Today’s Top Story
AHRQ releases communication toolkit to assist providers when an error occurs.
The U.S. Agency for Healthcare Research and Quality (AHRQ) has released an online toolkit to help healthcare providers communicate accurately and openly with patients and their families when a medical error has occurred. The toolkit is designed to expand use of the Communication and Optimal Resolution (CANDOR) process, which gives hospitals and health systems the tools to respond immediately when a patient is harmed and to promote candid, empathetic communication and timely resolution for patients and caregivers. AHRQ notes that CANDOR and similar programs help remove barriers to the reporting of near misses and errors and encourage open communication regarding prevention of future errors. The CANDOR process has been tested and applied in 14 hospitals across three health systems.
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Read the AHRQ statement…
View the CANDOR toolkit…

Other News

Study: Hospital consolidation may lead to higher prices for heath care.
According to information published online in the journal Inquiry, hospital consolidation may be linked to rising prices for healthcare services. The researchers reviewed data from hospitals in California from the period 2004 to 2013, and found that overall hospital prices increased 76 percent per admission over the course of the study period. However, prices at hospitals associated with the largest multi-hospital systems increased at a rate of 113 percent, while prices at smaller hospital systems increased 70 percent. The researchers note that at the start of the study period, prices were similar across both cohorts, but by 2013, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4,000 per patient admission.
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Read the complete study…

Study: MIS may be an effective approach for certain patients who undergo spinal fusion for spondylolisthesis.
Findings from a study published online in the journal Spine suggest that spinal fusion via minimally invasive surgery (MIS) may be a safe and effective approach to treat grade I and grade II spondylolisthesis. The authors conducted a systematic review and meta-analysis of 10 studies covering 602 patients and found that MIS was associated with less intraoperative blood loss and shorter length of hospital stay compared to open surgery (OS). In addition, they found no significant difference overall between MIS and OS in terms of functional or pain outcomes. However, a sub-group analysis of prospective studies revealed that MIS was associated with increased operative time and lower final functional scores compared to OS.
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Study: Additional procedures performed during TAA may not increase risk of early complication.
A study published online in the journal Foot & Ankle International suggests no association between additional procedures requiring a separate incision and an increased rate of early complication for patients undergoing total ankle arthroplasty (TAA). The researchers conducted a retrospective review of 124 consecutive patients who underwent TAA. Excluding percutaneous Achilles lengthening, 35 of 124 patients (28 percent) had a total of 54 adjuvant procedures that required a separate incision during TAA. At 1-year follow-up, the researchers found that 27 percent of patients (24 of 89) without additional incisions and 23 percent of patients (8 of 35) with additional incisions had complications. The authors state that “surgeons can add adjuvant procedures during TAA to improve alignment, stability, or treat adjacent segment arthritis without affecting short-term complication rates.” However, they argue that the necessity or utility of such adjuvant procedures requires further study.
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Study: Idiopathic scoliosis may be linked to irregular cerebrospinal fluid flow.
According to findings published in the June 10 issue of the journal Science, irregular fluid flow through the spinal column linked to gene mutations may be associated with the development of idiopathic scoliosis. The research team demonstrated that ptk7 mutant zebrafish exhibited defects in ependymal cell cilia development and cerebrospinal fluid (CSF) flow. However, transgenic reintroduction of ptk7 in motile ciliated lineages restored cerebrospinal fluid flow and prevented scoliosis in ptk7 mutants. “Together, our results indicate a critical role for cilia-driven CSF flow in spine development, implicate irregularities in CSF flow as an underlying biological cause of IS, and suggest that noninvasive therapeutic intervention may prevent severe scoliosis,” the research team writes.
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California.
The California Medical Association reports that the California State Senate Judiciary Committee has rejected a bill that, if enacted, would have required physicians and other health professionals to notify patients if their licenses were placed on probationary status. Opponents of the bill argued that probationary status is not intended to prevent physicians from continuing to practice medicine, but passage of the bill as written would severely restrict physicians’ ability to practice by requiring patient notification based on preliminary accusations, not final judgments.
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Call for volunteers: Sports Medicine Evaluation Committee.
Aug. 1 is the last day to submit your application for a position on the Sports Medicine Evaluation Committee (six member openings). Members of the Sports Medicine Evaluation Committee write questions for the Sports Medicine Orthopaedic Self-Assessment Examination. All applicants must have a practice emphasis in sports medicine. Applicants for this position must be active fellows, emeritus fellows, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic.
Learn more and submit your application…(member login required)