Nurse Alliance Roundup, Jan. 8, 2010

Modern Healthcare

'Meaningful use' criteria released

FYI: The Nurse Alliance Ad Hoc Committee on HIT is currently developing Comments on the proposed regulations, which will be reviewed, approved and submitted by the Nurse Alliance Leadership Committee.

HHS issued two sets of much-anticipated federal regulations that significantly further the government's healthcare information technology adoption agenda. The first set of regulations lists the "meaningful use" criteria that healthcare providers must meet to qualify for federal IT subsidies based on how they use their electronic health records. The second set of regulations lays out the standards and certification criteria that those EHRs must meet for their users to collect the money.

Between $14.1 billion and $27.3 billion is at stake, which was made available under the Health Information Technology for Economic and Clinical Health Act provisions of the American Recovery and Reinvestment Act of 2009.

The meaningful use regulations are proposed regulations subject to a 60-day public comment period after which HHS would issue final regulations. The EHR certification regulations are interim final regulations that take effect in 30 days with a 60-day public comment period. HHS said final regulations will be published in 2010.

Under the proposed meaningful use regulations, eligible healthcare providers must use their EHRs to: improve the quality, safety and efficiency of healthcare services; reduce healthcare disparities; engage patients and their families; improve the coordination of care; improve population and public health; and ensure the privacy and security of personal medical information.

Under the interim final EHR regulations, EHRs must be able to securely exchange information among providers and between providers and patients using standardized data elements and technologies. The regulations outline standardized formats for such things as clinical summaries; medical descriptions of clinical conditions and test results; and how that information is exchanged over the Internet.


Center for Studying Health System Change
Gap Exists Between Vision for Electronic Medical Records to Improve Care Coordination and Clinicians' Experiences

A gap exists between policy makers' expectations that current commercial electronic medical records (EMRs) can improve coordination of patient care and clinicians' real-world experiences with EMRs, according to a study by HSC published online in The Journal of General Internal Medicine. Journal Article Abstract and News Release.


RWJF Nursing News Digest
Report: Some Hospitals Using 'Unfit' Temporary R.N.s
Given that some nurse staffing firms fail to effectively screen their employees, hospitals may be using temporary R.N.s with documented histories of underperformance, neglect and even crime, according to a report from the nonprofit investigative news organization ProPublica and the Los Angeles Times.


ANA SmartBrief
Ohio bill would raise penalties for assaulting a nurse
A bill expected to be introduced early next year in the Ohio House of Representatives would make an assault on a nurse at work a fourth-degree felony, rather than a misdemeanor or lesser felony. A fourth-degree felony generally carries a fine of up to $5,000 or up to 18 months of prison time. American City Business Journals/Cincinnati (12/30)

HHS issues first national health security strategy
The HHS has introduced the country's first health security strategy focused on managing large-scale health threats. "The National Health Security Strategy is a call to action for each of us so that every community becomes fully prepared and ready to recover quickly after an emergency," said HHS Secretary Kathleen Sebelius. The strategy includes 10 objectives for achieving health security. Healthcare IT News (1/7)

"Single stay" wards keep patients happy, reduce stays
Providence Regional Medical Center, in Everett, Wash., has improved patient satisfaction and reduced lengths of stay by at least a day using a "single stay" ward. The hospital allows cardiac patients to remain in one room throughout their stay and moves staff and equipment in and out as needed. BusinessWeek (1/7)

U.S. nurse shortage to worsen as population ages
By 2025, the U.S. will face a shortage of 260,000 registered nurses, according to analyst Peter Buerhaus at the Vanderbilt University School of Nursing. Nursing experts said there are not enough nursing faculty to train all of the RNs the country needs, so the U.S. might have to rely on more foreign nurses. CNNMoney.com (12/22)

Top 10 health care trends for 2010
The Health Research Institute of PricewaterhouseCoopers predicted the top health care issues in 2010 will include major efforts to reduce costs, adopt health IT, and focus on fraud and abuse recovery. The group also expects more physician groups to join health systems and the number of alternative care delivery models to increase. Healthcare IT News (12/17)

Study: Advanced cancer patients want spiritual needs met
People with advanced cancer who have their spiritual needs addressed are more likely to choose hospice care, and the very religious are more likely to forgo aggressive end-of-life treatments, a study found. However, about 60% of the patients said their spiritual needs weren't met or were only minimally addressed. Yahoo!/HealthDay News (12/18) 


FierceHealthcare 
State-run website calls out hospitals with high infection rates

With a few clicks of a mouse, folks in Washington State can find out which hospitals have unusually high infection rates, thanks to a new website launched this week by the state's health department. The site helps the state comply with a 2007 law that requires facilities to report hospital-acquired infections, the Seattle Post-Intelligencer reports.


Court: Physician-assisted suicide shouldn't be punished

In a case being diligently watched by those who support physician-assisted suicide, the Montana Supreme Court last week ruled 4-to-3 that doctors cannot be punished for helping terminally ill patients "die with dignity." The ruling, however, didn't go as far as to dub physician-assisted suicide a right under the Montana state Constitution, according to the New York Times.

Initially, trucker Robert Baxter--along with advocacy group Compassion and Choices--sued for the right to "seek help" from a doctor to end his life. Baxter died in December 2008 at age 76 after battling lymphocytic leukemia.

Had Montana ruled on the constitutionality of physician-assisted suicide, it would have been the first state in the nation to do so. Washington and Oregon allow physician-assisted suicide, but referendum votes--not Supreme Court rulings--determined those cases. California has considered the practice, as well, but has not made it official as of yet.

Justice James C. Nelson wrote in a concurring opinion that the "right to physician aid in dying quintessentially involves the inviolable right to human dignity," a right that he also called "our most fragile."

To learn more about this case: read this New York Times article.


Hospital employment takes major hit

In the past year-and-a-half many hospitals have responded to the recession by making deep staffing cuts, a process that has just started to tail off in the third quarter of 2009.

Staff cutting began in earnest in mid-2008, one of the worst years on record for mass layoffs in the hospital industry. By November 30 of last year, 107 hospitals had laid of 50 or more employees, including both administrative staffers and employed doctors, according to the U.S. Department of Labor's Bureau of Labor Statistics. That included the spectacular layoff of 3,800 employees from the University of Texas Medical Branch, though those were driven directly by the impact of Hurricane Ike a few months earlier.

By the end of the second quarter of this year, it seemed as though layoffs had begun to tail off, though a few hospitals continued to make significant cuts. And as of this point, as hospitals close the books on 2009, some have made turnarounds and posted unexpected profits for the year. 


Hospitals defy dire financial predictions

Throughout the health reform debate, hospitals have highlighted the ongoing financial challenges they face, no surprise given how heavily even small changes in policy can affect their health. That being said, critics are jumping all over some facilities that seem to be spend-happy despite the AHA's complaints about the industry's condition.

One market where hospitals are under fire is Chicago, where some of the high-profile flagship facilities are enjoying relative prosperity. These hospitals that seem to have recovered their bearing post-recession are resuming their building programs and buying other facilities, the Chicago Tribune notes.

Rush University, for example, is proceeding with a $1 billion renovation of its campus on Chicago's West Side. Another area health system, Advocate Health Care, is spending millions on new facilities and acquiring hospitals. According to Moody's Investors Service, Advocate saw its unrestricted cash rise 30 percent to $2 billion over the first three quarters of '09.

And Northwestern Memorial Hospital has announced that it will buy a rival hospital in a Chicago suburb and later replace the facility; it also spent $1 billion recently to build two teaching facilities.

While all of these investments are typical for large facilities, critics there are suggesting that these hospitals wouldn't be spending this way if they were providing enough charity care and otherwise investing in the community. This comes in the wake of a major brouhaha over the University of Chicago's program diverting less-acute patients away from its ED.

To learn more about Chicago's hospital market: read this Chicago Tribune piece.


SEIU Blog Gets Covered
SEIU blogger Jessica Kutch saw her work covered on MSNBC and Politico after she wrote here about Rush Limbaugh and his appreciation of the Hawaii healthcare system and the nurses who cared for him at Queen's Medical Center.