Archive for June 2011

Never Say Never (Events)

Earlier this month, the National Quality Forum released its revised list of “Serious Reportable Events in Healthcare, 2011,” with four new events added to the list. While the NQF no longer refers to this list as “Never Events,” it doesn’t really matter, since everyone else does. And this shorthand has helped make this list, which will soon mark its tenth anniversary, a dominant force in the patient safety field. The NQF was founded in 1999 at the recommendation of Al Gore’s Presidential Advisory Commission on healthcare quality. For its founding chair, the organization selected Ken Kizer, a no-nonsense, seasoned physician-administrator who had just done a spectacular job of transforming the VA system from the subject of scathing articles and movies into a model of high-quality healthcare, a veritable star in patient safety galaxy. Kizer original charge at NQF was to develop a Good Housekeeping seal-equivalent for quality measures (“NQF-endorsed measures”).…

Cellulitis guidelines reduce antibiotic and consultant use

In this single institution pre-post study, the implementation of an institutional evidence based guideline for patients with cellulitis / abscess significantly reduced the number of days of antibiotic use (13 days to 10 day), use of broad spectrum gram negative antibiotics (66% to 36% of patients) and use of ID consultants (46% to 30%), with no change in the clinical failure rate. This study is not surprising, but adds weight to the argument that standardization of evidence based care is extremely valuable in reducing resource utilization (abstract)

Hodge Podge

Today is a grab bag of newsworthy citations: (more…)

24/7 ICU attending staffing reduces LOS

In this before-after single center retrospective analysis, 24/7 attending staffing in a 24-bed medical ICU was associated with a reduced LOS (3 vs 2.6 days). Those in the highest APACHE scores admitted at night had a 61% lower cost (after the intervention compared to before the intervention). 24/7 ICU staffing may reduce cost and LOS for the sickest patients admitted at night, at least in large academic medical ICUs (abstract)

Cardiac rehab after PCI

In this population based cohort of patients who underwent PCI over the course of 14 years, 40% participated in at least 1 session of cardiac rehab. After propensity score matching, compared to those that did not participate in rehab, those that did had a 47% lower rate of all cause mortality. PCI patients appear to significantly benefit from rehab (abstract)