Issue link: https://beckershealthcare.uberflip.com/i/1235187
36 QUALITY IMPROVEMENT & MEASUREMENT Consistent hospitalist care linked to better patient outcomes, study finds By Mackenzie Bean P atients who receive continuous care from one hospitalist during a hospital stay have better outcomes than those treated by several different hospitalists due to intermittent work schedules, accord- ing to a study published in JAMA Internal Medicine. For the study, researchers analyzed 2014-16 Medicare data on 114,777 patient admissions from 229 hospitals in Texas. Patients received general medical care from hospitalists during three- to six-day hospital stays. Patients treated by hospitalists whose work schedules allowed for care continuity had lower 30-day mortality after discharge, lower readmission rates, higher rates of discharge to the home and lower healthcare costs 30 days after discharge. Researchers suggest efforts to build work schedules that promote more care continuity for hospitalists could help improve patient outcomes. n Frailty plays large role in surgical outcomes, study suggests By Mackenzie Bean M inor surgeries can still pose a high risk for patients who are older or frail, according to a study pub- lished in JAMA Surgery. For the study, researchers analyzed data on 432,828 veter- ans who underwent noncardiac surgical procedures at Vet- erans Health Administration hospitals nationwide between April 2010 and March 2014. Researchers identified 8.5 percent of patients as frail and 2.1 percent as very frail. These patients demonstrated high mortality rates across all types of surgical procedures, even those of low operative stress. For example, frail patients who underwent the lowest-stress surgeries had a 30-day mortality rate of 1.55 percent, which exceeds the 1 percent mortality rate typically correlated to high-risk surgeries. "These findings suggest that frailty screening should be ap- plied universally because low- and moderate-stress proce- dures may be high risk among patients who are frail," study authors concluded. n How Jefferson Health is promoting nurse safety with a new alert system By Gabrielle Masson P hiladelphia-based Jefferson Health has partnered with the healthcare technol- ogy start-up Strongline to develop an easier way for nurses and other hospital staff to call for help during potentially dangerous situations. e Strongline Staff Safety System features Bluetooth-enabled ID badges with built-in alert buttons clinicians can discreetly press during emergencies. Jefferson is currently piloting the Strongline system on three units at Philadelphia-based omas Jefferson University Hospital and intends to eventually expand the program across its 14 hospitals. Below, Michelle Lewandowski, RN, a nurse manager at omas Jefferson University Hospital, discusses the challenges and advantages involved in piloting the system. Editor's note: Responses have been edited for length and clarity. Question: Can you briefly explain the new emergency call system? Michelle Lewandowski: If an employee is in a patient room or encounters a disgruntled family member in the hall, he or she can quietly push a button on their ID badge that sends an alert to security. e alert says "this person needs assistance here" and is also sent to all unit cellphones and unit leadership. is way, nearby employees can also assist the staff member in danger. We also get an alert confirming that help is on the way. Q: What was the motivation behind establishing the new system? ML: Our nursing staff experienced violence while working, particularly when patients would become agitated. Some nurses even began to think violence against staff was the norm. Before implementing the new system, we had duress alarms at nursing stations. is required staff to leave the patient room to pull the alarm, which could escalate situations even further because patients knew we were calling for security or assistance. e new system has really helped de-escalate situations sooner. Q: Were there any unforeseen obstacles in the implementation process? ML: Initially, the device had a lot of false alarms, and nurses weren't really sure if someone was actually coming to help. We worked with Strongline and specifically tailored the device for Jefferson staff. e feedback from frontline staff was really what made the device work. Now, the device uses a double-click technology to prevent false alarms. Q: What improvements have you seen since implementing the system? ML: We implemented the program a year and a half ago on our neurotrauma, epilepsy monitoring and ear, nose and throat units. e most important change is that staff feel more supported by leadership and peers. When they press the button, they know someone will be there in seconds. n