Today’s Top Story
Study: Admission through ED linked to reduced satisfaction.
According to a research study published in the October issue of the Journal of the AAOS, admission through the emergency department (ED) may be an independent risk factor for reduced satisfaction with physician performance. The researchers evaluated 6,524 inpatient patient experience surveys from two academic level I trauma centers over a 5-year period. They found that 85.18 percent of patients admitted through the ED were satisfied with their care, compared to 89.44 percent of patients admitted through other pathways. Read the abstract…

Other News

Study: Ultrasound Thomposon test may offer cost-effective adjunct in diagnosis of acute Achilles tendon rupture.
Data from a study published online in the journal Foot & Ankle International suggest that use of an ultrasound Thompson test may help diagnose acute Achilles tendon rupture. The authors prospectively evaluated 22 consecutive patients with operatively confirmed acute Achilles tendon rupture using the Realtime Achilles Ultrasound Thompson (RAUT) test and static ultrasonography. For static ultrasound, the authors found that sensitivity was 76.8 percent and specificity was 74.8 percent among 47 novice reviewers, and 79.6 percent and 86.4 percent respectively among 11 foot and ankle attending physicians. For RAUT testing, sensitivity and specificity were 87.2 percent and 81.1 percent among the novice group, and 86.4 percent and 91.7 percent among the attending group, respectively. The authors write that “the κ coefficient was 0.62 and 0.27 for novice and attending RAUT reviewers, indicating substantial and fair agreement, respectively, but only 0.46 and 0.12 for static ultrasonography, representing moderate and slight agreement, respectively.” Read the abstract…

CMS: BFCC-QIOs to resume initial patient status reviews of short hospital stays.
The U.S. Centers for Medicare & Medicaid Services (CMS) has announced that Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIOs) will resume initial patient status reviews of short stays in acute care inpatient hospitals, long-term care hospitals, and inpatient psychiatric facilities to determine the appropriateness of Part A payment for short stay hospital claims. On May 4, 2016, the agency temporarily paused the reviews in an effort to promote consistent application of medical review policies regarding patient status for short hospital stays and to allow time to improve standardization in the review process. CMS states that it has examined and validated BFCC-QIO peer review activities related to short stay reviews and initiated provider outreach and education regarding the Two-Midnight policy. Read more…

CMS Hospital Improvement and Innovation Network program seeks to reduce errors and readmissions.
CMS has awarded $347 million to 16 national, regional, or state hospital associations and other organizations to serve as Hospital Improvement Innovation Networks (HIINs) and reduce hospital-acquired conditions and readmissions in the Medicare program. HIINs will seek to achieve a 20 percent decrease in overall patient harm and a 12 percent reduction in rate of 30-day hospital readmissions by 2019, based on a 2014 baseline. The program will also work to expand and develop learning collaboratives, and address a wide variety of topics, including:

  • Adverse drug events, including opioids and anticoagulants
  • Injury from falls and immobility
  • Sepsis and Septic Shock
  • Surgical Site Infection
  • Venous thromboembolism

Read more…

House and Senate leaders say passage of 21st Century Cures Act is a priority.
The Hill reports that U.S. Senate Majority Leader Mitch McConnell (R-Ky.) and U.S. House Speaker Paul Ryan (R-Wis.) say that passage of the 21st Century Cures Act will be a priority during the “lame duck” session following the November election. Among other things, the measure is designed to streamline the approval process for drugs and medical devices, increase funding for the National Institutes of Health, and enhance health information technology interoperability. An earlier version of the act passed the House in 2015, but has not passed the Senate.
The American Association of Orthopaedic Surgeons (AAOS) recently joined a number of other medical specialty societies in thanking Speaker Ryan for his support of the bill. Read more…
Learn more about the bill…
Read more about the AAOS support letter…

Do some providers avoid seeking treatment for mental health?
Information published in the November-December issue of the journal General Hospital Psychiatry suggests that some physicians may be reluctant to seek treatment for mental illness due to stigma surrounding treatment and disclosure. The research team surveyed a convenience sample of 2,106 female physicians regarding mental health history and treatment, perceptions of stigma, opinions about state licensing questions on mental health, and personal experiences with reporting. They found that almost 50 percent of respondents believed that they had met criteria for mental illness, but had not sought treatment. The research team states that key reasons cited for avoiding care included:

  • A belief they could manage independently
  • Limited time
  • Fear of reporting to a medical licensing board
  • A belief that diagnosis was embarrassing or shameful

In addition, the research team found that only 6 percent of respondents with formal diagnosis or treatment of mental illness had disclosed to their state. Read the abstract…

Call for volunteers: Bylaws Committee.
Oct. 7 is the last day to submit your application for a position on the Bylaws Committee (two member openings). The Bylaws Committee recommends amendments to the AAOS bylaws and standards of professionalism. Applicants for this position must be active or emeritus fellows who are familiar with the AAOS governance structure and decision-making processes. Learn more and submit your application…(member login required)