HCPro.com - Medical Staff Leader Insider

Overcoming Competency Assessment Challenges: Practitioners With Temporary, Telemedicine, and New Technology Privileges

Thu, 23 May 2013 12:27:00 GMT

Have you developed standards for assessing the competency of locum tenens, telemedicine, or new technologies at your facility? Medical staff professionals and physician leaders must be prepared for the challenges these areas create for competency assessment. Not having a process and policy in place can jeopardize patient safety and disrupt clinical processes. Anne Roberts, CPCS, CPMSM, and Carol S. Cairns, CPMSM, CPCS, discuss these common problem areas when assessing competency and what to do about them in a live webcast on Tuesday, June 18 from 1:00-2:30 (EST). This is session 1 of a 3-part webcast series.

At the conclusion of this program, participants will be able to:

List competency criteria for granting temporary privileges
Identify solutions to decrease risk from using locum tenens practitioners
Describe the contractual and credentialing requirements related to telemedicine services
Evaluate and process requests for new technology/techniques
Identify whether new competencies or privileges are required when implementing new technology or techniques

To learn more about this webcast, please visit www.hcmarketplace.com.

ED physicians key to half of hospital admissions

Thu, 23 May 2013 12:25:00 GMT

John Commins, for HealthLeaders Media, May 21, 2013

Doctors in the emergency department are the major decision makers in nearly half of all hospital admissions, giving them a significant role in controlling healthcare costs, research shows.

Jay A. Kaplan, MD, has been an emergency physician for more than 30 years and over the decades he has witnessed firsthand what he says is the evolving role of the emergency department in providing frontline healthcare.

"When I first started practicing we called it the emergency room," Kaplan says. "Then we got called the emergency department. We have morphed again. We are no longer an emergency department. We are an emergency care and acute diagnostic center."

Kaplan, a board member with the American College of Emergency Physicians, points to a Rand Corporation study commissioned by the Emergency Physician Action Fund which shows that emergency physicians are key decision makers for nearly half of all hospital admissions. Because of that, Kaplan says, emergency physicians are playing a critical role in controlling healthcare costs.

RAND found that hospital admissions from the ED increased 17% over seven years, accounting for nearly all the growth in hospital admissions between 2003 and 2009, offset by a 10% drop in admissions from primary care physicians and clinical referrals. Nearly all of the increase was from "non-elective" admissions from the ED—a rate 3.8 times the rate of population growth.

Read the full article atHealthLeaders Media.

Overnight physicians in ICU show little effect on outcomes

Thu, 23 May 2013 12:22:00 GMT

Researchers have found that nighttime intensivist staffing did not significantly improve outcomes, and may increase costs unnecessarily, according to a study published in the New England Journal of Medicine. In a study of more than 1,500 patients, researchers discovered no benefits on hospital length of stay, hospital mortality, readmission to the ICU, or discharge. This indicates that nurses and residents are capable of handling ICU patients without an ICU physician on duty, one of the study’s authors noted.

The benefits of nighttime intensivists include improving staff satisfaction and patient experience and reducing physician burn-out, as well as the reduction of malpractice claim incidents, according to researchers.

Source: Fierce Healthcare

Hospitals moving toward care teams

Thu, 16 May 2013 04:00:00 GMT

Nearly three-quarters of hospitals are implementing team-based care, according to a recent survey from the American Hospital Association (AHA). Common roles included in these teams are registered nurses, physicians, social workers, pharmacists, physical therapists, and nutritionists and dieticians. The AHA noted that hospitals can use multidisciplinary care teams to effectively deliver primary care. Of those hospitals who are implementing care teams, nearly half are implementing them throughout the facility.

Source: AHA News Now

Experience why your peers call Greeley "the expert in peer review"

Wed, 15 May 2013 18:16:00 GMT

Past Peer Review Boot Camp participants have said, “The boot camp should be mandatory training for PRC chairs and members," and “Greeley is the expert in peer review." Join us in Colorado Springs June 13-15 and see for yourself why peer review by physician experts for physicians works.

Not in an acute-care setting? Peer Review Boot Camp’s new expanded format for 2013 includes data on applying peer review in clinical, ACO, and ambulatory settings, more clinical case reviews and case studies, the ability for attendees to submit their own cases, and more time for discussion. You will leave prepared to:

Perform reliable peer review with less bias
Increase the use of aggregate data and identify patterns and trends
Create a positive peer review culture
Implement multispecialty- based peer review
Apply peer review methods in ambulatory settings and ACOs

For more information or to register, click here or call 888-232-8915 for details.

Other programs offered in Colorado, June 13-14, 2013:

Training Physicians to Lead Clinical integration, June 13-15, 2013

Medical Executive Committee Institute, June 13-15, 2013

Flexible plans, not clinical practice guidelines, reduce variation and improve care

Thu, 09 May 2013 04:00:00 GMT

Developing and implementing standardized clinical assessment and management plans (SCAMP) could help hospitals reduce variation and improve care, according to a study published in Health Affairs. The study points to SCAMPs as flexible guidelines that allow for modification based on analyzing data and new medical literature. Compare to clinical practice guidelines, which do not allow for adjustment in care, SCAMPs are able to be evaluated and developed.

The study found that the use of SCAMPs at Boston Children’s Hospital was associated with more than $700,000 in savings for a group of 1,000 patients, and an 11% to 51% decrease in total medical expenses for six conditions. The rate of ideal outcomes also grew when using SCAMPs.

Source: Fierce Healthcare

Lead your medical staff

Thu, 09 May 2013 04:00:00 GMT

Take time out in Colorado Springs this June to learn practical skills for managing today’s most pressing hospital and physician leadership challenges. The Greeley seminar experience provides an unparalleled opportunity to bring hospital executives and medical staff leadership teams together to learn and participate in cutting-edge discussions and to walk away with shared goals and strategies for your organization.

Here’s what’s new, based on your feedback:

June debuts an all-new program, Training Physicians to Lead Clinical Integration This is a small, interactive course for hospital executives and physician leaders to help them create all components necessary for an integrated model—from vision to metrics to rewards and a communication plan. Register today; attendance will be limited.
Peer Review Boot Camp is offered in an expanded format in response to requests for more clinical case reviews/case studies, the application of quality and peer review in ambulatory and ACO settings. Now, you can submit your cases for discussion (anonymity maintained).
We welcome Medical Executive Committee registrants and all attendees to the beautiful Broadmoor resort in Colorado Springs. This is a new location for Greeley, in response to participants’ suggestions.

Hospital execs forecast higher IT spending

Thu, 02 May 2013 04:00:00 GMT

Admissions will shift significantly from the inpatient to the outpatient setting in 2013 as providers transition to new care delivery models, says a Premier healthcare alliance survey. It also indicates that hospitals will make their biggest capital investments this year in information technology.

In its spring 2013 Economic Outlook, Premier reports that 65% of the 530 survey respondents—mainly hospital C-suite executives and materials and practice area managers—are projecting a decrease in inpatient volume in 2013 compared to 2012.

Accordingly, 69 percent of respondents are projecting an increase in 2013 outpatient volume compared to 2012.

"As these survey results suggest, more care is being shifted to outpatient care sites that are less intensive and expensive, but with lower reimbursement rates," says Premier COO Mike Alkire. "In other words, health systems are adjusting to reimbursement cuts and lower inpatient volumes, while they have a foot in both camps managing the financial transition away from fee-for-service to accountable, pay-for-performance models."

News about clinical integration, from Greeley CMO Rick Sheff, MD

Thu, 02 May 2013 04:00:00 GMT

Dear Medical Staff Colleague,

Clinical integration, the advancement of physician-hospital collaboration to increase quality and decrease costs, is harder than it looks. The impending pay for value world we are rapidly entering requires that physicians lead clinical integration to achieve success.

Join me and my fellow speakers in Colorado Springs June 13-15, 2013 for a brand new Greeley course titled, Training Physicians to Lead Clinical Integration. This is the most hands-on program on the market aimed at teaching participants new, practical skills necessary to lead physician-hospital integration: from the vision, to the correct players “on the team,” to metrics, rewards/incentives, dealing with performance issues, and a full communication plan.

Click here for information about other courses offered June 13-15, 2013 in Colorado Springs.

I hope to greet you and your colleagues in Colorado Springs!

Sincerely,

Rick Sheff, MD

Principal and Chief Medical Officer

The Greeley Company

Medical interns spend too much time on paperwork, too little time on direct patient care

Thu, 25 Apr 2013 04:00:00 GMT

Medical interns are spending a surprisingly small percentage of their time directly caring for patients, according to a study published online in the Journal of General Internal Medicine. In a study of first-year residents at two large academic medical centers in Baltimore, researchers from Johns Hopkins found that only 12% of residents’ time was spent talking with and examining patients. Of their remaining time, interns spent 64% on indirect patient care such as filling out paperwork and placing orders, 15% on education activities, and 9% on activities such as walking, sleeping, and eating.

Researchers questioned whether interns are receiving enough training and experience to deliver high-quality care despite spending so little time with patients. Previous research has shown that a physician’s bedside manner can benefit both the patients’ and hospitals’ bottom lines. One researcher from Johns Hopkins noted that building a relationship with patients can improve diagnoses and reduce medical errors.

Source: Fierce Healthcare

Three-quarters of participating hospitals have received incentive payments for meaningful EHR use

Thu, 25 Apr 2013 04:00:00 GMT

As of March 2013, 85% of hospitals are currently participating in electronic health records incentive programs with Medicare and Medicaid, and 75% of them have received incentive payments for meaningful use, according to a fact sheet released by CMS and the Office of the National Coordinator for Health Information Technology.

View the fact sheet.

Source: Becker’s Hospital Review

Calling medical staff leaders!

Thu, 25 Apr 2013 04:00:00 GMT

The Greeley Company invites you to an engaging and informative seminar experience at the Broadmoor resort in Colorado Springs, June 13-15, 2013.

Join executive leaders, directors, and physician leaders for what promises to be an exciting and informative exchange of ideas, strategies, and practical advice for dealing with today’s most pressing hospital and medical staff leadership challenges. The Greeley seminar experience provides an unparalleled opportunity to bring hospital executive and medical staff leadership teams together to learn and participate in cutting-edge discussions and to walk away with shared goals and strategies for your organization. Click on the seminars links below to register, or call 888-232-8915 for more information today:

• ALL NEW: Training Physicians to Lead Clinical Integration
• EXPANDED: Peer Review Boot Camp
• Medical Executive Committee Institute

We hope to greet you and your colleagues in Colorado Springs this June!

Hospital groups question medical staff rule from CMS

Thu, 18 Apr 2013 04:00:00 GMT

Several hospital groups are objecting to a CMS proposal that would “remove the ability of hospital systems and their medical staffs to make their own determinations about the optimal medical staff framework” and prevent integration of medical staffs in multihospital systems. The groups released a letter on April 8 asking that CMS provide a convincing reason for the necessity of the policy. The groups argue that individual hospital systems are best able to determine whether to have an integrated medical staff or to have separate medical staff at each facility, and that CMS should not regulate this.

The groups also point to the potential patient safety benefits of an integrated medical staff and the burden that would be placed on existing integrated medical staffs if required to break those into separate medical staffs. The American Hospital Association, the Association of American Medical Colleges, the Federation of American Hospitals, the Children’s Hospital Association, and the National Association of Public Hospitals and Health Systems all signed the letter.

Source: Fierce Healthcare

Bridging the clinical, academic gap won't be easy

Thu, 18 Apr 2013 04:00:00 GMT

Although physicians and hospitals continue to push for more collaborative care with multidisciplinary teams, they have a number of hurdles to overcome before realizing the holy grail of full-blown cooperation.

One of the root problems starts with the lack of integration between academic and clinical settings.

In January, the Josiah Macy Jr. Foundation, an organization that focuses on healthcare education, convened a meeting among educators and healthcare providers to discuss the need for "interprofessional education" with a focus for both sides on understanding each other's needs, perspectives, attitudes, and strategies to deliver better care.

In a recent follow-up report, the Macy Foundation concluded that academics aren't communicating properly with practicing clinicians, and it's a serious problem. The result, the report says, is disjointed oversight of care that too often bypasses team-based care and too often fails to elevate the needs of patients and families—which is sorely needed to improve healthcare delivery models.

The blame extends beyond academicians and physicians; it also rests upon onerous regulatory requirements. As it now exists, healthcare education and healthcare delivery have "developed and functioned separately with little recognition that the two are inextricably linked," the Macy Foundation report states.

Seminar updates for 2013: You spoke, we listened!

Thu, 18 Apr 2013 04:00:00 GMT

The Greeley national seminars promise are better than ever in 2013. Here’s a sample of what’s new, based on your feedback:

June debuts an all-new program, Training Physicians to Lead Clinical Integration. This is a small, hands-on, interactive course for hospital executives and physician leaders to help them put together all components necessary for an integrated model—from vision to metrics to a communication plan.
Peer Review Boot Camp is offered in a newly expanded format in response to requests for more clinical case reviews/case studies, the application of peer review in ambulatory and ACO settings, and an expanded focus on FPPE and OPPE including physician performance management. Now, you can submit your cases for discussion (anonymity maintained).
We welcome Medical Executive Committee registrants and all attendees to the beautiful Broadmoor resort in Colorado Springs. This is a new location for Greeley, in response to participants’ suggestions.

Debate over Medicare payment for PAs and APRNs

Thu, 11 Apr 2013 04:00:00 GMT

Members of the Medicare Payment Advisory Commission (MedPAC) are calling for greater recognition and reward of advanced practice registered nurses (APRN) and physician assistants (PA). Because states’ scope-of-practice laws can vary greatly, and because Medicare payments are aligned with those laws, APRNs and PAs may not receive appropriate payment for that service. For example, if a state allows an APRN or PA to practice independently of a physician, that practitioner would receive 85% of what a physician would receive for providing that service, but if a state requires the APRN or PA to work under a physician, the physician would receive 100% of the payment for the service, at the regular rate. MedPAC members discovered a wide variation in states’ scope of practice laws, and thus in the ways that APRNs and PAs can bill Medicare.

Source: MedPage Today

Patient advocates are not the enemy

Thu, 11 Apr 2013 04:00:00 GMT

If you're a nonprofit hospital or health system leader, it may seem that no matter what you do to benefit your community, someone's always pointing out your shortcomings and how you could do more. Some examples are more egregious than others, of course.

Much of this bad publicity surrounds efforts promoting healthcare access and finance for the most vulnerable people in the community. Time magazine may have just discovered this problem, but we and others in the trade press have documented over the years instances when nonprofit hospitals and health systems have gotten into trouble with their nonprofit status.

Make 2013 the Year to Course-Correct Your Peer Review Program

Thu, 11 Apr 2013 04:00:00 GMT

Past Peer Review Boot Camp participants have said, “Greeley is the expert in peer review," and “The boot camp should be mandatory training for PRC chairs and members." Join us in Colorado Springs June 13-15 and see for yourself.

Peer Review Boot Camp’s new expanded format for 2013 includes data on applying peer review in clinical, ACO, and ambulatory settings, more clinical case reviews and case studies, the ability for attendees to submit their own case studies, and additional time for discussion. You will leave prepared to:

Perform reliable peer review with less bias
Increase the use of aggregate data and identify patterns and trends
Create a positive peer review culture
Implement multispecialty- based peer review
Apply peer review methods in ambulatory settings and ACOs

For more information or to register, click hereorcall 800-807-9819 for details.

Other programs offered in Colorado, June 13-14, 2013:

Training Physicians to Lead Clinical integration, June 13-15, 2013

Medical Executive Committee Institute, June 13-15, 2013

New med school focuses on training primary care physicians

Thu, 04 Apr 2013 04:00:00 GMT

The new Frank H. Netter MD School of Medicine at Quinnipiac University in North Haven, Conn., will aim to train physicians who want to go into primary care, rather than a specific medical specialty, according to an article from Kaiser Health News. The school’s dean Bruce Koeppen notes that selecting the correct applicants it crucial in achieving its mission; the school will enroll its first class in the fall of 2013. Demographic data shows that women are more likely to choose general medicine than men, and individuals entering medicine as a second career are also more likely to pursue primary care.

According to Koeppen, the fact that primary care physicians don’t make as much money as specialists, the range of knowledge required for primary care, and the lack of respect the accompanies a primary care practitioners are the main challenges for attracting medical school students to practice primary care after graduation. However, the Quinnipiac program plans to partner students with primary care physicians with the aim of giving students hands-on experience in primary care. The school’s goal is for 50% of its graduates to stay in primary care.

Read the full article on the Kaiser Health News website.

Most Physician Spouses/Partners Are Happy

Thu, 04 Apr 2013 04:00:00 GMT

Despite the portrayals of rocky home lives and marriages on the brink in TV soap operas and primetime dramas, an overwhelming majority of physicians' spouses and partners say they are happy with their relationships, Mayo Clinic research shows.

The study, "The Medical Marriage: A National Survey of the Spouses/Partners of US Physicians,"published this month in Mayo Clinic Proceedings, found that 85% of the 891 spouses or partners of physicians who responded said they were satisfied with their mate, and 80% said they'd pick a physician again if they had to revisit the choice.

Three-quarters of the physicians' spouses or partners who responded to the survey were female, and 40% of the respondents had a full-time job and worked at least 30 hours a week outside of the home, the survey shows.

Read the full article at HealthLeaders Media.