1 in 6 Open Heart Surgery Patients Readmitted Within a Month

A new report by the Pennsylvania Health Care Cost Containment Council (PHC4) shows that in 2008, 2208 patients in Pennsylvania who had coronary artery bypass surgery and/or heart valve surgery were readmitted to the hospital within 30 days.
PHC4's Executive Director Joe Martin says that's one in six open heart surgery patients "this illustrates why the medical community, researchers and policymakers are focused on identifying the causes of readmissions and implementing evidence-based strategies to reduce those that are preventable."
Martin says that not all readmissions can be avoided even with optimal care, but they are a significant cost driver. The 2,208 readmissions resulted in an additional 11,065 hospital days and more than $81 million in additional hospital charges.
The report shows that patients who underwent valve and bypass surgery had a 21% readmission rate within 30 days compared to 17.8% of those who had valve surgery only and 14.6% of patients who had bypass surgery only.
Council spokeswoman Stephanie Suran says the main reason for readmission following open heart surgery is infection.
Suran says the mortality rate of open heart surgery patients edged up slightly from 1.75% to 1.9%. This small increase came after the mortality rate was nearly cut in half (46%) from 1994 to 2007.
Suran says in the Pittsburgh area, UPMC Presbyterian and Shadyside had higher than expected rate of deaths among heart surgery patients, but UPMC Mercy had mortality rates in the expected range. Suran says Allegheny General Hospital had a higher than expected mortality rate 30 days and longer after bypass surgery, but lower than expected rates after 7 days.

West Penn Will Shed Services, Jobs

About 1,500 employees at the West Penn Allegheny Health System will lose their jobs in the coming months. That's due to the consolidation of Allegheny General Hospital and West Penn Hospital. AGH will become the primary hospital of the health system while most medical and surgical programs at West Penn will move to AGH in the first quarter of next year. IN addition West Penn's emergency department will close in January.
West Penn will continue to provide its Women's and Infants' Center, bariatric surgery program and the burn center and inpatient rehabilitation programs.
President and CEO Christopher Olivia says despite improving its cost structure West Penn Allegheny has lost $11.6 million in the first three quarters of this fiscal year.
Olivia says he can’t say yet how much money the system will save through the consolidation. Most of the 1,500 lost jobs will come from West Penn which currently employs 2,400.
Olivia said the city and county’s population has declined and more patients are seeking care closer to home ...outside of the city as population shifts in the region. He also says more patients are seeking care in an outpatient setting. On an average day West Penn has about 240 patients, or just 47 percent capacity. West Penn will see its inpatient beds cut from 505 to 202.

“After long and careful deliberation, we believe this consolidation, together with our suburban strategy, will help us achieve this goal and ensure that we have the necessary capital and alignment of resources to fulfill our mission and charitable purpose."

In May, West Penn Allegheny announced that the Suburban Campus of AGH in Bellevue, would become an outpatient facility only. Two weeks ago, the system announced plans to build an ambulatory care and surgery center in Peters Township.

Allegheny Gen., West Penn Share Some Services

West Penn Allegheny Health System is consolidating some inpatient services of the West Penn and Allegheny General Hospitals.

“More people are seeking outpatient care than inpatient care these days, because health care frankly has gotten much better,” says West Penn Allegheny spokeswoman Kelly Sorice. “As far as West Penn Hospital and Allegheny General Hospital are concerned, we’re looking at what services these hospitals should offer to respond to these changes in the marketplace.”

Sorice says neonatology and obstetrics are now only offered at West Penn. Neurosurgery will only be offered at Allegheny General after the West Penn department moves.

More consolidations could occur in the near future.

Sorice says West Penn Allegheny won’t know about any job losses until it works out more details.

Bloomfield residents still have many inpatient care options, including the University of Pittsburgh Medical Center’s Children’s Hospital and UPMC Shadyside nearby.

PA Hospitals Cause Fewer Infections in 2009

Pennsylvania’s Department of Health released a report yesterday that found declining infection rates in hospitals in the state.

The report says in 2009, 25,914 people were infected while in hospitals in Pennsylvania – that’s a 12.5% drop from 2008.

President of the Pittsburgh Regional Health Initiative Karen Wolk Feinstein says the Department of Health will audit that information to check for any reporting errors or omissions from hospitals.

Wolk Feinstein says one of the most common hospital contaminations is a central line bloodstream infection -- that’s when a catheter infects an important artery or vein, resulting in a 20% mortality rate. She says central line infections have been reduced by 68% in southwestern Pennsylvania hospitals.

Wolk Feinstein says Medicare and many private insurers have stopped paying for medical bills caused by hospital infections.

“With this kind of public reporting, with Department of Health sanctions, with financial disincentives, we are closing the door on the fact that for a while, you actually got rewarded as a provider for these infections and you got larger payments.”

She says hospital visits without infections averaged about $35,000 in Pennsylvania, but patients and their insurers would usually pay a bill closer to $192,000 if the person was infected. She says now that insurers have stopped covering these costs, hospitals have incentive to put effort into infection control.

Emergency Room in Bellevue to Close

West Penn Allegheny is shuttering their emergency room and ending inpatient care at their Bellevue facility. The shutdown will occur by the end of the summer.

State law prohibits a hospital from having an emergency room unless it has inpatient beds.

Kelly Sorice, spokesperson for the hospital said inpatient care is only about four percent of the services the facility provides. She added that Allegheny General Hospital is seven miles away for those that require inpatient care. She said hospital officials met with community leaders before making their decision.

LifeCare Hospitals operates 41 beds in the hospital. They plan to expand their services to 50 beds, and may add another 50 skilled nursing or transitional care beds.

There will be an urgent care center and physician offices at the facility. They will offer some service on an outpatient basis, such as radiology and imaging services, laboratory, dialysis, physical therapy, oncology and pediatric services.

Western PA Hospitals Laud New Medicare System

Local hospitals say they stand to gain from the recently passed health care reform legislation.

Patricia Raffaele of the Hospital Council of Western Pennsylvania says the new law changes the method by which the federal government allots Medicare reimbursement.

Raffaele says western Pennsylvania’s current Medicare wage index is inexplicably low and brings in little funding.

“It’s the same as say, for example, Laredo, Texas, or Lawton, Oklahoma, or sort of these smaller rural areas, when we have obviously large amounts of care being provided here,” says Raffaele.

She says the new Medicare wage index system would use data from the Bureau of Labor Statistics rather than information from individual hospitals. Raffaele says that would help bring equity to the reimbursement system.

“It creates what MedPAC likes to call a ‘smoothing effect,’ where it takes out the cliffs and valleys for reimbursement for Medicare under this formula,” says Raffaele.

Unfortunately for local hospitals, the new system takes effect in fiscal year 2013. Raffaele says until then, regional hospitals will continue to find ways of maintaining their financial health.

Hospitals Prepare for the G-20

As city, state and federal officials prepare the Pittsburgh area for the G-20 Summit, local hospitals are getting their emergency rooms ready for whatever may come their way.
Thousands of people will be in the region. Historically, Allegheny General Hospital has been the designated White House Hospital, where the president would be treated if he got sick.
There are two other trauma hospitals in the Pittsburgh region. They are UMPC Mercy and Presbyterian.
Hospitals outside the region, such as St. Clair Hospital, are also getting ready.
We visit all of the hospitals.
Listen to a longer version of this story here.

Medicare Program Urges Reduction of Hospital Readmissions

Fourteen regions across the nation have been chosen as pilot areas for the Care Transitions Project, which will attempt to cut down on the number of patients that return to hospitals for continuing treatment. The Centers for Medicare and Medicaid Services (CMS), which has been monitoring readmission rates in these designated areas for some time, hopes to eliminate unnecessary returns to hospitals by educating patients on how to treat their own chronic illnesses from their homes. Naomi Hauser, Director of the Care Transitions Project in Pennsylvania, says this is an effort to localize health services to a community level. "Patients need to understand that they can identify some of their symptoms, be able to contact their physicians and work with physicians in the community, rather than go to the emergency room or go to the hospital for acute management of their symptoms," says Hauser. Hauser says since many readmissions are due to misuse or misunderstanding of medication, much of the program's energies will be focused on teaching correct ways for patients to deal with meds. Each of the fourteen pilot areas will approach the program in a unique way; the Pennsylvania pilot will implement "transition coaches," who will meet the patient while they are at the hospital and continue to check up on them through phone calls and home visits. Allegheny, Fayette, Washington and Westmoreland Counties were included in the three-year Western Pennsylvania pilot.

UPMC 'CONDITION L'

UPMC is announcing a new initiative to locate missing patients. It's called 'Condition L.' Holly Lorenz, chief nursing officer and vice president of patient care services, says staff will be mobilized from across all areas of a facility in a comprehensive effort to rapidly locate a patient. She says that would include doctors, nurses, security, maintenance and housekeeping workers. There would be an announcement made with a description of the missing patient broadcast throughout the facility. She says local police would be notified. This new procedure is being implemented following the recent death of an elderly patient who was missing from Montefiore Hospital. Rose Lee Diggs, who suffered from dementia, was found dead on the hospital's roof earlier this month after wandering away from her room.

Lorenz says "Condition L" will be utilized first at UPMC Presbyterian and then put in place throughout the UPMC system. UPMC wants to have photos taken of patients who are identified as at-risk when they are first admitted to help in the identification process. Those patients would also be given special hospital gowns to make them easier to spot if they leave a unit. Lorenz says UPMC is also evaluating the use of trained search dogs to help locate missing patients.