint Commission report. The authors say hospital leadership must • commit to the goal of zero patient harm rather than viewing it as unrealistic •…

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The economy continues to present staffing and budgetary challenges, our annual staffing survey finds; little has changed since the 2008 recession despite slightly better overall conditions (see cover story). Perioperative leaders report they’ve had to reduce overtime, eliminate open positions, and tell staff to take time off without pay in…

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Quality improvement efforts cut readmissions Hospitals participating in the Hospital to Home Quality Improvement Initiative had statistically significant changes in strategies to reduce readmissions, a study finds. In a survey of 437 participants, more hospitals reported: • partnering with other local hospitals to reduce readmissions • discharging patients with a…

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How long can a flexible endoscope be stored before it needs to be reprocessed for use in a patient? Guidelines differ, raising questions about the appropriate storage or “hang time.” Evidence is limited. What’s the best course? How do accreditation surveyors assess this? Though infections from GI endoscopes are rare,…

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Nurse burnout is linked to infection rates Nurse burnout leads to higher health care-associated infection rates and costs hospitals millions of dollars annually, new research finds. The study of more than 7,000 RNs in 161 Pennsylvania hospitals found more than one-third were suffering from burnout. Multivariate analysis showed a significant…

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NSQIP—you see those initials more and more in studies on surgical quality. NSQIP stands for the National Surgical Quality Improvement Program from the American College of Surgeons (ACS). NSQIP is gathering momentum, with 475 hospitals enrolled. Benefits are credible data for improving surgical outcomes and the buy-in from surgeons. By…

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  Readmission of patients who develop surgical site infections (SSIs) after total knee and hip replacement is common, adding more than $65 million to health care costs annually, in a new study. “We found that the impact of these infections is not only significant and profound in the immediate diagnosis…

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