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Hospitalist Program Weekly

Hospitalist Leadership Connection, March 29, 2006

1. Study identifies keys to a "good" handoff

A recent study conducted at the University of Chicago looked at the most common problems faced during patient handoffs, and identified several keys to ensuring "good" handoffs.

The study, reported on in the March 2006 issue of Today's Hospitalist, examined 26 medical interns who were caring for 82 patients. Most of the handoff problems the researchers uncovered resulted from practitioners' omission of important information.

According to the researchers, an effective handoff system incorporates the following factors:

Vineet Arora, MD, a hospitalist and associate director of the University of Chicago's internal medicine residency program (and co-author of the study), is quoted in the article as saying, "Hospitalists are in the perfect position to take the lead on developing these protocols for how best to hand off patients."

To read the full article, click here.

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2. Hospitals providing more charity care

Hospitals provided 30% more free healthcare to poor and uninsured patients in 2005 versus 1999 (to $27 billion from $20.7 billion, respectively), according to a PricewaterhouseCoopers (PwC) Health Research Institute report released in early March.

The report, titled "Acts of Charity: Charity Care Strategies for Hospitals in a Changing Landscape," found that the benefits hospitals provide to their communities may even be underestimated: "The burdensome and expensive process that hospitals must go through to classify a patient as charity care often means the amount of charity care blurs with bad debt," researchers stated in the report. Further, inconsistencies among hospitals about which individuals qualify for a community benefit make it harder for facilities to defend themselves when they are accused of overcharging patients who lack health insurance.

Although the nation's hospitals have spent more money on charity care in recent years, the report asserts that they remain plagued by

Under a section of the report that discusses how to ensure complete and accurate submission of IRS Form 990 (which enables hospitals to disclose important financial information on charity care to the federal government), PwC advises that, "The more care hospitals take to provide and exhibit benefit, the more favorably the IRS, local Departments of Revenue, and courts will be liable to treat them under scrutiny."

To access the compete report, click here.

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3. AMA to standardize performance measures

The American Medical Association (AMA) has signed an agreement with Congress to standardize performance measures in healthcare. The move is meant to pave the way toward a pay-for-performance system while improving the quality of healthcare, according to a February 21 article in The New York Times.

As part of the agreement, the AMA will develop more than 100 standard measures of performance, which physicians will track and report to the federal government. According to the article, the performance measures focus on tests and treatments known to produce better outcomes for patients with illnesses such as diabetes or pneumonia.

Critics worry that a uniform set of performance measures could be used to constrain physicians' pay, rather than guarantee better medical outcomes. The AMA disputes that view, asserting that a standard understanding of the measures will eliminate confusion in the industry as states adopt their own separate standards for performance measurement.

To read the complete article, click here.

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