Hospitals work to ensure high-risk patients are ready for surgeries

As healthcare becomes increasingly value-based, surgical outcomes are more important than ever, leading many providers to assess patients’ fitness for elective procedures.

Increasingly, providers make an effort to learn more about patients’ health before operations such as hip and knee replacements, according to The Wall Street Journal, looking for evidence of dangers of infection and other complications. Patients with chronic conditions or lifestyles that put them at higher risk may be directed to “pre-habilitation” programs to increase the odds that their procedures go off without a hitch. These initiatives can involve medical treatments or simply improved diet and exercise, according to the article.

This approach builds on strategies surgeons have employed for years, including advising patients to quit smoking or get in better shape ahead of a procedure, but the range of risks they focus on has broadened considerably to encompass everything from sleep disorders to mental illness, according to the article.

“In health care, we often bring patients into surgery without fully addressing their chronic medical conditions,” Solomon Aronson, M.D., executive vice chair in the anesthesiology department at Duke University School of Medicine in Durham, North Carolina, told the WSJ, and when patients are healthier pre-surgery, “we can significantly diminish the risk of complications.”

For example, Duke Health’s “Poet” (Peri-Operative Enhancement Team) program has focused its efforts on patients with anemia, malnourishment, poor tolerance for exercise, complex pain disorders and diabetes. The fixes the provider offers range from pre-operative iron infusions for anemic patients to a protein shake regimen for older, malnourished patients. In the cases of patients who need such fixes as weight loss or blood sugar control, the Duke team employs longer-term regimens as well.


Big-name hospitals often fail to prevent C. diff infections


Some of the most well-known hospitals in the nation rank among the worst in preventing deadly Clostridium difficile infections, according to a new Consumer Reports analysis.

The publication analyzed C. diff infections at hospitals across the country, based on data reported to the Centers for Disease Control and Prevention between 2014 and 2015. It found well-known teaching hospitals like the Cleveland Clinic, Baylor University Medical Center in Dallas, Brigham and Women’s Hospital in Boston and Cedars-Sinai Medical Center in Los Angeles had the lowest or second-lowest ranking, indicators that these hospitals fall short against the national benchmark to control such infections.

“Teaching hospitals are supposed to be places where we identify the best practices and put them to work,” Lisa McGiffert, director of Consumer Reports‘ Safe Patient Project, said in an announcement of the findings. “But even they seem to be struggling against this infection.”

The report analyzed data from more than 3,100 U.S. hospitals and found that more than a third received a low score for C. diff infection control.

Only two large teaching hospitals, Mount Sinai Medical Center in Miami Beach, Florida and Maimonides Medical Center in Brooklyn, New York, earned top marks from Consumer Reportson controlling C. diff.

Ascension reveals new, unified branding campaign

There will no longer be any doubt whether a hospital belongs to the Ascension health system. This week the nation’s largest non-profit health system rolled out plans to rename all 2,500 of its sites of care under its brand name.

Hospitals in Michigan and Wisconsin, its two largest markets, will be among the first to adopt the new name, the organization announced. The Catholic health system includes 141 hospitals in 24 states and the District of Columbia.

The branding strategy aims to make it clearer and easier for patients to access and navigate care within the system.

The switch began on Tuesday, as Ascension changed the name of its 15 Michigan hospitals and 24 Wisconsin facilities–for example, Detroit’s St. John Providence Hospital will become Ascension St. John Hospital.


Make room for lawyers at the hospital C-suite table


As payment models shift and other industry changes shine a spotlight on regulatory concerns, it’s becoming more and more common for hospitals and health systems to use in-house attorneys.

These legal experts are becoming a C-suite mainstay, too, according to an article from Becker’s Hospital Review, as roles like chief legal officer gain importance.

“Gone are the days where CEOs could afford to say, ‘I hate lawyers,’ or, ‘I don’t want to deal with lawyers,'” Werner Boel, principal and practice leader of legal services at executive search firm Witt/Kieffer, told Becker’s.

Though smaller hospitals may not be able to afford an in-house team, many larger systems are investing in a group of attorneys. Having on-site legal advice beyond general counsel, for example, can help hospitals navigate mergers and increased oversight from institutions such as the Centers for Medicare & Medicaid Services related to privacy and anti-kickback laws, Boel told Becker’s.

Boel emphasized the need for a true team, according to the article, as having a group of lawyers with diverse regulatory knowledge is key to helping hospitals weather any number of storms. Other executives must also be open to the legal team’s advice, and must actively engage with them on legal matters, Boel said.

A knowledge of regulatory matters can also benefit the executive team, according to the article, as roles like compliance officer and even CEO are increasingly filled by people with a legal background. These leaders have the right mix of experience to help guide change in hospitals under the constraints of healthcare reform, Boel said.