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Newsletter Article


Recent Commonwealth Fund reports and Fund-supported studies in the professional literature

Brigham and Women's Hospital: "Moving the Needle" Takes People, Processes, and Leadership. J. Edwards. December 22, 2008. A case study of Brigham and Women's Hospital, a national leader on measures of patient satisfaction.

Duke University Hospital: Organizational and Tactical Strategies to Enhance Patient Satisfaction. S. Silow-Carroll. December 17, 2008. In this case study, Duke University Hospital leaders explain that ensuring patient satisfaction requires both organizational and tactical strategies.

Flowers Hospital: Nearing Perfection on Core Measures. J. Edwards. December 17, 2008. How a community hospital in Alabama climbed from average to exemplary on process-of-care measures for heart attack, heart failure, pneumonia, and surgical infection prevention in just two years.

Hutcheson Medical Center: Focusing on Personal Interactions. J. Edwards. December 17, 2008. By focusing intently on patient-staff interactions and patients' needs, Hutcheson Medical Center has turned around its quality and financial indicators in the last two-and-a-half years.

Munson Medical Center: Constant Focus on Patient Satisfaction. S. Silow-Carroll. December 17, 2008. Munson Medical Center has become one of the better large hospitals in the U.S. in overall patient satisfaction in part by engaging frontline staff in improving care.

Interruptions in Medicaid Coverage and Risk for Hospitalization for Ambulatory Care–Sensitive Conditions. A. B. Bindman, A. Chattopadhyay, and G. M. Auerback. Annals of Internal Medicine, December 16, 2008. A study of adult Medicaid patients in California found that beneficiaries who experienced interruptions in their Medicaid benefits had a substantially higher risk of hospitalization for ambulatory care-sensitive conditions than did those with continuous coverage.

Transparency as a Pillar of a Quality and Safety Culture: The Experience of the New York City Health and Hospitals Corporation. A-M. J. Audet, R. Raju, C. M. Jacobs et al. Joint Commission Journal on Quality and Patient Safety, December 16, 2008. Beginning in 2001, the New York City Health and Hospitals Corporation—the largest municipal public hospital system in the United States—made a commitment to promote greater transparency in health care.

Checking Up on Retail-Based Health Clinics: Is the Boom Ending? H. T. Tu and G. Cohen. December 15, 2008. The authors find that the boom in retail store-based health clinics appears to be slowing, and that continued fall-off will mostly affect families that lack affordable alternatives for primary care.

Gaston Memorial Hospital: Driving Quality Improvement with Data, Guidelines, and Real-Time Feedback. J. Meyer. December 12, 2008. At this not-for-profit facility in North Carolina, adherence to evidence-based practice guidelines, multidisciplinary committees engaged in root-cause analysis, and strong leadership combined to produce near-perfect compliance with evidence-based process-of-care measures in four clinical areas.

Luther Midelfort Mayo Health System: Laying Tracks for Success. J. Edwards. December 12, 2008. Luther Midelfort Mayo Health System, a physician-led, integrated health system serving west-central Wisconsin, has advanced a culture that supports staff in their efforts to test new ideas and improve care.

Assisting Primary Care Practices in Using Office Systems to Promote Early Childhood Development. P. A. Margolis, K. T. McLearn, M. F. Earls et al. Ambulatory Pediatrics, November–December 2008. An innovative quality improvement collaborative in Vermont and North Carolina shows that if provided assistance, physician practices can successfully implement systems to provide parents of young children with information on healthy development and guidance on childrearing.

Quality Monitoring of Physicians: Linking Patients' Experiences of Care to Clinical Quality and Outcomes. T. D. Sequist, E. C. Schneider, M. Anastario et al. Journal of General Internal Medicine, November 2008. A study evaluating the association between clinical performance and patients' care experiences found modest correlations between the two areas, suggesting they are related but distinct domains that may require separate goals and improvement activities.

Racial and Ethnic Disparities in the Treatment of Dementia Among Medicare Beneficiaries. I. H. Zuckerman, P. T. Ryder, L. Simoni-Wastila et al. Journal of Gerontology, October 2008. This study of Medicare beneficiaries diagnosed with dementia found that use of anti-dementia medications was approximately 30 percent higher among non-Hispanic whites compared with other racial and ethnic groups.

Racial Disparities in Access to Long-Term Care: The Illusive Pursuit of Equity. D. B. Smith, Z. Feng, M. L. Fennell et al. Journal of Health Politics, Policy and Law, October 2008. While African Americans use rates of nursing homes have now surpassed whites' rates, there has been little gain in equity in long-term care.

Variation in the Use of Federal and State Civil Money Penalties for Nursing Homes. C. Harrington, T. Tsoukalas, C. Rudder et al. The Gerontologist, October 2008. In this study, researchers examined federal and state use of civil money penalties (CMPs) against nursing homes and found that CMPs are an underused tool for spurring improvement in the quality of resident care. Moreover, state enforcement varies widely from state to state.

Health Spending in OECD Countries: Obtaining Value per Dollar. G. F. Anderson and B. K. Frogner. Health Affairs, November/December 2008. In 2005, the U.S. had more than double the median per capita health care spending of the 30 industrialized countries in the Organization for Economic Cooperation and Development.

Cost-Effectiveness of Automated Telephone Self-Management Support with Nurse Care Management Among Patients with Diabetes. M. A. Handley, M. Shumway, and D. Schillinger. Annals of Family Medicine, November/December 2008. A recent study found that managing type 2 diabetes with the aid of an automated telephone self-management tool, plus nurse care management, was comparable in cost and outcomes to other accepted diabetes-management interventions.

In Chronic Condition: Experiences of Patients with Complex Health Care Needs, in Eight Countries, 2008. C. Schoen, R. Osborn, S. K. H. How, M. M. Doty, and J. Peugh. Health Affairs Web Exclusive, November 13, 2008. A new Commonwealth Fund survey of chronically ill patients in eight industrialized nations finds that those in the U.S. are by far the most likely to forgo care because of the cost, as well as the most likely to experience medical errors, care coordination problems, and high out-of-pocket costs.

Medicare's National Coverage Decisions for Technologies, 1999–2007. P. Neumann, M. S. Kamae, and J. A. Palmer. Health Affairs, November/December 2008. A multiyear analysis of Medicare's "national coverage decisions"—policies for reimbursing health care providers for particular medical services—shows that the program considers the available evidence "fair" or "poor" for most medical technologies it reviews.

Health Care Opinion Leaders' Views on Payment System Reform. K. Stremikis, S. Guterman, and K. Davis. November 3, 2008. Leaders in health care and health care policy expressed robust support for fundamentally reforming the way health care providers are paid and resounding dissatisfaction with the current payment system, known as "fee-for-service."

Patients' Perception of Hospital Care in the United States. A. K. Jha, E. J. Orav, J. Zheng, and A. M. Epstein. New England Journal of Medicine, October 30, 2008. While patients in U.S. hospitals are generally satisfied with their care, satisfaction levels are not as high as they could be, and rise significantly when hospitals have more nurses at bedside.

How Have Employers Responded to Health Reform in Massachusetts? Employees' Views at the End of One Year. S. K. Long and P. B. Masi. Health Affairs Web Exclusive, October 28, 2008. Employers in Massachusetts have not dropped health insurance coverage for their employees as a result of state health reform legislation; likewise, employers have also not tightened eligibility standards, increased workers' premiums, or scaled back on the scope of coverage.

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