'dirty little secret' of low cancer surgery volumes
Seasoned healthcare data junkies may know this dirty little secret in
surgical care: A surprisingly large number of hospitals very rarely perform
some common, elective surgery types. But some analysts said they were
surprised when they realized just how many times extremely low volumes were
reported for 11 types of cancer surgery throughout California's hospitals.
The analysis of more than 300 hospitals from Crescent City to the Tijuana
border revealed that for nine types of common elective cancer surgery,
between 12% and 63% of hospitals that performed one or more types of
procedure performed just one or two of that type in 2014. According to the
report, nearly 700 patients had cancer surgery at a hospital that did just
one or two of that type that year. And thousands had cancer surgery at a
hospital that performed no more than five of the procedures.
These are skill- and team-sensitive surgeries for which there is good
evidence that more procedures also equate to reduced re-admissions, fewer
repeat surgeries, and lower rates of cancer recurrence. Experts agree that
while there is some evidence for volume thresholds for some types of cancer
surgeries - for example, 15 or 20 a year - no hospital should be performing
only one or two.
The statistics didn't get better for hospitals doing between one and five
cancer surgeries in any of the 11 types. The report revealed that between
14% and 75% of the hospitals that performed any of 11 types of cancer
surgery performed the procedure only five times or less.
Report contributor Karl Bilimoria, MD, a surgical oncologist and the
director of surgical outcomes and quality improvement at the Feinberg School
of Medicine at Northwestern University in Chicago, said the California data
show what has long been known to happen in other states.
Bilimoria, who is heavily involved with the ACS's National Surgical Quality
Improvement Program, was asked why hospitals persist in allowing such small
surgical volumes when there is a much greater chance that something can go
wrong; he put some of the blame on referring doctors: "Patients are often
referred within their system, and often follow their doctor's referral
One of the leading proponents of establishing volume thresholds is surgery
researcher John Birkmeyer, MD, a general surgeon and executive vice
president of Dartmouth-Hitchcock in New Hampshire. He has suggested that
volume thresholds should become a criteria for hospital medical executive
committees and their staff privileging oversight.
In May 2015, he and Peter Pronovost of Johns Hopkins and colleagues at the
University of Michigan launched their "take the volume pledge" campaign, in
which 15 hospitals affiliated with those systems would not allow surgeries
unless each surgeon and hospital maintained certain volumes in 10
Visit MedPage Today for the article.
and Vancive Medical Technologies launch new vascular dressings with CHG
BD (Becton, Dickinson and Company) and Vancive Medical Technologies, an
Avery Dennison business, launched a line of transparent vascular dressings
with chlorhexidine gluconate (CHG) antimicrobial preservative that are
designed to enhance patient care and be easy for clinicians to apply and
The new BD ChloraShield dressings, which feature BeneHold CHG, an innovative
adhesive technology from Vancive Medical Technologies, comfortably secure
the dressing to the skin, absorb fluids and protect the site from external
contaminants. The CHG incorporated within the adhesive preserves the
dressing from microbial growth, making them well-suited for catheter
insertion sites. The Infusion Nurses Society recently released guidelines
recommending the use of CHG dressings.
BD ChloraShield dressings are available in a variety of designs including
bordered and non-bordered as well as sizes commonly used for peripheral IVs
Visit BD for more information.
little molecules could help stop both Ebola and cancer
University of Virginia School of Medicine researcher Christopher Stroupe has
his eye on six little molecules that could be the key to new treatments for
both Ebola and cancer.
The molecules, which act together as a single unit known as HOPS, are
essential for Ebola to infect cells and for cancer cells to grow and
survive. As such, they represent a shared weakness â a weakness Stroupe is
seeking to exploit.
To do that, he is creating a new tool to produce a purified form of HOPS
that would facilitate the development of drugs targeting the molecules. By
blocking HOPS in human cells, he hopes, doctors can cut the legs from under
Ebola and cancer.
So what do HOPS actually do? For one thing, the protein molecules play a
critical role in the functioning of the lysosome, an organelle inside cells
that high school biology has long labeled the cellular garbage dump, where
damaged materials were degraded. But Stroupe likens the lysosome more to a
recycling center, where useful materials are repurposed, and that's why
targeting HOPS could be beneficial.
So by targeting HOPS, doctors could deny cancer cells the sustenance they
need, making them more vulnerable to cancer-killing treatments.
The Ebola virus, like all viruses, has evolved to hijack the internal
workings of the cell in order to replicate and infect its host. Ebola takes
a circuitous route as it invades cells, tunneling a path to the lysosome
along the way. To do this, Ebola essentially hitches a ride on HOPS. And so
Stroupe believes that drugs that block the action of HOPS may be not only
powerful anti-cancer agents, but also useful against Ebola.
Visit Medical Express for the report.
issues draft guidance for the coordinated development of antimicrobial drugs
and antimicrobial susceptibility test devices
The Food and Drug Administration has announced the availability of a draft
guidance entitled âCoordinated Development of Antimicrobial Drugs and
Antimicrobial Susceptibility Test Devices.â
This draft guidance is intended to assist drug sponsors and device
manufacturers who are planning to develop new antimicrobial drugs and
antimicrobial susceptibility test (AST) devices and who seek to coordinate
development of these products such that the AST device could be cleared
either at the time of new drug approval or shortly thereafter. This draft
guidance is not final nor is it in effect at this time.
This guidance, when finalized, is intended to assist drug sponsors and
device manufacturers who are planning to develop new antimicrobial drugs and
AST devices and who seek to coordinate development of these products such
that the AST device could be cleared either at the time of new drug approval
or shortly thereafter.
Specifically, the guidance intends to describe the interactions between drug
sponsors and device manufacturers for coordinated development of a new
antimicrobial drug and an AST device; explain the considerations for
submitting separate applications to the Center for Drug Evaluation and
Research (CDER) and the Center for Devices and Radiological Health (CDRH)
when seeking clearance of an AST device coincident with, or soon following,
antimicrobial drug approval; and clarify that the review of the new
antimicrobial drug product and AST device(s) will remain independent, and
that coordinated development does not influence the review timelines for
Visit FDA for the guidance.
U.N. pledges to fight antibiotic resistance in historic agreement
Every year, more than 2 million Americans get sick with antibiotic-resistant
infections, and tens of thousands die as a result, says the Centers for
Disease Control and Prevention. Common diseases, like urinary tract
infections and pneumonia, are becoming harder and harder to treat. And new
superbugs are cropping up - even here in the U.S. - that are resistant to
Doctors have been warning about this problem for decades. But in the past
year or so, another group of researchers has started taking interest in
superbugs: economists. And they quickly realized the problem goes way beyond
recent report from the U.K. government found that antibiotic-resistant
bacteria could cost the world $100 trillion by 2050 if nothing is done about
it. The World Bank predicts drug-resistant infections could damage the
economy as much as - or even more than - the 2008 financial crisis. And
annual global GDP could drop by 1 to 4 percent, the agency says.
On top of that, farmers around the world have come to rely on antibiotics to
raise animals. The drugs make pigs, cows and chickens grow fatter more
quickly - and keeps them healthy in densely packed quarters.
And that's why world leaders are now getting involved. The U.N.'s
declaration requires countries to come up with a two-year a plan to protect
the potency of antibiotics. Countries need to create ways to monitor the use
of antibiotics in medicine and agriculture, start curbing that use and begin
developing new antibiotics that work.
After two years, the U.N.'s secretary-general will assess each country's
plan and check to make sure each is making progress.
Back in 2001, the U.N. made a similar declaration about the HIV pandemic.
And that declaration had a big impact on curbing the spread of HIV around
the world, says Ramanan Laxminarayan, who directs the Center for Disease
Dynamics, Economics & Policy in Washington, D.C.
He says there are a few weaknesses in the U.N.'s new plan on
antibiotic-resistant bacteria. For example, there are no hardcore targets
for reducing antibiotic use by a certain amount in two years.
But he thinks the declaration could have the same impact on fighting
antibiotic-resistant bacteria as the previous one had on fighting HIV. Since
2004, there has been a 45 percent drop in AIDS-related deaths in countries
supported by global HIV campaigns.
Visit NPR for the report.
U.S. food supply poised to get safer as FDA rule takes effect
An estimated 1 in 6 Americans contracts a foodborne illness each year, but
that figure should decline as a result of safety measures that thousands of
food facilities must implement.
The September 19 deadline took effect for large food processors to meet new
prevention-based regulations developed by the U.S. Food and Drug
Administration (FDA), which oversees the safety of roughly 80 percent of the
food supply - nearly everything except meat, poultry, and egg products.
The central element of FDAâs rule - and the law that authorized it, the FDA
Food Safety Modernization Act (FSMA) - establishes that the companies
growing and processing food have an affirmative, legally enforceable
responsibility to take steps to prevent contamination of their products.
Many Americans may assume that these FDA-regulated businesses already had
such an obligation, but in fact, they have not until now.
Under the new national requirements, each facility must develop a food
safety plan that identifies possible points of contamination throughout the
production process, along with steps to mitigate them. Companies also must
monitor the effectiveness of their efforts and, when problems arise, correct
FDA will be able to stop a large processing facility from making or
distributing tainted products if it fails to meet the requirements, before a
single person gets sick. No longer will the agency have to wait to act until
a firmâs unsafe practices cause serious illnesses.
While many larger operations have prevention-based food safety programs in
place, this approach may be new to many midsize and small farms and
facilities. They are receiving more time to ramp up and be ready. Educating
these smaller operations on the FSMA requirements has been, and will
continue to be, a major focus at FDA.
Visit Pew Charitable Trusts for the announcement.
Does your favorite restaurant serve too many antibiotics?
Although you might pay attention to what kind of meat you buy at the grocery
store - organic, grass-fed, cage-free - chances are, you aren't as informed
about the meat that's on the menu at your favorite fast food joint.
collaborative new report ranks the 25 largest US fast food and "fast casual"
restaurant chains on their antibiotics policies and practices. For the
second year in a row, Panera Bread and Chipotle Mexican Grill take top
honors, each receiving an A grade. Sixteen of the 25 chains received a grade
of F, though that's actually an improvement over last year's findings.
The report, called Chain Reaction II, is co-authored by six nonprofit
activist organizations, including the Natural Resources Defense Council,
Consumers Union and Friends of the Earth. It seeks to sound the alarm about
the overuse of antibiotics in poultry and livestock, typically "to help them
survive and make them grow faster in unsanitary, crowded and stressful
This year, in the second annual report, twice the number of restaurant
chains received a passing grade. The authors say this is in large part due
to companies' transition of chicken supplies away from routine use of
SUBWAY jumped from a grade of F all the way up to a B, on account of it
being the only restaurant chain to adopt a new antibiotics policy that
applies to all types of meat it serves, according to the report.
In August, McDonald's USA (Grade: C+) announced completion of its commitment
to only serve chicken not treated with antibiotics important to human
medicine nearly a year ahead of schedule.
While they agree that restaurants are making changes for the better, when it
comes to healthier, more responsible food sourcing, they add that efforts to
date are simply not enough.
Visit CNN for the report.
Deadline reminder for the Jeannie A. Akridge Memorial Scholarship presented
Each year, Healthcare Purchasing News (HPN) will present an
International Association of Healthcare Central Service Materiel Management
(IAHCSMM) member a scholarship that will cover his or her tuition to the
annual conference, including travel expenses up to $1,000.
Jeannie Akridge served as HPNâs Managing Editor for more than a
decade before she succumbed to breast cancer in November 2014 at age 42.
Kristine Russell, HPN Publisher and Executive Editor, and the entire
HPN staff, are proud to continue âThe Jeannie A. Akridge Memorial
Scholarshipâ as a tribute to her.
Akridge actively demonstrated her passion for her editorial work, for her
extensive coverage of CS/SPD topics and for her profound respect for and
appreciation of CS/SPD professionals.
HPN chose IAHCSMM
for the award because of the long-standing partnership between the two
organizations in the area of continuing education and CS/SPD advocacy, which
continues monthly in print and daily online.
yearâs IAHCSMM meeting is May 7-10, 2017, at the Gaylord in Nashville,
is accepting submissions for the award, which includes a short essay by the
candidate explaining why his or her departmentâs efforts to clean and
sterilize instruments makes a difference in the delivery of high-quality and
safe patient care. HPN will announce the winner in early November to
commemorate the anniversary of Akridgeâs passing.
Submissions must be unique to Healthcare Purchasing News.
Last yearâs inaugural winner, Jo M. Wood is currently the Central Processing
Department Compliance & Education Supervisor at Boston Medical Center in
Boston, MA. View her submission
Please send your submissions to email@example.com by
October 3, 2016. Candidates must be available to attend the IAHCSMM meeting
2016 AHE Exchange,
September 25-28, Pittsburgh, PA
Tru-D SmartUVC to attend and exhibit at AHE Exchange 2016
invites attendees to its AHE booth #515 to learn about total room
disinfection and how Tru-D implements seamlessly into hospitalsâ
workflows, saving precious dollars and reducing hospital-acquired
The Association for
the Healthcare Environment (AHE) of the American Hospital Association is
the professional organization of choice for experts responsible for caring
for the patient and resident care environment across all care settings;
including hospitals, long-term care, continuing care retirement
communities and ambulatory care. AHE represents, defines and advances more
than 2,000 professionals working to ensure quality outcomes and healthy
An enhanced cleaning
strategy, Tru-D is brought into a room after the EVS staff cleans using
traditional methods. Tru-D then operates from a single position and
administers a single cycle of UV light, destroying up to 99.9 percent of
harmful pathogens that can remain behind such as C. diff, MRSA,
MERS, VRE, Ebola and many more.
disinfection process, EVS staff are free to complete other tasks such as
cleaning rooms, changing linens or other duties. Taking whatever time is
necessary to provide total room disinfection, including in direct and
shadowed areas, Tru-D alerts the operator when the cycle is complete with
an audio and/or text message that the room has been thoroughly
Aerobiotix enters new market segments in IAQ
Aerobiotix, Inc. is
embarking on an aggressive product expansion plan to introduce five new
product offerings within the next twelve months to address critical needs
in healthcare and whole-home indoor air quality (IAQ) markets.
expanded its home care line of products with the launch of the AeroCure
DNA Dust and Allergy air purifier. Designed to fight home or office dust
and allergens, these units continue Aerobiotixâs standard of high-end IAQ
products manufactured in the USA. This product joins the AeroCure by
Aerobiotix line of high-end home air purification systems, and the Tower
One line of healthcare air disinfection systems used in leading hospitals.
Aerobiotix will be
showcasing its technologies at the 2016 AHE Exchange Conference at booth