Today’s Top Story
Study: Reducing resident duty hours may have little effect on patient safety.
Findings from a Canadian study published online in the journal CMAJ suggest that the implementation of reduced resident duty hour schedules may not improve patient safety and physician well-being. The research team randomly assigned 47 residents across two university-affiliated intensive care units to in-house overnight schedules of 24, 16, or 12 hours, in 2-month rotation blocks. They found that schedule had no significant effect on adverse events or resident sleepiness (based on the 7-point Stanford Sleepiness Scale). In addition, seven of eight preventable adverse events occurred during the 12-hour schedule. The researchers noted that mortality rates were similar across cohorts. However, residents’ somatic symptoms were more severe and more frequent with the 24-hour schedule, although burnout was similar across the groups. ICU staff rated residents’ knowledge and decision-making worst with the 16-hour schedule. Read more…
Read the abstract…
Other News
GAO report on ICD-10 transition notes progress, but is it too “optimistic”?
According to a report from the U.S. Government Accountability Office, the U.S. Centers for Medicare & Medicaid Services (CMS) has undertaken a number of efforts to prepare for the Oct. 1, 2015, transition to the International Classification of Diseases, 10th edition (ICD-10), and taken steps to address several areas of concern identified by stakeholders. The report notes that CMS has scheduled end-to-end testing with 2,550 covered entities during 3 weeks in 2015 and has promoted awareness of its educational materials by partnering with payers, providers, and others to direct users to educational resources. However, HealthLeaders Media reports that a spokesperson for the Medical Group Management Association questions the “optimism” of the GAO report, noting that only two state Medicaid agencies have completed internal and external testing of ICD-10, and that the federal government does not consider software vendors to be covered entities in the transition to ICD-10, so they are not required by law to upgrade their systems. Read more…
Read the complete report (PDF)…
Study: Outcomes similar for meniscal repair with or without PRP.
Data from a small study published online in the journal Clinical Orthopaedics and Related Research (CORR) suggest little efficacy for the use of platelet-rich plasma (PRP) in meniscal repair. The authors reviewed data from 26 isolated arthroscopic meniscus repairs. Of those, 11 were augmented with PRP, and 15 were performed without PRP augmentation. The authors write that during the study period, PRP was used for patients with meniscus tears in the setting of no anterior cruciate ligament reconstruction. At mean 4-year follow-up, the authors found no significant difference across cohorts in reoperation, functional outcome measures (IKDC score, Tegner Lysholm Knee Scoring Scale), return to work, or return to sports. The authors point out that larger prospective studies may be needed to definitively determine whether PRP should be used with meniscal repair. Read the abstract…
Study: Use of vitamin E-blended UHMWPE may not reduce MRSA biofilm formation.
According to information published in the March issue of CORR, use of vitamin E-blended ultra-high-molecular-weight polyethylene (UHMWPE) may not reduce the formation of biofilms by methicillin-resistant Staphylococcus aureus (MRSA). The research team blended vitamin E with UHMWPE material and compared its ability to resist MRSA biofilm formation against highly crosslinked UHMWPE, compression-molded UHMWPE, and polyetheretherketone. They found that, compared to materials that did not have vitamin E, vitamin E-blended UHMWPE did not reduce biofilm formation of a clinically relevant strain of MRSA, and in fact vitamin E-blended materials had similar amounts of biofilm formation compared to materials not containing vitamin E. The research team noted that the roughness of vitamin E-blended material surfaces compared to that of materials without vitamin E did not appear to influence biofilm formation. Read more…
How secure is patient data?
In the wake of a large theft of patient data from Anthem Health Insurance, an article in The New York Times looks at patient data security. The writer notes that patient records include information that can be used to open fake credit lines, file false tax returns, and create fake medical records. According to the U.S. government, more than 10 million people in the United States were affected by health data breaches during 2014. One security expert estimates that the healthcare industry is generally about 10 years behind the financial services sector in terms of protecting consumer information, making healthcare companies easier targets for hackers. Read more…
Idaho.
The Wall Street Journal Law Blog reports on a decision by the Ninth U.S. Circuit Court of Appeals, which affirms a lower court ruling that orders a hospital system to undo a 2012 deal in which it acquired a large medical practice. The health system had argued that the deal would allow it to provide improved care integration. However, the appeals court cited factual findings from the trial court stating that the hospital system did not require the merger in order to adopt a more integrated approach. In addition, the appeals court agreed that the acquisition could lead to higher prices for primary care services. Observers say the decision helps build precedent for moves by the U.S. Federal Trade Commission to stop potentially anticompetitive healthcare mergers. Read more…
Ohio.
According to The Columbus Dispatch, an interim report released by the Ohio Children’s Hospitals’ Solutions for Patient Safety, a program to increase hospital safety prevented serious harm in nearly 230 patients and saved nearly $6 million between January 2012 and October 2014. The program began in 2009 with a focus on reducing surgical site infection in designated orthopaedic and other procedures, and adverse drug events. In 2012, participating hospitals broadened their scope of work and began focusing on eliminating serious safety events (SSE). Read more…
Read the press release (PDF)…
Call for volunteers: FDA Science Board.
AAOS seeks to nominate orthopaedic surgeons to serve as AAOS liaison to the U.S. Food and Drug Administration (FDA) Science Board. The Science Board advises the FDA commissioner and other appropriate officials on specific complex scientific and technical issues important to FDA and its mission, including emerging issues within the scientific community, regulatory science, and the agency’s research agenda, facilities, and training opportunities. FDA will ask potential candidates to provide detailed information concerning such matters related to financial holdings, employment, and research grants and contracts to permit evaluation of possible sources of conflicts of interest. 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 highlighting his or her expertise in the relevant subject area and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted by Tuesday, March 10, 2015 at 11:59 p.m. CT, to Kyle Shah at shah@aaos.org.
Learn more and submit your application…(member login required)
