Today’s Top Story
CMS releases hospital star ratings, despite concerns.
Medscape reports that the U.S. Centers for Medicare & Medicaid Services (CMS) has released hospital quality star ratings on its Hospital Compare website, despite concerns of some stakeholders that the ratings system would unfairly penalize hospitals that serve higher numbers of lower-income patients. The publication notes that teaching hospitals, which often treat poor and indigent patients, had an average ranking of 2.87 stars, compared with 3.11 stars for nonteaching hospitals. In addition, safety-net hospitals had a mean rating of 2.88 stars, compared with 3.09 stars for non–safety-net hospitals. Under the star ratings system, hospitals are rated based on 64 of 100 existing individual hospital measures already available on the CMS Hospital Compare website. Read more…
Visit the Hospital Compare website…
     A related blog post from the director of the CMS Center for Clinical Standards and Quality discusses the star ratings and states, “CMS will continue to analyze the star rating data and consider public feedback to make enhancements to the scoring methodology as needed.” Read more…

Other News

Study: ASCs may offer safe environment for appropriate patients undergoing TJA.
Findings from a study published in the July/August issue of the journal Orthopedics suggest that certain total joint arthroplasty (TJA) patients may be safely and effectively treated at stand-alone ambulatory surgical centers (ASCs). The researchers conducted a retrospective review of 51 consecutive TJA patients (22 total hip, 15 total knee, and 14 unicondylar knee) treated at a single ASC. At mean 14.9-month follow-up, they found that 16 patients (31.4 percent) reported minor adverse events such as nausea or pain in the postanesthesia care unit. However, early intervention permitted 50 patients (98.0 percent) to be discharged home an average of 176 minutes after surgery, with 1 patient discharged to a rehabilitation facility as arranged prior to surgery. The researchers found no major adverse events through 90 days perioperative. Overall, one patient was hospitalized for persistent incisional drainage, and none required admission for pain. Read the complete study…

Study: Nearly 30 percent of pediatric readmissions may be preventable.
According to a study published in the July issue of the journal Pediatrics, many children’s hospital readmissions may be potentially preventable. The authors conducted a cross-sectional study of 305 children aged younger than 18 years who were readmitted within 30 days to a freestanding pediatric hospital. They conducted 1,459 interviews with parents and guardians, patients who were at least 13 years old, inpatient clinicians, and primary care providers. In addition, they evaluated medical records and interview summaries and transcripts, and performed multivariate regression analysis to identify factors associated with potentially preventable readmission. They found that 29.5 percent of readmissions were potentially preventable. The authors noted that the likelihood of a readmission being potentially preventable was greatest when the index admission and readmission were causally related, and when hospital or patient factors were identified. They also noted that potentially preventable readmissions tended to occur sooner after discharge than non–potentially preventable readmissions (5 vs 9 median days). Finally the authors found that, in 31.2 percent of cases, interviews provided new information about the readmission, and therefore argue that such interviews should be considered when evaluating readmissions. Read more…
Read the abstract…

Study: History of concussion may be linked to long-term effects on brain.
A study published online in the Journal of Neurotrauma suggests that concussion may be associated with long-term effects on the brains of young athletes. The research team used multimodal magnetic resonance imaging (MRI) to evaluate abnormalities in brain structure and function of 43 athletes, 21 of whom had a history of concussion and 22 of whom had no known prior concussion. They found that athletes with a history of concussion displayed frontal decreases in brain volume and blood flow, along with increased posterior cortical volume and elevated markers of white matter microstructure. The research team writes that a greater number of prior concussions was associated with more extensive decreases in cerebral blood flow and insular volume, whereas recovery time from most recent concussion was correlated with reduced frontotemporal volume. They state that overall, white matter showed limited correlation with clinical factors, predominantly in the anterior corona radiata. Read more…
Read the abstract…

AAOS seeks lay member for Board of Directors.
AAOS seeks candidates for the lay member position on the Board of Directors. This non-orthopaedist should have a background in business and hold a position in his/her organization at the vice-president level or higher. The ideal candidate will have strong leadership skills, experience on other boards of directors, expertise in finance, no connection to orthopaedics, and a general understanding of health care and patient safety. The position is not compensated (except for expenses), and is a 2-year term commitment with the possibility of a 2-year reappointment. AAOS members who would like to suggest a candidate to be considered for this position should contact AAOS Chief Executive Officer, Karen L. Hackett, FACHE, CAE, at 847-384-4042 or via e-mail, at:
     AAOS would like to thank those members who have already submitted candidates for the lay board member position.

Evidence-based Quality and Value Committee releases roadmap to facilitate CPG and PM development.
Members of the AAOS Evidence-based Quality and Value Committee have created a set of tools to facilitate and encourage the conduct of high-quality research with the goal of establishing a stronger and more comprehensive evidence base for clinical practice guideline (CPG) recommendation and performance measure (PM) development. Drawing on the methodology and resources used in guideline development, the Research Roadmap seeks to give researchers insight to improve or self-assess their work, regardless of level of experience. The Roadmap is available for free on the AAOS website and includes resources related to the following: IRB approval, grant funding, study planning, study calculations, manuscript preparation, quality appraisal, and journal submission criteria. Read more…

Last call: Committee positions closing soon!
A number of openings on the AAOS Committee Appointment Program website are closing soon. Act now to apply for the following positions:

  • Central Evaluation Committee (closes Aug. 1)
    • Hand (one member)
    • Oncology (one member)
    • Spine (one member)
    • Sports medicine (one member)
    • Trauma (one member)
  • Diversity Advisory Board (one resident member; July 31)
  • Hip, Knee & Adult Reconstruction Evaluation Committee (one member; Aug. 1)
  • International Committee (two members, one resident member; July 31)
  • OKU Evaluation Committee (one member—oncology; Aug. 1)
  • Pediatric Evaluation Committee (one chair, eight members; Aug. 1)
  • Resolutions Committee (two members; July 31)
  • Sports Medicine Evaluation Committee (seven members; Aug. 1)

Learn more and submit your application…(member login required)