The summer edition of the Dallas-Fort Worth Hospital Council Foundation’s E-Newsletter is now available. The issue highlights a readmissions data report created by the research department. The claims data report covers 2011 hospitalizations of patients 18 years and older from 77 acute care facilities. The analysis produced surprising results. Additional highlights include the Aug. 16-17 Patient Safety Summit attracting an impressive 400-plus attendees. You can also meet Richard Howe, the new executive director of the North Texas Regional Extension Center. Click on the graphic below for the full story.

In a readmissions report created by the Dallas-Fort Worth Hospital Council Foundation (DFWHC Foundation) in August, claims data in 2011 for hospitalizations of patients 18 years and older from 77 acute care facilities was analyzed with surprising results.

Readmission rates, characteristics, patient age, gender, ethnicity, discharge status, payer and diagnoses were included in the study. Results showed that 14 percent of all hospitalizations for patients 18 years and older were followed by at least one readmission within 30 days. Readmissions for patients 85 and older (17.4 percent) were almost two times more likely to readmit as those who were aged 18-44 years (9.2 percent).

One in every 100 hospital stay (1 percent) was followed by readmission due to an infection or complication. Patients admitting for congestive heart failure (CHF) had the highest number of readmissions (2996) with a rate of 22.6 percent. Heart failure was the top reason for readmission for both the Medicare and uninsured patients. Medicaid patients were most often readmitted with complications of pregnancy. The top reason for an insured patient’s readmission was chemotherapy.

Results also revealed patients were most commonly readmitted for the same condition they were hospitalized for in the index stay. The top three conditions with the highest number of readmissions within 30 days were congestive heart failure, Septicemia and complication of device, implant or graft.

Patients initially admitted for congestive heart failure returned with the same condition, accounting for 38 percent of heart failure patients. The average length of stay was 5.61 days with a mortality rate of 3 percent.

For patients initially admitted for septicemia, 22 percent returned to the hospital within 30 days, with an average length of stay of 8.17 days.

Patients originally admitted for complication of device, implant or graft returned to the hospital 29 percent of the time, with a length of stay of 7.4 days.

Overall, Septicemia was in the top 50 percent of reasons why people readmit within 30 days from their index hospitalization. Additional research is necessary to determine the reasons why people are being readmitted for Septicemia.

Not all 30-day readmissions are preventable, with many planned due to follow-up treatments. Results show hospitals could decrease readmissions by reducing infection risks, paying closer attention to medication and ensuring discharge at an appropriate time according to the patient’s condition.

UPDATE: Table 3 – You can read the full report here

Richard Howe has been hired as the new executive director of the North Texas Regional Extension Center (NTREC), replacing former director Mike Alverson who retired August 1 after leading the organization from its inception in 2010.

Previously, Howe served in several health care IT positions as a consultant and executive. Richard was also a CIO at two academic medical centers, a software vendor executive and a medical school professor. He graduated from the University of Colorado and obtained his doctorate degree from UCLA. He also served in the U.S. Army as a Medical Service Corp officer.

NTREC, funded by an April 2010 grant from the U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology (ONCHIT), has a mission to provide education and assistance to physicians when implementing Electronic Health Records (EHR) technology to improve the quality of health care services in the region. Established by the Dallas-Fort Worth Hospital Council Foundation (DFWHC Foundation), NTREC assists physicians in 42 North Texas counties in implementing EHR.

“We are thrilled to have Richard Howe on board,” said Kristin Jenkins, president of the DFWHC Foundation. “He will work closely to continue the strong NTREC tradition started by Mike Alverson. He will also work diligently to assist North Texas healthcare providers in serving patients while utilizing the most effective electronic health records and health care technology on the market.”

Under Alverson’s leadership, NTREC officially enrolled 1,498 providers, achieving 100 percent of its enrollment goal. NTREC was the first group in Texas to achieve its complete goal.

Your final chance to register for the Dallas-Fort Worth Hospital Council Foundation’s (DFWHC Foundation) annual Patient Safety Summit, “Health Crusaders, Call for Quality,” is rapidly approaching. The event takes place August 16-17 at the Hurst Conference Center, at Highway 183 and Precinct Line Road, Hurst, Texas. Times are 8:30 a.m. – 5 p.m. August 16 and 8 a.m. – 12:30 p.m. August 17.

Deadline to register is this Friday, August 10.

This event is free of charge, but you must preregister. Register online at www.2012patientsafetysummit.eventbright.com.

This year’s summit will team the DFWHC Foundation and Centers for Medicare and Medicaid Services Region VI together to bring attendees essential information to support successful safety cultural transformation. The education summit provides peer-to-peer learning opportunities designed for practitioners across the continuum of care to help transform the patient safety process. Speakers are the most respected leaders in their field and will present vital information targeting all healthcare organizations.

Speakers include Robert M. Wachter, MD, professor and associate chairman of the Department of Medicine at the University of California, San Francisco and author of Understanding Patient Safety; Alicia Cole, survivor of Necrotizing Fasciitis and a patient safety advocate; Lisa H. Lubomski, PhD, assistant professor, Armstrong Institute for Patient Safety & Quality, Johns Hopkins University; and Jane Brock, MD, MSPH, chief medical officer for the Colorado Foundation for Medical Care, the Medicare Quality Improvement Organization for Colorado and the lead contractor for the CMS Readmissions Initiative.

Approved Nursing Contact Hours is available for each day, with 5.5 hours for Aug. 16 and 4.0 hours for Aug. 17. Huguley Memorial Medical Center is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

This two-day education conference is made possible through the Hospital Engagement Network (HENs) Contract from Centers for Medicare and Medicaid Services.

For additional information, please contact Carol Young at 972-717-4279 or e-mail cyoung@dfwhcfoundation.org.

I try hard most of the time to not “let my lawyer show.” This is not one of those times.

I know everyone has read and heard much about the recent U.S. Supreme Court ruling on the Patient Protection and Affordable Care Act.  So, I won’t favor you with another legal analysis complete with an attorney’s glee at being “right” in the outcome but “wrong” in the reasoning (or vice versa). The most interesting part of the decision’s impact on healthcare delivery and insurance markets have been well covered by experts. Instead, I wanted to look at the decision from a different perspective.

Chief Justice John Roberts and the majority followed a fundamental truth of legal analysis experts often forget. When a law is passed by the other two branches of government (executive and legislative), it is the judiciary’s obligation to find any and all legal and constitutional arguments in favor of upholding the law. This applies in all areas of law, in all cases, in all U.S. common law-based courts (meaning everyone but Louisiana – another story altogether). The court did this in the final ruling, and the new law stands, with the exception of the now newly-minted constitutional restriction on coercion of states to adopt federal programs in extreme cases. This is the first time the “coercion” doctrine has been confirmed at this level of legal evaluation – but I digress.

Why is this fundamental truth in decision making important? It is a lesson in analysis of complex issues and one we should take to heart. The court read every word of every brief and thousands of pages of instructive legal precedent. The justices learned the excruciating details of a healthcare reimbursement system that is in disarray and heard of fragmentary care delivery models too complex for complete understanding by many of us in the field for 20-40 years.

But they decided the most important issues on a fundamental truth of law – the judiciary is an evaluator of law, not a policy maker. Policy is left to the other two branches of government. This is the ultimate in constitutional separation of powers. It is fundamentally important to a constitutional democracy. This is the disciplined part of excellent leadership.

All of us in healthcare can make our decisions in complex situations using fundamental truths. If the fundamental truths of healthcare are:

1. We do not want people to get sick – we want them to stay well; and

2. When people do get sick, we want to make them well with the least disruption to the patient and society;then our decisions, based on complex facts and circumstances,
can be made and articulated clearly for the world to hear and support.

As we continue to lead our employees and patients through the changes to come, we must make our ultimate decisions on fundamental truths. When things are most complex, these truths will guide us. Articulating these truths as the reason for change will gain the support we need for the changes to come. U.S. Supreme Court justices are this country’s leaders of the legal field. If they can cut through the rhetoric and make decisions on fundamental truths, so can all of us.