Healthcare benchmarks
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Healthcare benchmarks · Sep 1999
Hospitalists: do they represent a best practice for patients? Part I.
Hospitalists: Do they improve care? Hospitalists are physicians dedicated to the care of hospitalized patients. The use of hospitalists is growing rapidly nationwide, primarily in markets marked by competitive managed care environments. ⋯ The "handoff" of the patient from primary physician to hospitalist upon admission is seen by many as a weak, and possibly fatal, characteristic of the hospitalist model. The key to making the hospitalist model work in today's health care system is to make the "handoff at the hospital" voluntary, thereby garnering vital primary physician support.
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Several recent high-profile tragedies have heightened public and practitioner concerns over the safety and quality of office-based anesthesia procedures. Inadequate office-based anesthesia procedures and precautions expose what some estimate to be 8 million people a year to unnecessary risk. The Accreditation Association for Ambulatory Health Care has established new quality standards for office-based, or mobile or "itinerant," anesthesia organizations.
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A grass-roots effort led by nurses allowed a North Carolina hospital to cut the length of stay for patients on ventilators by 34% and the overall ICU length of stay by 25% in nine months. A ventilator protocol approved by physicians lets nurses and respiratory therapists begin weaning patients without calling the physician at every turn. Ventilator patients averaged savings of $35,000 in hospital charges during the nine-month study period.
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Tennessee hospital emergency staff vie for appointments to the "PIT Crew," a performance improvement team that is racing to cut waiting times. Arkansas emergency department director uses military humor to impress upon staff the importance of improving patient satisfaction. Improvements include protocols for common complaints, portable two-way radios, and a glassed-in area for patients waiting for test results.