Becker's Clinical Quality & Infection Control

Sign up for the Free Becker's Clinical Quality & Infection Control E-Weekly at www.beckersasc.com/clinicalquality. task of reducing harm events by half over six years presented the challenge of maintaining enthusiasm for patient safety efforts and maintaining improvements. "It takes constant vigilance to make sure improvements are sticking," Dr. Conway says. "Many times there's a period of relapse after introducing change. It's very hard to achieve consistent [improvement]." To ensure patient safety advances are long-lasting, it is essential health systems constantly measure patient safety metrics. "Never stop measuring data," Ms. Hawkins says. By not measuring data, organizations are susceptible to not recognizing patient safety issues right away, which makes 13 improvement more difficult. "There's a constant dynamic between [infections] and people," Dr. Conway says. "When we see a spike in infections, we figure out why it happened and get on top of it right away." While a health system may have multiple hospitals across several regions or states, it is possible to implement a single approach to patient safety. Some key components of engaging all providers in the patient safety effort include a robust structure, a culture of safety, accountable leadership, transparency and continued monitoring of data. n Report: Top Academic Medical Centers Have High Variation in Care Practices By Sabrina Rodak  T op academic medical centers vary widely in their intensity of care, procedure rates, patient experience and patient safety, according to a report from the Dartmouth Atlas Project. The report, "What Kind of Physician Will You Be? Variation in Health Care and Its Importance for Residency Training," explores variation in care among 23 academic medical centers to guide medical residents as they choose teaching hospitals. The medical centers consist of hospitals that were rated by U.S. News & World Report as the best hospitals for clinical excellence in 2012-13 as well as other notable hospitals. Cleveland Clinic, The Johns Hopkins Hospital in Baltimore, Northwestern Memorial Hospital in Chicago and University of Washington Medical Center in Seattle are among the hospitals featured in the report. Together, the hospitals represent approximately 17 percent of all primary residency slots in 2012. The authors used 2010 Medicare data and data for surgical procedures from 2008 to 2010 for their report. Examples of variation in care include the following: • n 2010, nearly half of chronically ill patients treated at The Johns I Hopkins Hospital were enrolled in hospice in their last six months of life compared with only 23.1 percent of patients treated at Mount Si- nai Medical Center in New York City. The authors suggested a Mount Sinai resident may learn a higher threshold for referral to hospice care, while a Johns Hopkins resident may be better trained in discussing patients' preferences. • atients were twice as likely to undergo knee replacement surgery in P Salt Lake City as in Manhattan. • atients at NYU Langone Medical Center in New York City were 47 P times less likely to contract an infection from a urinary catheter than patients at the University of Michigan Health System in Ann Arbor. The authors wrote that while all 23 academic medical centers have aboveaverage scores on patient experience, patient safety and processes of care and provide high-quality care, there is still room for improvement. David C. Goodman, MD, MS, co-principal investigator for the Dartmouth Atlas Project and director of the Center for Health Policy Research at the Dartmouth Institute for Health Policy & Clinical Practice, said "These findings challenge the assumption that clinical science alone drives medical practice at these prestigious institutions and thus raise a serious issue for academic medicine," according to a news release. "With such drastic variations from one institution to the next, they clearly cannot all be right. Academic medicine needs to address this gap in clinical science." n REGISTER TODAY! Becker's Hospital Review Annual Meeting CEO Strategy, ACOs, Physician-Hospital Integration, Improving Profits and Key Specialties 83 Health System Executives as Speakers Co-Chaired by Chuck Lauer and Scott Becker May 9-11, 2013; Chicago Westin Michigan Avenue, Chicago For more information and to register, visit: www.beckershospitalreview.com/4th-annual-beckers-hospital-review-meeting.html

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