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| Study: Hospitals In Fiscal Crisis |
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More than half of the nation's short-term, acute-care hospitals are either insolvent or near insolvency due to declining revenues from patient care and the overall downturn in the U.S. economy, a new study shows.
Fifty-three percent of the nearly 4,000 hospitals studied by professional services firm Alvarez & Marsal aren't treating enough patients to generate a profit, and another 19 percent aren't profitable enough to cover essential capital expenditures. Urban hospitals were found to be at a greater risk of insolvency than rural hospitals.
Although the analysis hinges on data from 2005 and 2006, George D. Pillari, managing director of A&M's Healthcare Industry Group, told the Wall Street Journal that hospital insolvencies and bankruptcies are in "the heyday right now" and are likely to increase this year.
The study identifies several changes in the healthcare industry that have contributed to hospitals' financial woes, including higher costs, declining reimbursements and the migration of both physicians and patients to "alternative settings," including ambulatory surgery centers. Adding to those troubles, the weakening economy is straining the sources of non-patient revenue - particularly state and local governments - on which many hospitals rely. The study's authors point out that the financial squeeze on hospitals is self-perpetuating, as facilities that cannot afford to maintain and upgrade their physical structures are losing even more patients.
Alvarez & Marsal cautions against looking for quick fixes to these issues. "It has become critical for hospital management and boards to deal with these troubling issues head-on and take urgent steps - such as restructurings, mergers or recapitalizations - to improve their finances and allow hospitals to execute on their missions," says Mr. Pillari in a press release.
Irene Tsikitas |
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| Automated Anesthesia System Unveiled |
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Researchers say they've developed a fully automated anesthesia system that administers drugs and monitors their effects in patients undergoing surgery without external intervention.
The closed-loop software system, dubbed "McSleepy" by the researchers at McGill University's Department of Anesthesia and Montreal General Hospital, was recently used during a three-and-a-half hour partial nephrectomy. In a press release, the scientists claim it was the "world's first totally automated administration of an anesthetic."
In addition to delivering anesthesia drugs via infusion pumps, McSleepy constantly monitors three separate patient parameters - depth of hypnosis, pain and muscle relaxation - and adjusts its dosage according to how the patient is responding to each drug throughout surgery. The researchers say the system "calculates faster and more precisely than a human can the appropriate drug doses for any given moment of anesthesia," but they stress that McSleepy is there to assist, not replace, anesthesia providers.
They liken it to a vehicle with an automatic transmission. The software is intended to help anesthesia providers with the basic task of administering drugs while allowing them to concentrate on other aspects of direct patient care. "Automatic systems in life only help us to perform our task better, they will not replace us," lead developer Thomas M. Hemmerling, MD, told reporters last week.
Dr. Hemmerling predicts it will take about two more years to perfect the system, but he anticipates that a commercial version of the technology will be available within the next five years.
Irene Tsikitas |
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| High Five for Hand Hygiene |
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Hospitals and ASCs in New Hampshire have been put on notice: It's time to get on board the first statewide initiative to improve hand hygiene compliance. The New Hampshire Commission on Healthcare Quality Assurance hopes to generate complete compliance with its "High Five for a Healthy N.H." campaign, based on the CDC Guideline for Hand Hygiene in Healthcare Settings.
According to the commission, the High Five program is built on the following five "fingers," which recommend that each facility in New Hampshire:
Lead from the top. Management and administration should commit their facility, organization and resources to the campaign's goal of 100 percent hand hygiene compliance.
Make it easy. Supply staff with easy access to waterless hand sanitizers, handwashing sinks, soaps and paper towels.
Teach and test. Instruct all staff and surgeons in proper hand hygiene protocols and test their understanding of those protocols with frequent demonstrations.
Measure progress. Employ a trained staff member to observe and uniformly measure point-of-care hand hygiene compliance.
Provide feedback. Regularly update the facility's hand hygiene compliance rates and performance areas that need improvement.
The commission says it expects all individuals entering patients' rooms to cleanse their hands after contact with inanimate objects in the immediate vicinity of the patient, and all individuals who have direct contact with patients to do so before and after the contact occurs. The program's success - and quality patient care - hinges on healthcare workers taking greater responsibility for sanitizing their own hands, says the commission.
Daniel Cook |
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| News and Notes |
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A SAFER LATEX GLOVE? The FDA has greenlighted the marketing of a patient exam glove made from a natural rubber which appears to sidestep the allergy concerns of traditional latex. The glove, manufactured by the Maricopa, Ariz.-based Yulex Corp., taps the guayule bush, a plant native to the southwestern U.S. and north central Mexico and long second to the tropical rubber tree as a source of natural rubber latex. The advantage of guayule latex, say experts, is that it doesn't contain the proteins that trigger allergic reactions to traditional latex. "Gloves made from guayule latex may prove to be a safer alternative for some people with sensitivity to traditional latex," says Daniel Schultz, MD, of the FDA. "And yet they will not sacrifice the desirable properties of traditional latex such as flexibility and strength." Due to a lack of long-term studies, the gloves will still be labeled with warnings of potentially allergic reactions.
IOWA'S LAWMAKERS HAVE APPROVED legislation that would let most of the state's hospitals bypass public approval for the construction of new facilities. The requirement eliminated under the measure applies to the state's 82 small, rural hospitals, which in the past have had to submit to public hearings and obtain a certificate of need from the state before relocating to newly constructed replacement hospitals.
A WRONGFUL DEATH LAWSUIT that faulted a North Carolina anesthesiologist for allowing a surgical patient to remain conscious but paralyzed - an experience which reportedly prompted the patient to take his own life two weeks later - has been settled confidentially, according to a published report. The lawsuit claimed the patient was paralyzed but fully aware for 16 minutes after the first incision during an exploratory laparotomy and gall bladder removal at Raleigh General Hospital in January 2006.
IT TAKES AT LEAST 150 COLONOSCOPIES to develop the diagnostic skills necessary for a good screening, according to a study in the April issue of the journal Gastrointestinal Endoscopy. South Korean researchers compared the records from 4,351 colonoscopies performed by first-year GI fellows and found the success rate for cecal intubation in under 20 minutes exceeded 90 percent, a goal in training, after the fellows performed an average of 150 procedures and continued to improve with subsequent screenings. The average time it took to perform cecal intubation also improved from 11.16 minutes to 8.39 minutes after the 150th procedure. |
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