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Forty-four acute care hospitals participated in a prospective study over four years to determine the effect of quality improvement (QI) interventions on appropriate prescribing of surgical antimicrobial prophylaxis. Hospitals were randomly assigned to either feedback on the results of the ongoing audit vs feedback plus an intensive collaborative intervention group. Both groups showed improvement in most quality indicators, but there appeared to be no benefit of the intensive QI collaborative intervention over performance feedback.
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Unfractionated heparin (UFH) is the standard bridging therapy for patients with mechanical heart valves who need to temporarily stop oral anticoagulants. Small case series have suggested that low molecular weight heparin (LMWH) may be useful for this purpose.
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Terminally ill cancer patients who had end-of-life discussions with their physician had better quality of life during their last week, and their caregivers had an easier bereavement.
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News: A mother went to two area emergency departments on three consecutive days, complaining of nausea, vomiting, headaches, and numbness in her extremities. Each time, she was prescribed medication to treat the nausea, diagnosed with a possible gastrointestinal infection, and sent home. Just days after her third ED visit, the woman passed out and fell down a stairway. She was taken to a third hospital, where a CT scan showed a brain tumor, and physicians determined that the woman had suffered a brain infarction.
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Risk management continues to be an exciting career opportunity that offers new challenges all the time, says Georgene Saliba, RN, HRM, CPHRM, FASHRM, administrator for claims and risk management at Lehigh Valley Hospital & Health Network in Allentown, PA, and president of the American Society for Healthcare Risk Management (ASHRM) in Chicago.
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With all the concerns lately about the economy, health care risk managers at least can take some solace in knowing that their median income is holding steady with indications for upward movement.
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As Healthcare Risk Management enters 2009, we celebrate 30 years of serving health care risk managers across the country. It has been an eventful three decades, with many changes in technology, philosophy, and strategies.
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The health care industry is awaiting a ruling from the U.S. Supreme Court in the case of Wyeth v. Levine, a case that could determine the future of drug labeling and potential liability for providers who don't follow those instructions to the letter.
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A ruling in favor of the plaintiff could threaten the authority of the FDA by giving more power to state courts, says Maureen Martin, JD, senior fellow for legal affairs with The Heartland Institute in Chicago. She says the case could lead to a wholesale expansion of state regulation in other areas of law for any industry subject to intensive federal regulation. If that happens, the FDA will become ineffective, she predicts.
