Today’s Top Story
Hospitals adopt initiatives to reduce SSI.
An article in HealthLeaders Media looks at efforts to reduce the incidence of surgical site infection (SSI). The writer notes that SSI occurs in an estimated 2 percent to 5 percent of patients who undergo inpatient surgery, and may cost up to $10 billion annually. Among other things, the article addresses efforts at one institution to reduce SSI among orthopaedic patients. The hospital instituted a best practices initiative that includes screening for Staphylococcus aureus infection, assessment of diabetic patients, standardizing skin sanitation and antibiotics, and proper humidity and airflow in the operating room. Read more…
Other News
FDA strengthens warning for diabetes medication in light of bone fracture risk.
The U.S. Food and Drug Administration (FDA) has strengthened the warning for the type 2 diabetes medicine canagliflozin related to an increased risk of bone fractures and has added new information about decreased bone mineral density. To address these safety concerns, FDA added a new WARNING AND PRECAUTION and revised the ADVERSE REACTIONS section of the Invokana and Invokamet drug labels. The agency recommends that healthcare professionals consider factors that contribute to fracture risk prior to starting patients on canagliflozin. In addition, the agency continues to evaluate the risk of bone fractures with other drugs in the SGLT2 inhibitor class—including dapagliflozin and empaglifozin—to determine if additional label changes or studies are needed. Healthcare professionals and patients are urged to report side effects involving canagliflozin or other SGLT2 inhibitors to the FDA MedWatch program. Read more…
Study: Delirium linked to adverse outcomes for surgical patients.
Data from a study published online in the journal JAMA Surgery suggest that delirium may be a significant contributor to adverse outcomes among older surgical patients. The authors conducted a prospective cohort study of 566 patients aged 70 years or older without recognized dementia or history of delirium, who underwent elective major orthopaedic, vascular, or abdominal surgical procedures with a minimum 3-day hospitalization. They found that 47 patients (8.3 percent) developed major complications and 135 patients (23.9 percent) developed delirium. Delirium significantly increased all adverse outcomes, including prolonged LOS, institutional discharge, and 30-day readmission. Patients with both complications and delirium displayed the highest rates of all adverse outcomes. The authors noted that overall, delirium exerted the highest attributable risk at the population level compared with all other adverse events. Read more…
Read the abstract…
Study: Medial meniscal injury and meniscectomy after ACL tear may increase risk of OA.
According to a study published in the August issue of the British Journal of Sports Medicine, medial meniscal injury and meniscectomy after anterior cruciate ligament (ACL) rupture may increase risk of later development of osteoarthritis (OA). The research team conducted a meta-analysis of 64 studies and found that, at minimum 2-year follow-up, medial meniscal injury/meniscectomy displayed moderate evidence for influencing OA development, while lateral meniscal injury/meniscectomy and time between injury and reconstruction both showed moderate evidence for no relationship. Read the abstract…
MedPAC offers comments on 2016 Physician Fee Schedule.
The Medicare Payment Advisory Commission (MedPAC) has submitted comments to CMS regarding proposed 2016 revisions to payment policies under the Medicare Physician Fee Schedule. Among other things, MedPAC notes the complexity of various CMS quality systems such as the PQRS, the value modifier, and the Merit-Based Incentive Payment System. “It is unlikely that a system with this level of complexity will be effective at signaling high or low performance to the public and will not provide clinicians with the information that they need to improve their performance,” the authors write, noting that “the efforts required to assess the performance of individual clinicians and redistribute payments across them may not be worth the resources and effort required.” The authors point out that the Medicare Access and CHIP Reauthorization Act of 2015 attempts to consolidate the various systems as a “first step.” Read more…
AAOS also submitted comments on the Physician Fee Schedule. Read more (PDF)…
Study: Vision test may serve as component of sideline testing for concussion.
Findings from a study published online in the journal Concussion suggest that use of a rapid number naming test, in which athletes read numbers on a series of cards as quickly as possible, may have efficacy in sports-related concussion testing. The researchers conducted a meta-analysis of 15 studies covering 1,419 participants. All studies used preseason baseline scores of the King-Devick (K-D) test to identify concussed versus non-concussed athletes. The researchers found that sensitivity was 86 percent (96 of 112 concussed athletes had K-D worsening) while specificity was 90 percent (181 of 202 controls had no K-D worsening). Read more…
Read the complete study…
States consider legislation to limit balance billing.
An article in HealthLeaders Media discusses out-of-network billing for health care. The writer states that legislatures in at least seven states have considered laws to limit what physicians and hospitals can charge when they are outside a payer’s provider network. At least one insurer has filed suit against physicians in New Jersey, alleging that they overcharged for out-of-network services. The writer profiles a balance billing law enacted in Illinois, which allows for arbitration for balance billing disputes, as well as consumer protections for health plan beneficiaries who receive medical services at in-network hospitals and ambulatory surgery centers. Read more…
Call for volunteers: ACGME Sponsoring Institution 2025 Task Force.
AAOS seeks to nominate members to the Accreditation Council for Graduate Medical Education (ACGME) Sponsoring Institution 2025 Task Force. This is an 18-month project to develop and elaborate a future vision for ACGME-accredited institutional sponsors of GME programs. The task force will gather substantial information from key stakeholders such as designated institutional officials, residency program leadership and staff, residents and fellows, hospital and medical school leadership, healthcare professionals, partner organizations, government leaders, regulatory entities, and the public. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest (not to exceed two pages) highlighting the applicant’s expertise in the subject area. All supporting materials must be submitted by Sunday, Sept. 13, 2015 at 11:59 p.m. CT, to Kyle Shah at: shah@aaos.org
Learn more and submit your application…(member login required)
