Today’s Top Story
C. Difficile infections linked to increased readmission rates and length of stay.
According to a study published in the April 1 issue of the American Journal of Infection Control, reducing rates of Clostidium difficile infection (CDI) may be associated with reduced readmission rates. The authors reviewed information on 51,353 discharges at a single tertiary healthcare system. They found that 615 patients were diagnosed with CDI. Overall, CDI discharges were linked to an increased rate of 30-day readmission compared to non-CDI discharges (30.1 percent vs.14.4 percent). In addition, the average length of stay for CDI readmissions was 5 to 6 days longer compared to non-CDI readmissions, and time to readmission was shorter among CDI discharges diagnosed on admission than CDI discharges diagnosed later during their hospital stay. Read more…
Read the abstract…

Other News

Study: Outcomes similar for LSS patients treated with surgical decompression or PT, although many PT patients cross over to surgery.
Findings published in the April 7 issue of the journal Annals of Internal Medicine suggest that surgical decompression may yield similar effects to a physical therapy (PT) regimen among surgical candidate patients with symptomatic lumbar spinal stenosis (LSS). The researchers conducted a randomized, controlled trial of 147 patients treated with either surgical decompression (n = 74) or PT (n = 73). At 24-month follow-up, they found that mean improvement in physical function for patients in the surgery cohort was 22.4 on the Short Form-36 (SF-36) Health Survey, compared to 19.2 for patients in the PT cohort. The researchers write that sensitivity analyses using causal-effects methods to account for a high proportion of crossovers from PT to surgery (57 percent) showed no significant differences in physical function between groups. They also note that, without a control group, it is not possible to judge success attributable to either intervention. Read the abstract…

Study: ACL reconstruction surgery linked to improved function in younger patients.
Data presented in the April 1 issue of The Journal of Bone & Joint Surgery suggest that anterior cruciate ligament (ACL) reconstruction surgery may significantly improve physical health and function among younger patients. The research team evaluated 1,411 patients (median age at enrollment 23 years) enrolled in a prospective multicenter cohort. They found that mean SF-36 Physical Component Summary scores were 41.9 points at baseline, 53.6 points at 2 years, and 54.0 points at 6 years. Similarly, mean SF-36 Mental Component Summary scores were 51.7 points at baseline, 52.0 points at 2 years, and 52.4 points at 6 years. The research team noted that significant predictors of higher PCS score were a higher baseline PCS score, younger age, lower baseline body mass index, having >50 percent of the lateral meniscus excised, or having no treatment done on a lateral meniscal tear. Significant predictors of lower PCS score were a shorter follow-up time since surgery, revision ACL reconstruction, smoking at baseline, fewer years of education, and chondromalacia of the lateral tibial plateau. Read more…
Read the abstract…

Survey: Mixed bag of communications technologies may hinder communication among clinicians.
A survey conducted on behalf of PerfectServe finds that nearly all clinician respondents believe that successful care collaboration leads to reduced readmissions, but more than two-thirds say they are hindered by a patchwork of communication technologies, wasted exchanges, and concerns about privacy and security. The researchers surveyed 955 physicians, nurses, and case managers, and found that 69 say that patient care is often delayed while waiting for important information about the patient. Among the survey’s other findings are the following:

  • 52 percent of clinicians said they do not always know the correct care team member to contact in a given situation
  • 71 percent of responding physicians indicated that they have wasted time trying to communicate with the broader care team
  • Only 25 percent of physicians strongly agree that they can usually contact colleagues for collaboration or consults in an effective manner
  • 48 percent of physicians report being frequently contacted erroneously when they’re not caring for the patient in question

The most common current communication technologies cited by clinicians for optimizing population health management were phone calls (83 percent) and online patient portals (74 percent). Read more…
Read the press release…

Study: Year-round baseball may be linked to increased elbow problems for young pitchers.
Research to be presented at the annual meeting of the American Medical Society for Sports Medicine suggests that year-round play may be associated with increased risk of elbow injury for young baseball pitchers. The research team defined “warm weather” states as those with a yearly temperature average of 55 degrees or higher. They then reviewed baseball media guides to identify pitchers with ligament injuries in the elbow. Of 58 injuries, they found that 40 occurred in the Southeastern Conference and 18 occurred in the Big Ten conference. In addition, the research team determined that college baseball pitchers were at a 5.5 percent increased likelihood of tearing a ligament in their elbows if they currently play in the South. Further, players who pitched high school baseball in southern states were 6.2 percent more likely to tear an elbow ligament, compared to those who pitched high school baseball in northern states. Read more…
Visit the American Orthopaedic Society for Sports Medicine STOP Sports Injuries website…

Study: Quality-based pay may narrow performance variation among providers.
According to a study published online in the journal Health Affairs, transition to a quality-based payment model may help narrow variation in provider performance. The authors drew data from a Pioneer accountable care organization in which 40 percent of primary care provider compensation was based on clinic-level quality outcomes. Based on publicly reported performance data from 2010 and 2012, they found that improvement in quality metrics was not greater than improvement seen in other comparable medical groups, and that the quality incentive program fell short of its overall quality improvement aim. However, providers whose baseline performance was in the lowest tertile improved on average three times more than those in the middle tertile, and almost six times more than those in the top tertile, which the authors suggest could translate into narrowing socioeconomic disparities. Read more…
Read the abstract…

New York.
HealthLeaders Media reports that healthcare transparency legislation enacted in New York goes into effect this week. The “Emergency Medical Services and Surprise Bills” law includes consumer protections for out-of-network care, a pricing benchmark for healthcare services, and an independent dispute resolution process for providers and payers to arbitrate contested billings. Read more…

AAOS seeks member feedback on website redesign.
AAOS is working to improve the design and functionality of the www.aaos.org website. As part of this project, the Academy seeks member feedback to ensure that the final design fits the needs of members and other users. AAOS is looking for Academy members who are willing to volunteer about 1 hour of their time to be personally interviewed regarding their use of the site and how it can be improved. The interview will be conducted by a member of the design team that is partnering with AAOS on the project. To schedule an interview, please click the link below and select a time that suits your schedule. A meeting invitation will be sent to confirm the scheduled time. AAOS appreciates and values your time and feedback! Schedule an interview…