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| A New Standard in Hospital Infection Reporting |
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ANTIBIOTICS ARE FAILING TO PREVENT ACUTE ENDOPHTHALMITIS AFTER CATARACT SURGERY, according to a study in the November American Journal of Ophthalmology. Researchers identified 42 eyes of 42 patients with acute endophthalmitis occurring within six weeks after cataract surgery. Thirty-one of 42 eyes (74 percent) had been treated with perioperative gatifloxacin or moxifloxacin and 24 eyes (57 percent) were continuously taking one of these antibiotics at the time of diagnosis. Nineteen eyes (45 percent) had a positive bacterial culture. The most frequent organism isolated was coagulase-negative Staphylococcus. Sensitivities to ciprofloxacin (50 percent), ofloxacin (44 percent), levofloxacin (46 percent), gatifloxacin (38 percent), and moxifloxacin (38 percent) were noted. "Acute endophthalmitis can develop after cataract surgery despite the prophylactic use of fourth-generation fluoroquinolone antibiotics," researchers conclude. "Gram-positive organisms causing acute endophthalmitis are frequently resistant to all fluoroquinolones, including a significant number of cases resistant to gatifloxacin and moxifloxacin."
THE AMERICAN SURGICAL HOSPITAL ASSOCIATION is changing its name to Physician Hospitals of America. The new name reflects the association's focus on promoting the advancement of hospitals that include physicians as owners. The 100-member group, which was founded in 2001, offers support, advocacy and educational services. "With the end of the federal government's moratorium on physician ownership in hospitals, the physician-owned hospital industry is growing again," says Jim Grant, president of the board of PHA. Around 125 hospitals across the country are at least partially owned by physicians.
NEWHOPE BARIATRICS SECURED $18.5 MILLION to develop facilities designed specifically for the treatment of obese patients. The Charlotte-based firm will partner with bariatric surgeons nationwide to build ASCs and short-stay hospitals. Representatives of NewHope plan to announce the company's initial partnerships in the coming months. |
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| TASS Strikes Again
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Toronto's Scarborough Hospital closed its surgery center last week after an outbreak of toxic anterior segment syndrome was diagnosed in more than a dozen cataract patients. The surgery center remains closed as an independent consultant investigates the cause of the outbreak, but a hospital spokeswoman says the center hopes to re-open on or around Nov. 24.
The closure came days after ophthalmologists gathered at the annual meeting of the American Academy of Ophthalmology for a symposium on TASS outbreaks that occurred throughout the United States in 2006.
TASS is a non-sterile, post-op inflammation occurring predominantly in cataract patients. Between Jan. 17 and July 11, 2006, 113 U.S. facilities reported cases of the disease, prompting the formation of an ad hoc TASS task force.
"The disease is more prevalent than we realize and probably the most underrated complication of cataract and anterior segment surgery," said the AAO symposium's moderator, David Chang, MD, an ophthalmologist with Altos Eye Physicians in Los Altos, Calif. "There are lots of questions about what we should do now from surgeons around the world and here in the United States."
Potential causes of TASS are numerous and varied. Anything that gains access to the eye is being viewed with suspicion, noted most of the symposium's speakers. In order to narrow the field of potential causes, they recommended documenting the trade names and serial numbers of ophthalmic solutions, instrument lists, attending OR staff and instrument-processing employees for every eye case.
"Detailed record keeping will help investigators review relevant data when an outbreak occurs," says Henry Edelhauser, PhD, a professor of ophthalmology and director of ophthalmic research at Emory University Eye Center in Atlanta, Ga., and a member of the ad hoc TASS task force. Dr. Edelhauser estimates that 70 percent of TASS cases occur in surgery centers.
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| Florida Hospital to Become Global Surgical Training Site
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Envisioning a world-class training center for minimally invasive surgery that would educate as many as 20,000 surgeons each year, Florida Hospital announced last week that it would construct a $20 million facility on its Celebration Health Campus in Celebration, Fla.
The proposed 35,000-square-foot facility will be named the Nicholson Center for Surgical Advancement. The facility will feature a 500-seat amphitheater on its first floor and 20 surgical training stations on its second floor, says the hospital and its corporate partners, which include GE Healthcare, Ethicon Endo-Surgery, Karl Storz Endoscopy-America, Inc., and Getinge USA.
"Just like families and tourists come to central Florida for Disney and our world-class attractions, physicians will be coming to central Florida for our world-class surgical training," says Steven McCarus, MD, of Florida Hospital, who trains surgeons to master minimally invasive procedures. "These partnerships will also advance progress in the realm of minimally invasive surgeries, resulting in more lives saved and faster healing for patients with less discomfort."
The center — named after benefactors Tony and Sonja Nicholson, who pledged $5 million toward the establishment of the new facility — is expected to take two years to build.
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| News and Notes |
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MEDICARE'S PROPOSED OVERHAUL OF THE ASC PAYMENT SYSTEM was a hot topic at the American Academy of Ophthalmologists' annual meeting in Las Vegas this month. The consensus: tying ASC payments to hospital outpatient department rates will benefit to practices performing retina, cornea and glaucoma procedures, as reimbursements for those procedures will likely increase. On the other hand, facilities specializing in cataracts may suffer from a slight dip in payment levels. As it stands now, ASCs are slated to be paid 62 percent of what hospital outpatient departments receive for the same procedures. Ophthalmic procedures performed in ASCs are currently reimbursed, on average, 72 percent of the hospital rate, according to Sara Rapuano, COO, a coding and billing consultant to Wills Eye Hospital in Philadelphia. "We'd take a 10 percent bath on 62 percent," she says. "Performing straight cataracts will be tough, but adding subspecialties will help."
THE EXPENSE OF MAINTAINING REUSABLE ENDOSCOPES may boost their per-procedure costs beyond that of single-use endoscopes, reports the Millennium Research Group, a Waltham, Mass.-based healthcare information consulting firm, suggesting that budget-conscious facilities may do well to consider a switch. The study, "U.S. Rigid Endoscope Cost Analysis," surveyed hospital and surgery center OR managers on the financials of laparoscopes, arthroscopes, bronchoscopes and other rigid devices to find that purchase price ends up constituting only a fraction of a scope's per-procedure cost. Expenses associated with backup, repair, refurbishment, processing and OR downtime, however, add an average 650 percent to the purchase price over the equipment's lifetime, the firm's analysts say.
A FORMER SYMBION EXECUTIVE has been named president and CEO of Atlanta-based surgery center management firm Alliance Surgery. Charles Neal joined Alliance as its COO in March of this year after having risen to the role of president of Symbion's multi-specialty division, which operates 61 surgery centers in 23 states. At Alliance, which runs seven surgery centers and is developing 13 more, he replaces Charlotte Larkin, who resigned from her post. Alliance recruited former Symbion vice president Doug Peter for its regional vice president of operations post in June.
MED-XS SOLUTIONS HAS LAUNCHED a purchasing service for excess medical equipment. The Mentor, Ohio, company's service will let healthcare facilities and distributors bundle and sell medical equipment in one transaction. Med-XS says it also intends to work with clients who would like to donate excess medical equipment through the company's partnership with the Hope Foundation. |
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