Patient Satisfaction

What departments are the heaviest users of point-of-care ultrasound in an American-based hospital?

The answer varies from hospital to hospital, but we usually see Emergency Medicine, Cardiology, Critical Care and Anaesthesiology rounding out the heavyweight users of bedside ultrasound.

“Anyone who ever sat through nurses making multiple IV needle sticks understands the value of ultrasound-guided vascular access, but this goes much deeper than an annoying hour trying to draw a few vials of blood or an arm that is bruised for a day or two,” said Vascular Access Coordinator Matthew ­­­­­­Ostroff. When St.

Group Practice Journal
Michael Shabot, M.D. FACS, FCCM, FACMI, is chief medical officer, Memorial Hermann Healthcare System, Houston and Adjunct Professor at the University of Texas School of Biomedical Informatics and the University of Texas School of Public Health at Houston.

Michael Warneke, M.D. is medical director of quality, Memorial Hermann Southeast Hospital.

In his article that advises American Hospital Association member trustees, Rodney Hockman, MD warns that hundreds of hospitals are likely to be penalized by Medicare for patient injuries under the Hospital-Acquired Condition (HAC) Reduction Program starting in October 2014. He points out that each penalized hospital stands to lose nearly $434,000 in Medicare reimbursements on average, with large hospital systems and those with a high volume of Medicare payments potentially facing much greater losses should they provide unsafe care.

Dr. Hochman points to institutions using a bundle of best practices to address this,  including 353-bed White Memorial Hospital, part of the Adventist Health System in Los Angeles, to eliminate two of the serious complications used to determine penalties under Medicare’s HAC Reduction Program: pneumothorax and central line-associated bloodstream infections (CLABSIs).  Both conditions are now included on AHRQ’s list of patient safety indicators. 

In his article that advises American Hospital Association member trustees, Rodney Hockman, MD warns that hundreds of hospitals are likely to be penalized by Medicare for patient injuries under the Hospital-Acquired Condition (HAC) Reduction Program starting in October 2014. He points out that each penalized hospital stands to lose nearly $434,000 in Medicare reimbursements on average, with large hospital systems and those with a high volume of Medicare payments potentially facing much greater losses should they provide unsafe care.

Dr. Hochman points to institutions using a bundle of best practices to address this,  including 353-bed White Memorial Hospital, part of the Adventist Health System in Los Angeles, to eliminate two of the serious complications used to determine penalties under Medicare’s HAC Reduction Program: pneumothorax and central line-associated bloodstream infections (CLABSIs).  Both conditions are now included on AHRQ’s list of patient safety indicators. 

The emerging healthcare environment requires expanded patient access while minimizing the cost of care. This is of particular importance for accountable care organizations that are assuming significant risk and must develop more innovative ways to deliver care to drive better outcomes and wring out inefficiencies. Our practice has experienced this struggle on a daily basis as patients, who needed a surgical consult, were frustrated with limited access. Our clinical schedule was filled with non-surgical candidates. This created a paradox where the most specialized health system resources (e.g., surgeon and MRI) were being allocated to a continuum of care that did not result in better care or outcomes, while also increasing physician and patient frustration. The long-standing dilemma was that the wrong patient was often in the wrong clinic leading to an inefficient and circuitous path for the delivery of appropriate care. When evaluating our practice it was clear that we could improve our allocation of available resources with the outcome being happy patients and happy physicians within a healthcare system that was delivering high quality, low cost, appropriate care.

Executive Insight
By Diku Mandavia, MD, FACEP, FRCPC