Changes in Medicare’s Hospital Readmissions Reduction Program Affect Poor and Low Poverty Hospitals Differently

MedicalResearch.com Interview with:

Karen Joynt Maddox, MD, MPHAssistant Professor of MedicineWashington University Brown School of Social Work

Dr. Joynt Maddox

Karen Joynt Maddox, MD, MPH
Assistant Professor of Medicine
Washington University Brown School of Social Work 

MedicalResearch.com: What is the background for this study?

Response: Medicare’s Hospital Readmissions Reduction Program has been controversial, in part because until 2019 it did not take social risk into account when judging hospitals’ performance. In the 21st Century Cures Act, Congress required that CMS change the program to judge hospitals only against other hospitals in their “peer group” based on the proportion of their patients who are poor. As a result, starting with fiscal year 2019, the HRRP divides hospitals into five peer groups and then assesses performance and assigns penalties.  Continue reading

Cataract Surgery: QI Initiative Markedly Reduced Low-Value Preoperative Care

MedicalResearch.com Interview with:

John N. Mafi MPH Assistant Professor of Medicine David Geffen School of Medicine University of California, Los Angeles Natural scientist in Health Policy RAND Corporation Santa Monica, California

Dr. Mafi

John N. Mafi, MD, MPH
Division of General Internal Medicine and Health Services Research
Department of Medicine
David Geffen School of Medicine at UCLA
RAND Health, RAND Corporation

MedicalResearch.com: What is the background for this study? What types of services are low-value in this setting? 

Response: For decades we have known that offering routine preoperative testing for patients undergoing cataract surgery provides limited value, yet low-value preoperative testing persists at very high rates, even at Los Angeles County Department of Health Services, one of the largest safety net health systems in the United States.

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Catholic Hospitals Often Not Transparent About Health Care Restrictions In Their Institutions

MedicalResearch.com Interview with:

Maryam Guiahi, MDAssociate Professor, Ob/GynSchool of MedicineUniversity of Colorado

Dr. Guiahi

Maryam Guiahi, MD
Associate Professor, Ob/Gyn
School of Medicine
University of Colorado 

MedicalResearch.com: What is the background for this study?

Response: The United States Conference of Catholic Bishops expects providers in Catholic Health Care Facilities to follow the Ethical and Religious Directives for Catholic Health Care Services, which places limits on reproductive and end-of-life care.

Prior research has demonstrated that many patients do not anticipate religious health care restrictions, yet often face conflicts in care. We were interested in whether Catholic hospitals disclose their religious affiliation and explain to patients how this affiliation may impact the care they are offered.

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More Hospitals Dropped Addiction Services Than Added Them

MedicalResearch.com Interview with:

Cory E. Cronin PhDDepartment of Social and Public HealthOhio University College of Health Sciences and ProfessionsAthens, Ohio

Dr. Cronin

Cory E. Cronin PhD
Department of Social and Public Health
Ohio University College of Health Sciences and Professions
Athens, Ohio

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: One of my primary areas of research is exploring how hospitals interact with their local communities. My own background is in health administration and sociology, and I have been working with colleagues in the Heritage College of Osteopathic Medicine here at Ohio University (Berkeley Franz, Dan Skinner and Zelalem Haile) to conduct a series of studies looking at questions related to these hospital-community interactions.

This particular question occurred to us because of the timeliness of the opioid epidemic. In analyzing data collected from the American Hospital Association and other sources, we identified that the number of hospitals offering in-patient and out-patient substance use disorder services actually dropped in recent years, in spite of the rising number of overdoses due to opioid use. Other factors seemed to matter more in regard to whether a hospital offered these services or not.

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Hospital Wide Crew Resource Management Training Improves Communication and Teamwork

MedicalResearch.com Interview with:

Dr. Susan Moffatt-Bruce, MD PhD Cardiothoracic surgeon Associate professor of surgery and assistant professor of molecular virology, immunology and medical genetics The Ohio State University Wexner Medical Center Columbus, OH

Dr. Moffatt-Bruce

Dr. Susan Moffatt-Bruce, MD PhD
Cardiothoracic surgeon
Associate professor of surgery and assistant professor of molecular virology, immunology and medical genetics
The Ohio State University Wexner Medical Center
Columbus, OH

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Crew Resource Management (CRM), a training for all health care providers, including doctors, nurses, staff and students, focusing on team communication, leadership, and decision-making practices, was implemented throughout a large academic health system – across eight departments spanning three hospitals and two campuses. All those in the health system, inclusive of those that took the training, took a survey measuring perceptions of workplace patient safety culture both before CRM implementation and about 2 years after. Safety culture was significantly improved after Crew Resource Management training, with the strongest effects in participant perception of teamwork and communication. This study was the first health-system wide CRM implementation reported in the literature.

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