As each year draws to a close the healthcare industry hosts one of the last trade shows on the circuit, a post-Thanksgiving extravaganza in Chicago that prominently features diagnostic imaging equipment and supplies and typically attracts more than 60,000 attendees from around the world. While the Radiological Society of North America’s 2008 outing didn’t disappoint with some of the technology debuts and upgrades, RSNA did seem a bit lighter in traffic even as it expanded to three halls but with fewer exhibitors and more than a dozen or so empty booths. Perhaps the tightening economy played a role in the no-shows.

Still, the thousands of attendees witnessed a continued blurring of the lines between imaging, information technology, oncology and surgery functions. They also were treated to a flurry of new modalities and new spins on current modalities, as well as software improvements stressing flexibility, modularity, portability and above all else, integration.

High-speed computed tomography seemed to give way to high-definition CT with low-dose capabilities, and adding an attached-at-the-hip spouse in the form of positron emission tomography. In fact, the imaging industry continued to push PET without CT to the brink of extinction.

Ultrasound’s ongoing renaissance was seasoned with such new modality concepts as molecular particle imaging, photon counting, proton beam and several women’s imaging breakthroughs. Nanotechnology, as well as simulation or "serious gaming" as researchers dubbed it, new three-dimensional rendering and even creative imaging uses of iPhones turned heads.

For more details, visit HPN Online for an exclusive recap of RSNA 2008.

Technology is often touted as the "cure" for healthcare, but a new Joint Commission Sentinel Event Alert warns that implementation of technology and related devices is not a guarantee for success, and may actually jeopardize the quality and safety of patient care.

The Joint Commission’s Alert urges greater attention to understanding when a technology may (or may not) be applicable, choosing the right technology, understanding the impact technology can have on the quality and safety of patient care and attempting to quickly fix technology when it becomes counterproductive. The Alert makes clear that the overall safety and effectiveness of technology in healthcare ultimately depend on its human users, and that any form of technology can have a negative impact on the quality and safety of care if it is designed or implemented improperly or is misinterpreted.

The Alert notes that there is very little data on the number of errors directly caused by the increasing combined use of health information and devices. In addition to specific recommendations contained in the Alert, The Joint Commission urges healthcare organizations to use its Information Management accreditation standards to improve patient safety while using technology.

The Alert notes that the implementation of technology can threaten care and patient safety when: Clinicians and other staff are not included in the planning process; Providers do not consider the impact of technology on care processes, workflow and safety; Technology is not fixed when it becomes counterproductive; and technology is not updated.

To reduce the risk of errors related to health information and technology, The Joint Commission’s Sentinel Event Alert recommends that healthcare organizations take a series of 13 specific steps.

The full report is available at www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_42.htm

The Association for Healthcare Resource & Materials Management (AHRMM) announced a donation of more than $22,800 to Project Perfect World Foundation (PPWF). Each year, AHRMM hosts a charity golf event at its annual conference and as in the past the money raised went to PPWF, which provides humanitarian medical care for hundreds of children in third world countries.

This year’s donation represents the proceeds of the 12th Annual Charity Golf Tournament in San Antonio, TX in conjunction with AHRMM’s 46th Annual Conference & Exhibition. The majority of the funds were raised from over 17 sponsoring companies including McKesson, the Title Sponsor of the Tournament. AHRMM expressed its gratitude to the many individuals who contributed time and energy to the event, especially the Charity Golf Task Force.

Environmental stewardship can be confusing and costly for hospitals. With goals of reducing the confusion of "going green" and ultimately reducing costs, Novation, the leading healthcare contracting services company, announced today the launch of its first interactive flash tool dedicated to helping member hospitals implement Environmentally Preferable Purchasing (EPP) practices.

The Growing Green tool features a graphical user interface (GUI) in the form of a growing tree with branches representing a staged approach by department and topic area. Members begin the going green process by selecting easy projects or low hanging fruit from the tree and then work upwards into other areas of the hospital to implement more robust EPP practices. The tool also provides information and resources to assist hospitals just beginning to implement their green programs – including templates to assist in assembling internal cross functional teams and outlines of activities and flowcharts to assist in garnering internal support.

In the last decade, more than 60,000 patients in the United States were asked to get tested for hepatitis B virus (HBV) and hepatitis C virus (HCV) because healthcare personnel in settings outside hospitals failed to follow basic infection control practices, according to a new study by the CDC. This first full review of all the CDC investigations over the past 10 years of healthcare-associated viral hepatitis outbreaks appears in the January 6th issue of the journal Annals of Internal Medicine.

"This report is a wake-up call," said Dr. John Ward, director of CDC’s Division of Viral Hepatitis. "Thousands of patients are needlessly exposed to viral hepatitis and other preventable diseases in the very places where they should feel protected. No patient should go to their doctor for healthcare only to leave with a life-threatening disease."

In the United States, transmission of HBV and HCV while receiving healthcare has been considered uncommon. However, a review of CDC outbreak information revealed a total of 33 identified outbreaks outside of hospitals in 15 states, during the past decade: 12 in outpatient clinics, six in hemodialysis centers and 15 in long-term care facilities, resulting in 450 people acquiring HBV or HCV infection.

Patients were exposed to these potentially deadly diseases because healthcare personnel failed to follow basic infection control procedures and aseptic technique in injection safety. Reuse of syringes and blood-contamination of medications, equipment and devices were identified as common factors in these outbreaks.

CDC officials say the report shows the need for ongoing professional education for healthcare providers, as well as consistent state oversight in detecting and preventing the transmission of bloodborne pathogens in healthcare settings. For more information on preventing viral hepatitis in healthcare settings, visit www.cdc.gov/hepatitis/Populations/
HealthcareSettings.htm

HHS intends to update the plan in response to public input and new recommendations for infection prevention. The plan, and instructions for submitting comments on the plan, can be found online at www.hhs.gov/ophs.

The theme of this year’s annual conference is Mapping the Future. The conference will be held July 19 - 22, 2009, at the Tampa Convention Center, Tampa, FL. In keeping with this year’s theme AHRMM hopes to help you get ready to chart the course through these ever-changing economic times. Now more than ever, as a supply chain professional you can take the lead and show your organization how to implement creative ideas that save significant dollars, and map the future.

At AHRMM09, you will be able to receive information on current healthcare supply chain trends, issues and best practices. Learn lessons from experts in the healthcare and materials management field and network with colleagues from around the world. Also, view the latest marketplace solutions in AHRMM’s ever-expanding exhibition. Registration is available at www.ahrmm.org.

ECRI Institute, an independent, nonprofit organization that researches the best approaches to improving patient care, has issued a high priority medical device alert for several older models of infant radiant warmers. ECRI Institute recommends the removal from service of a series of warmer models manufactured by Borning and Hill-Rom. Draeger purchased the product line from Hill-Rom in 2004 but did not sell any units, which were last made in 1998. The complete findings and recommendations are posted for free public access on ECRI Institute’s Web site in its Patient Safety Center.

These recommendations are based, in part, on ECRI Institute’s involvement in the investigation of a hospital nursery fire that resulted in burn injuries to an eleven-hour-old infant receiving oxygen. Full access to the high priority alert, "Infant Radiant Warmer Fire Prompts ECRI Institute Recommendations for Replacement," is available for free at http://www.ecri.org/
PatientSafety/Pages/default.aspx.

Iahcsmm has redesigned their website giving it a new, fresh, bold look and incorporated new additions to better serve our membership. The site www.iahcsmm.org now has many interactive features, where the control is in the hands of the membership! Information about the Association and your membership will be readily available when you need it most.

In their new section titled "How May we Help You?" you’ll notice someone new. It’s the new IAHCSMM mascot. At present he (she?) remains without a name! Look for future news regarding this little character. There is a contest to name it and the lucky winner will receive a waiver of registration fee for the 2009 Annual Meeting in Orlando!

New quick and easy ways are now provided to find pertinent information about local chapters, the IAHCSMM Annual Meeting, and breaking news dealing with the Association. An extensive catalog of educational materials is provided, giving detailed descriptions for each of their publications and associated costs. A download section provides instant access to exam applications, forms used during the re-certification process, plus many other useful documents often requested to be mailed.

Tthe 44th IAHCSMM Annual Meeting is May 2-6, 2009, at the Wyndham Resort in Orlando, FL. Join hundreds of CS/SPD professionals gathered for hands-on instrument workshops, discussion groups, expert-led speaker sessions and interactive vendor exhibits. Educational programs will tackle the latest challenges in CS. They’ll include technical updates for sterile processing and offer insight into creating successful departments and teams.

Strategic Marketplace Initiative (SMI) now has thirty-two industry provider members that have announced their support to work with trading partners to implement the GS1 US Healthcare data standards by the publicly announced sunrise dates.

The standards body GS1 US Healthcare announced sunrise dates for data standards adoption are: Adoption of the Global Location Number standard (GLN) for standardized account/location identification and eliminate custom account numbers by December 2010; Adoption of the Global Trade Item Number (GTIN) for standardized product identification by December 2012.

SMI’S provider and supplier members have been at the forefront of the healthcare supply chain industry’s data standards movement, by fostering early adopter workgroups, assuming leadership positions with GS1 US Healthcare, educating members and the industry, piloting processes, and encouraging others to join the effort.

For the list of SMI industry provider members supporting the adoption
of the standards by the sunrise dates, visit the website at www.smisupplychain.com.

New test helps doctors determine appropriate antibiotic use
 

Growth in national health expenditures (NHE) in the United States is expected to significantly outpace economic growth in 2008 and 2009 due to the recession, according to a report issued by the Centers for Medicare & Medicaid Services (CMS).

In 2008, growth in national health expenditures is expected to be 6.1 percent, as health spending increases from $2.2 trillion in 2007 to $2.4 trillion in 2008, while growth in the economy, as measured by the gross domestic product (GDP) is anticipated to be 3.5 percent. For 2009, health spending is projected to increase 5.5 percent while GDP is expected to decrease 0.2 percent. The health share of GDP is expected to increase from 16.2 percent in 2007 to 16.6 percent in 2008 and to 17.6 percent in 2009. This represents about one-third of the total increase in the health share of GDP for 2008 through 2018.

Over the projection period, average annual spending growth by public payers (7.2 percent) is expected to outpace that of private payers (5.3 percent).

Hospital spending growth is expected to edge downward from 7.3 percent in 2007 to 7.2 percent in 2008, and then decelerate further in 2009 to 5.7 percent. Driving the expected deceleration in hospital spending growth is projected slowing growth in use associated with the recession and projected slower income growth. In addition, hospital price growth is expected to decelerate to the slowest rates since 2000 (2.9 percent in 2008 and 2.6 percent in 2009), also associated with the effects of the recession.

Prescription drug spending growth is projected to slow to 3.5 percent in 2008, down from 4.9 percent in 2007, as many consumers fill fewer prescriptions or become more willing to switch to lower-cost generic drugs. Prescription drugs are projected to be the fastest growing component of Medicare’s spending over the projection period, increasing from 10.9 percent in 2007 to 14.7 percent by 2018.

Physician and clinical services spending is expected to grow 6.2 percent in 2008, compared with the 6.5 percent growth experienced in 2007. In 2009, physician and clinical spending is projected to grow at 6 percent.

Medicare spending growth is projected to accelerate from 6.2 percent in 2011 to 8.6 percent by 2018. Medicaid spending growth is expected to slow from 9.6 percent in 2009 to 7.8 percent in 2012 due to projected improving economic conditions. However, as the relatively expensive aged and disabled eligibility groups comprise a larger share of total Medicaid enrollment through 2018, spending growth is expected to accelerate to 8.9 percent by the end of the coming decade.

The healthcare spending projection data can be found at www.cms.hhs.gov/NationalHealthExpendData/
03_NationalHealthAccountsProjected.asp.

The American Society for Healthcare Environmental Services (ASHES) announced the introduction of two new educational programs. ASHES developed a Certified Healthcare Environmental Services Professional (CHESP) study group for those interested in pursuing the certification and a supervisor course targeting the development of critical skills for department supervisors or new managers.

The supervisory course is a ten week program that covers areas such as: environmental sanitation, microbiology, management and distribution of work, customer service, quality assurance and provides program participants the opportunity to collaborate, interact and complete a targeted final project. Each week includes reading assignments, discussion opportunities and a project at the end of the course.

The CHESP study group is a six week program where CHESP candidates or potential candidates will collaborate, interact, review material and ultimately help each other prepare for the exam.

The CHESP study group is available for members of ASHES at $99.00. The non- member price is $135.00. The supervisor course is available for ASHES members at $189.00. The non-members price is $239.00. Both programs will be offered a limited amount of times in 2009. For courses syllabus, starting dates, and to register visit www.ashes.org or call 312-422-3860.

Baptist Medical Center’s laboratory in Jackksonville, FL, is among the first in the United States to provide a new test to help physicians rapidly diagnose sepsis.

The FDA approved the Procalcitonin (PCT) test last year, and Baptist Medical Center started offering it in October. An important goal of the test is to prevent patients from acquiring infections while they are in the hospital.The PCT is used to help determine: Which ICU patients might be at risk for severe sepsis; When a patient’s fever is due to a bacterial infection; and when antibiotic therapy is most appropriate.

Dennis Quaid opens HIMSS with medication errors reality talk

The FDA announced that manufacturers of 25 types of medical devices marketed prior to 1976 must submit safety and effectiveness information to the agency so that it may evaluate the risk level for each device type. Devices found by the FDA to be of high risk to consumers will be required to undergo the agency’s most stringent premarket review process.

These 25 device types, which are listed in the Federal Register announcement, were marketed in the U.S. prior to the Medical Device Amendments to the Food, Drug, and Cosmetic Act of 1976. That law authorized the FDA to review new medical devices. This announcement is the first step towards completing the review of Class III device types predating the 1976 law, as was recommended by the U.S. Government Accountability Office (GAO) in a January 2009 report to Congress.

The FDA classifies medical devices into three categories according to their level of risk. Class III devices represent the highest level of risk and generally require a showing of safety and effectiveness before they may be marketed. Class III devices include heart valves and intraocular lenses. After Congress enacted the medical device law in 1976, the FDA classified these 25 devices types into Class III (premarket approval). Under the law, these devices were not immediately required to undergo the premarket approval process. The law required the FDA to issue a rule subjecting the devices to that requirement. Until that time, new devices within those device types have been cleared through the premarket notification process, in which the agency determines whether they are substantially equivalent to legally marketed devices not requiring premarket approval. Devices that present a new intended use or include new technology that presents new questions of safety or effectiveness may not be found substantially equivalent and require premarket approval.

Manufacturers of the 25 remaining device types must submit the requested information within 120 days. The FDA will review the submitted data and, based on the risk level, issue regulations for each device type that either will require manufacturers to submit premarket approval applications or will re-classify the devices into Class I or Class II.

Federal Register notice:
http://edocket.access.gpo.gov/2009/pdf/E9-8022.pdf

FDA release:
http://www.fda.gov/bbs/topics/NEWS/2009/NEW0 1990.html

The Association for Professionals in Infection Control and Epidemiology (APIC) is proud to support Stand for Quality, a diverse coalition of more than 165 healthcare organizations who recently announced a plan to improve the quality and affordability of healthcare for all patients through a public-private partnership (www.standforquality.org).

Since 2006, APIC has been promoting a Targeting Zero philosophy — the viewpoint that every healthcare institution should be working toward a goal of zero HAIs. While not all HAIs are preventable, APIC believes that all organizations should strive for zero infections.

Actor Dennis Quaid focused on his recent experience with medication errors at HIMSS. Quaid was the featured keynote speaker Sunday, April 5th. Speaking to a packed ballroom Quaid told his emotional story about medication errors that almost killed his twin babies at Cedars Sinai Hospital. His story unfolded after his twins were diagnosed with an infection after their birth and their doctor put them in the hospital on IV antibiotics.

When changing the IV solution, the nurse in charge gave the twins 10,000 USP of Heparin instead of 10 USP Hep-Loc. A group of nurses the following morning made the same error.

Quaid blames the manufacturer on not differentiating the bottles and labels which were almost identical. He also blamed the fact that it got past the pharmacy, and nurse double check systems. He says what is needed is a "hospital technological backup" that would protect from human factors that could cause errors in the event that human checklists were ignored.

Quaid and his wife Kimberly have started the Quaid Foundation to reduce medical errors. Since the errors occurred at Cedars, the hospital has adopted barcoding, special pharmaceutical cabinets and other safety measures. HIMSS has donated $10,000 to their foundation to help facilitate safety measures.

Quaid ended his talk by saying that the next step for healthcare should be to make all of these systems interoperable and that systems must be user friendly. He stated that "we have to make barcoding, CPOE and electronic record keeping common in all hospitals".

IAHCSCMM announces award winners at annual conference

Healthcare quality is suboptimal and continues to improve
at a slow pace

Pandemic flu resources available on AHRMM website
 

IAHCSCMM announces award winners at annual conference

Award for Dedicated Service, Recipient: Richard Schule, CRCST, CHMMC, FCS, CST, MBA, BS

New President 2009-2011, Incoming President: Lisa Huber, CRCST, ACE, FCS, BA

Ruth Anne Brooks, RN Past Presidents, $1000 check, Receipient: Aaron Cloward, CRCST, Primary Children’s Medical Center, Salt Lake City, UT

Leonard Leipus / Brenda Sexton Award of Honor, Recipient: Sue Klacik, CRCST, CHL, ACE, FCS, St. Elizabeth Health Center, Youngstown, OH

Peggy Ryan, RN Technician Achievement, $1000 check, Recipient: Paula Vandiver, CRCST, CIS, Anderson Hospital, Maryville, IL

C.S. Supervisor / Manager of the Year Award, $1000 check, Recipient: John Best, CRCST, Southview Hospital, Dayton, OH

Golden Slipper Award for Service Excellence, $500 check, Recipient: Debbie Guerrero, CRCST, Long Beach Memorial Medical Center, Long Beach, CA

Anne Cofiell "Decontaminator" of the Year, Recipient: Clifford Gaines, CRCST,
Walter Reed Army Medical Center, Washington, DC

William B. Dennis Humanitarian, $500 check, Recipient: Crown Irwin Prince, CRCST, Hospital for Special Surgery, Brooklyn, NY

IAHCSMM / Purdue University Scholarship Awards: Central Service Technical Training Correspondence, Sandesh S. Kabare, Hinduja Hospital and Research Centre, Mumbai, India; Supervisions Principles Training Correspondence, Rudy Serrato, CRCST, CIS, Mission Hospital Regional Medical Center, Mission Viejo, CA

STERIS Chapter of the Year Awards, $1500 checks, Large Chapter: Central Indiana Chapter; Small Chapter: Pennsylvania Keystone State Association of Sterile Processing

Acknowledgement for Exceptional Service and Dedication to the Profession, Charles Hughes, General Manager, SPS Medical

Healthcare quality is suboptimal and continues to improve
at a slow pace

For the past 6 years, the National Health Quality Report (NHQR) has summarized the state of healthcare quality. This undertaking is difficult, as no single national healthcare quality survey collects a standard set of data elements from the same defined population for the same period each year.

Despite these limitations, the report finds that healthcare quality in America is suboptimal. Receipt of needed healthcare varies widely. While patients hospitalized with a heart attack receive 95% of recommended services, only 15% of patients on dialysis are registered on a kidney transplant waiting list. Across the core report measures tracked in the NHQR, the median level of receipt of needed care was 59%. We can and should do better.

NHQR presents an annual rate of change in quality, which represents how quickly the quality of services delivered by the healthcare system is improving or declining based on the report’s core measures. Based on these core report measures, quality of care continues to improve at a slow pace.

Overall, despite promising improvement in select areas, the healthcare system is not achieving the more substantial strides needed to close the gap or "quality chasm" that persists. Despite efforts to transform the U.S. healthcare system to focus on effective preventive and chronic illness care, it continues to perform better when delivering diagnostic, therapeutic, or rehabilitative care in response to acute medical problems.

It is evident that more attention devoted to patient safety is needed to reverse this apparent trend and to help ensure that healthcare does not result in avoidable patient harm. Systems for identifying and learning from patient safety events need to be improved. Many factors, such as concerns about sharing data confidentially across facilities or State lines, limit the ability to aggregate data in sufficient numbers to rapidly identify important risks and hazards in the delivery of patient care. More work is also needed to develop measures that capture the underlying processes and conditions that lead to adverse events and the practices that are most effective in mitigating them. Visit www.ahrq.gov/qual/qrdr08.htm for the report.

Pandemic flu resources available on AHRMM website

AHRMM has created an online library for Supply Chain related Pandemic Flu Resources. This collection of resources will make it easier for you to find the latest information and updates, including slides of AHRMM’s Webinar – Pandemic Flu Preparedness and Update. AHRMM will be adding to the library on a continuous basis. If you would like to contribute any additional resources to the collection please email the information to ahrmm@aha.org. For flu resources: See AHRMM pandemic resources at www.ahrmm.org.

Unsung heroes of healthcare reform? $36 billion in annual savings linked to "GPOs"

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Unsung heroes of healthcare reform? $36 billion in annual savings linked to "GPOs"

When President Barack Obama and Congress weigh healthcare reform options to rein in runaway medical costs, they should take a close look at the work of "group purchasing organizations" (GPOs), which already are achieving over $36 billion in annual healthcare and related costs savings in the United States, according to a new study of 429 hospitals and over three million hospital admissions by Dr. Eugene S. Schneller, principal Health Care Sector Advances, Inc. and professor at the Arizona State University School of Health Management and Policy.

Titled, "The Value of Group Purchasing 2009: Meeting the Needs for Strategic Savings," the new Health Care Sector Advances report by Dr. Schneller with data collection by Mathematica Research, Inc. finds the following results from GPOs as part of the $36 billion in projected direct price savings: $6.8 billion for hospital pharmaceuticals; $8.5 billion for medical/surgical purchases; $1.9 billion in attributed savings in the $10.4 billion cardiology implant marketplace (either directly or indirectly by providing members with GPO purchased goods or reference pricing from directly engaging the marketplace); and $840 million in attributed savings in the $7 billion dollar orthopedic implant marketplace (either directly or indirectly by providing members with GPO reference pricing for directly engaging the market).

Other savings arising from the work of GPOs include over $1.8 billion in reduced hospital purchasing costs by eliminating the need for hospitals to comprehensively carry out strategic sourcing, contracting and other key GPO activities for inpatient pharmacy, general medical products, orthopedic products, other clinical products and housekeeping products.

The study makes it clear that there are further potential savings that could be achieved through wider use of Group Purchasing Organizations. According to the new report, over half of U.S. hospitals and systems use GPO pricing as the benchmark for starting their own negotiations for physician preference items – the most expensive items that they purchase. Similarly, over half report the desire to improve GPO contract penetration.

"Though largely invisible to the healthcare consuming public, GPOs are key players in healthcare reform. They literally save the country tens of billions of dollars annually through the power of aggregated purchasing volume and negotiated discounts with manufacturers, distributors and vendors," said Dr. Schneller.

The Health Care Sector Advances survey and report conducted by Dr. Schneller was carried out with financial support from the Health Industry Group Purchasing Association (HIGPA). Visit www.GPOsSaveMoney.org

As the healthcare industry continues to move toward eBusiness as the status quo and data standardization efforts gain momentum, providers can gain from the experiences of early adopters. A new book titled, eBusiness in Healthcare: From eProcurement to Supply Chain Management describes the evolution of eBusiness as a driver of efficiency and process improvement in healthcare.

Edited by Ursula Hübner, PhD, The John Hopkins University School of Nursing Baltimore, and Marc A. Elmhorst, trinovis GMbh, Hanover, Germany, with contributions from Karen Conway, corporate communications, GHX, Richard Perrin, AdvanTech Inc., and other experts, this book from the Health Informatics Series, provides a detailed background of eBusiness, and discusses the unique challenges and opportunities for the supply chain model of eBusiness in healthcare.

Beyond automating transactions from order to invoice, eBusiness enables "standardization of procurement in terms of processes and goods, greater contract compliance, and finally, business analysis based on recent accurate data," noted the authors.

Case studies from healthcare institutions and suppliers in the US, the UK and Germany help illustrate achievements, barriers and future plans regarding eBusiness experiences.

eBusiness has moved from a "nice to have" to a "must have" situation, commented the authors, "with the consequence that those who don’t have it will be out of the game." Because eBusiness involves not only hardware and software upgrades but also organizational and process changes that may take years to achieve, "the idea of jumping on the bandwagon once the eBusiness train has gained enough speed might sound clever at first glance, but it is short-sighted with regard to the point in time when the benefits of eBusiness methods can materialize."

Joint Commission offers seasonal flu immunization strategies
 

The Joint Commission has been in discussion with multiple professional and trade organizations in regards to the common and proper use of sterilization using steam. Recently, some decisions have been made which will have an impact on the interpretation of standards as well as the survey process.

In reviewing this method of sterilization, several issues have emerged including:

The terminology used to describe the sterilization process. Flash sterilization is the most common term used to describe certain types of steam sterilization that do not utilize a full (also known as terminal) cycle. Originally, this term meant sterilizing unwrapped instruments using steam for 3 minutes, at 270°F at 27 to 28 lbs of pressure.

Over the last several decades, a number of improvements have been made to this process, such as longer exposure of the instruments to steam, the use of special trays and packs to hold and protect the instruments, and the routine use of biological indicators.

Indication-related issues that involve the selection of the sterilization cycle or method. Previously, the selection of a sterilization cycle or method was a primary focus during a survey. Now surveyors will be looking more closely into all aspects of the sterilization method or cycle. Examples of findings would be a high percentage of steam sterilization using less than a full sterilization cycle, as well as exclusive use of this process for certain types of instruments.

Process-related issues involving the way that a given sterilization method is executed. Examples of findings would be failure to adequately clean the instruments before sterilization, lack of chemical indicators, and transporting uncovered instruments back to the operating room after they have been sterilized.

Based on discussions with experts in the field, professional organizations, and government organizations, The Joint Commission has decided to refocus its survey efforts on all of the critical processes included in sterilization. If a complete and effective process of sterilization is used, it will be considered an effective sterilization method. Therefore, surveyors will review the critical steps of disinfection and sterilization to determine if the process is appropriate.

In summary, Joint Commission surveyors will focus on all of the critical steps and the integrity of the sterilization process.

Surveyors will, among other activities:

• Observe instruments from the time they leave one operating room to when they are returned to the next.

• Ask healthcare workers to provide the manufacturers’ instructions for instrument sterilization, and to describe and demonstrate how instruments are being cleaned and decontaminated according to those written instructions.

• Observe the cleaning of instruments.

• Verify that staff members are wearing appropriate personal protective equipment.

• Observe the sterilization process. The surveyor will ask for the manufacturer’s instructions for the following items: the sterilizer, wrapping or packing, and the instruments.

• Review sterilization logs. Surveyors will ask about parametric, chemical and biological indicators.

• Observe the return of instruments to the sterile field and verify that they are being protected from recontamination.

For the CDC/HICPAC guideline visit www.jointcommission.org/Library/WhatsNew/steam_sterilization.htm

New ratings for hospitals now available on CMS Hospital Compare website

Important new information was recently added to the Centers for Medicare & Medicaid Services’ (CMS) Hospital Compare website that reports how frequently patients return to a hospital after being discharged, a possible indicator of how well the facility did the first time around. The site is www.hospitalcompare.hhs.gov.

On average, 1 in 5 Medicare beneficiaries who are discharged from a hospital today will re-enter the hospital within a month. Reducing the rate of hospital readmissions to improve quality and achieve savings are key components of President Obama’s healthcare reform agenda.

With the update, Hospital Compare will provide better data on the posted mortality rates for individual hospitals, as well as the new data on 30-day readmissions for heart attack, heart failure, and pneumonia. Previously, Hospital Compare had provided only mortality rates for these three conditions.

Research has shown that hospital readmissions are reducing the quality of healthcare while increasing hospital costs. Hospital Compare data show that for patients admitted to a hospital for heart attack treatment, 19.9 percent of them will return to the hospital within 30 days, 24.5 percent of patients admitted for heart failure will return to the hospital within 30 days, and 18.2 percent of patients admitted for pneumonia will return to the hospital within 30 days.

Using a three-year data method for mortality measures, CMS estimates that the national 30-day mortality rate for patients originally admitted for heart attack care is 16.6 percent. For heart failure patients, the national 30-day mortality rate is 11.1 percent, and for pneumonia patients the national rate is 11.5 percent.

The Hospital Compare website will show a hospital’s mortality or readmissions rate is "Better than," "No different from," or "Worse than" the U.S. national rate. This data information includes each hospital’s risk-standardized mortality rate (RSMR), an estimate of the rate’s certainty (also known as the interval estimate), and the number of eligible cases for each hospital.

The proportion of U.S. adults who are obese increased to 26.1 percent in 2008 compared to 25.6 percent in 2007. The data come from CDC’s Behavioral Risk Factor Surveillance System (BRFSS), a state-based phone survey that collects health information from adults aged 18 and over.

In six states – Alabama, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia – adult obesity prevalence was 30 percent or more. Thirty-two states, including those six, had obesity prevalence of 25 percent or more. Only one state, Colorado, had a prevalence of obesity less than 20 percent. But no state showed a significant decrease in obesity prevalence from 2007 to 2008. A person is considered obese if they have a BMI of 30 or above.

The 2008 BRFSS obesity data indicate that none of the 50 states or the District of Columbia has achieved the Healthy People 2010 goal of reducing obesity prevalence to 15 percent or less. For more information visit: www.cdc.gov/obesity/data/trends.html.

Seasonal influenza in healthcare workers is a personal health threat, but also poses a significant risk to the patients in their care. In an effort to help healthcare organizations improve the rate of healthcare worker influenza vaccinations, The Joint Commission is releasing a monograph "Providing a Safer Environment for Health Care Personnel and Patients Through Influenza Vaccination: Strategies from Research and Practice."

The monograph is the result of the project Strategies for Implementing Successful Influenza Immunization Programs for Health Care Personnel, a 10-month collaboration between The Joint Commission, the Association for Professionals in Infection Control and Epidemiology Inc. (APIC), the Centers for Disease Control and Prevention (CDC), the Society for Healthcare Epidemiology of America (SHEA), and the National Foundation for Infectious Diseases (NFID).

The monograph includes information about seasonal influenza and the influenza vaccine, barriers to successful programs and strategies for overcoming them, and examples of successful initiatives organizations have used to improve their influenza vaccination rates. It also incorporates evidence-based guidelines and published literature to highlight practical strategies and the tools submitted by healthcare organizations. Copies of the monograph are available at www.jointcommission.org, and can be downloaded free of charge.

CDC released two new important preparedness and response tools on its website

Radio Frequency Identification (RFID) HIBC for Product Identification has been given final approval by the American National Standards Institute (ANSI). Also known as ANSI/HIBC 4.0, the new standard was developed by the Health Industry Business Communications Council (HIBCC), an accredited global standards development organization that was founded in 1983 to promote patient safety by creating industry-supported non-proprietary standards for healthcare product identification.

The RFID standard was already in early development phases when in June, 2008; the Journal of the American Medical Association (JAMA) published the results of a study of electromagnetic interference (EMI) with medical equipment and devices in critical care environments from RFID technologies. The study concluded that ultra high frequency (UHF) from RFID and UHF interfered with medical devices in 63% of the tests conducted.

"Since we first published our initial position paper on RFID in 2007, HIBCC has consistently warned that the UHF implementations proposed by non-healthcare standards organizations and some RFID product vendors could create problems in hospitals," said Robert Hankin, PhD., president of HIBCC. "Our position is that the use of generic retail identification standards in medical care settings poses unnecessary risks and the JAMA reported RFID study confirmed our position by indicating that there can be serious consequences from RFID in critical care environments. Our newly approved standard can now serve as a roadmap for safer implementation," said Hankin.

In ANSI/HIBC 4.0, HIBCC recommends that 13.56 Mhz High Frequency (HF) be adopted for healthcare item level tagging specifically because its smaller read range is less likely to result in EMI with medical devices. To read more about ANSI/HIBC 4.0 RFID HIBC for Product Identification, visit http://www.hibcc.org/RFID.htm

AHRMM10 conference call for presentations

AHRMM’s Annual Conference & Exhibition is asking for you to share your valuable expertise with your peers. Potential speakers are invited to submit educational session proposals for presentation at AHRMM10 in Denver, Colorado, August, 1-4, 2010. Focusing on current trends and industry news, this conference is the premier event for materials management professionals to turn to for education and networking while they are "Transforming the Future" of the healthcare supply chain.

AHRMM invites you to submit a proposal for consideration to present an educational session at the conference. The deadline for presentation proposals is October 16, 2009.

Applications are accepted for presentations in the following tracks: Distribution, Finance, Technology Solutions, Purchasing, Strategic Planning, Clinical Resource Management, Professional Development. This is an outstanding opportunity to be an industry leader and help transform the future of the profession. Submit your proposal for consideration at http://www.softconference.com/subs/ahrmm/2010/default.asp?log=1

The Centers for Medicare & Medicaid Services (CMS) announced that acute care hospitals will receive an inflation update in their payment rates of 2.1 percent in fiscal year 2010. Earlier this year, CMS had proposed to reduce payments to account for the effect of increases in aggregate payments due to changes in hospital coding practices that do not reflect increases in patient’s severity of illness.

The update was included in a final rule making policy changes and setting payment rates for inpatient services in general acute care hospitals paid under the Inpatient Prospective Payment System (IPPS), as well as long-term care hospitals (LTCHs), paid under the LTCH PPS. The changes will be effective beginning with discharges on or after Oct. 1, 2009.

The final rule also provides for an inflation update of 2.5 percent to payment rates for inpatient services furnished by long-term care hospitals (LTCHs). These hospitals typically treat patients requiring long-stay hospital-level care. To qualify for the higher payment rates under the LTCH PPS, the hospital’s average length of stay, taking into account all patients, must be greater than 25 days. The LTCH update is calculated using a special rate of inflation index that reflects the different mix of resources used by rehabilitation, psychiatric, and long-term care hospitals.

The final rule was placed on display at the Federal Register, and can be found under Special Filings at: www.archives.gov/federal-register/public-inspection/index.html.

Applications for the Robert "Bob" Majors Memorial Scholarship are now being accepted by Novation, the supply contracting company of VHA Inc., University HealthSystem Consortium (UHC) and Provista, LLC. The $2,500 scholarship competition is open to materials managers in healthcare from July 20 through September 22, 2009. Two recipients - one VHA member organization and one UHC member – will be selected and can use the award to cover costs associated with attending and participating in a 2010 materials management-related conference or leadership education opportunity.

Founded in 2007, the Bob Majors Memorial Scholarship is named in honor of Bob Majors, a leading materials management thought-leader at Bloomington Hospital in Indiana, who passed away in January 2007. To be considered for the scholarship, eligible members of VHA or UHC must complete an online application, available at www.novationco.com, and meet the established criteria. Former award winners are not eligible.

Applicants must: Be a permanent full-time employee at a VHA or UHC member facility, work in materials management, have at least one year of experience in current position, and complete a questionnaire detailing how they feel they exhibit Major’s leadership characteristics. Submit application by September 22, 2009.

MedCon:Pre-Event - designed to estimate the baseline medical care requirements (i.e., the number of persons that would require medical care) of a displaced population following a disaster due to pre-existing medical conditions. Users of MedCon:PreEvent should note that it has not been designed for estimating the medical care requirements due to direct impact of the event (e.g., injuries and illness) or additional medical care requirements resulting from the aggravation of the existing medical condition. The intended users of the MedCon:Pre-Event model are public health preparedness planners at local, state, and federal levels involved in addressing the large scale medical care requirements resulting from man-made and natural disasters. To download the tool visit http://emergency.cdc.gov/planning/medcon/

VacStockpile - designed to help planners and policy makers evaluate the potential health and cost impacts of stockpile decisions for each type of pediatric vaccine for an array of scenarios regarding possible vaccine shortages. The consequences of a vaccine shortage evaluated include potential doses of vaccine shortage, replenishment costs to replace stockpile doses that are used for shortages or discarded because of expiry of shelf life, and a number of potential health consequences (e.g., number of cases, hospitalizations and deaths) that may occur under various vaccine shortage scenarios. Although VacStockpile has been designed for use in the United States, it can be applied to other situations or locations where vaccine stockpiles are being maintained or considered. To download the tool visit http://emergency.cdc.gov/stockpile/vacstockpile/

MEDICA 2009 entrance passes available now

Novation, the healthcare contracting services company of VHA Inc., University HealthSystem Consortium (UHC) and Provista, LLC, announced the winners of its annual Standardization Program Awards. The award program has two categories, The Participation Leader Award and The Executive Savings Award. Each award category recognizes a specific achievement through Novation’s Standardization Program. This year, Novation honored 151 member hospitals for their participation in the Novation Standardization Program. In 2008, 130 member hospitals were honored.

The Participation Leader Award recognizes those participating institutions that have successfully implemented all 9 of Novation’s Standardization Program offerings. There were 81 members who received the award. The Executive Savings Award recognizes those members who have cumulatively saved over $250,000 in rebates. By maximizing standardization opportunities, members increase the amount of rebates they receive through the Novation Standardization Program. There were 65 members that were recognized with the Executive Savings Award. For more information on Novation, visit www.novationco.com.

The Association for Healthcare Resource & Materials Management (AHRMM) is pleased to announce the newly launched healthcare supply chain lexicon. AHRMM’s Lexicon, an alphabetical arrangement of words, terms, and their definitions as used in the supply chain, is a searchable online database containing terms developed by Supply Chain Visions and used by the Council of Supply Chain Management Professionals (CSCMP) as well as several key healthcare-specific terms.

Users will be able to suggest modifications or new terms through a comment box on the AHRMM website. To utilize this new resource, visit www.ahrmm.org/lexicon.

Teaming up with top hospitals and health systems across the country to use new methods to find the causes of and put a stop to dangerous and potentially deadly breakdowns in patient care, The Joint Commission is launching the Center for Transforming Healthcare. The Center’s first initiative is tackling hand washing failures that contribute to healthcare-associated infections.

Eight leading hospitals and health systems volunteered to address hand washing failures as a critical patient safety problem–one that requires fixes far more complex than just putting up signs urging caregivers to wash their hands.

Recognizing that there is no quick fix, the participating hospitals set out to solve the problems—soap or alcohol-based hand rubs that are not convenient for caregivers to use, faulty data that lull facilities into thinking hand washing is occurring more frequently than it is, and lack of individual accountability—by using Robust Process Improvement tools. The front-line work of the hospitals shows that random observation is not enough.

In fact, the eight hospitals, using the Center’s measurement methods consistently, found on average that caregivers washed their hands less than 50 percent of the time. The targeted solutions from the Center now being tested include holding everyone accountable and responsible – doctors, nurses, food service staff, housekeepers, chaplains, technicians, therapists; using a reliable method to measure performance; communicate frequently and use real time performance feedback; and tailor education in proper hand hygiene for specific disciplines. For more information on the Center for Transforming Healthcare, visit www.centerfortransforminghealthcare.org

Entrance passes and show directories for MEDICA 2009, International Trade Fair with Congress- 40 Years World Forum for Medicine, can now be ordered from Messe Düsseldorf North America in advance of the show at reduced rates: $19.60 each for a one-day entrance pass, $70 each for a four-day entrance pass and $28 each for a show directory.

The MEDICA 2009 entrance pass also permits attendees entry to the concurrently held COMPAMED 2009 trade fair (high tech solutions for medical technology). MEDICA 2009 will take place from November 18 - 21, 2009 at the fairgrounds in Düsseldorf, Germany.

The MEDICA 2009 visitor, exhibitor and press entrance passes can be used as a free public transportation ticket on all buses, streetcars, underground trams (U-Bahn), urban railways (S-Bahn) and German rail service within the Rhine-Ruhr regional network (VRR) of Düsseldorf and the Rhein-Sieg transportation network (VRS). To order, visit their website www.mdna.com.

New tools help emergency planners select alternate care facilities during disasters
 

The U.S. Food and Drug Administration announced that it has commissioned the Institute of Medicine (IOM) to study the premarket notification program used to review and clear certain medical devices marketed in the United States. The IOM study will examine the premarket notification program, also called the 510(k) process, for medical devices. While the IOM study is underway, the FDA’s Center for Devices and Radiological Health (CDRH) will convene its own internal working group to evaluate and improve the consistency of FDA decision making in the 510(k) process.

The 510(k) process was established under the Medical Device Amendments of 1976 with two goals: make safe and effective devices available to consumers and promote innovation in the medical device industry.

During the past three decades, technology and the medical device industry have changed dramatically, making it an appropriate time for CDRH to review the adequacy of the premarket notification program in meeting these two goals.

As part of the study, the IOM will convene a committee to answer two principal questions: Does the current 510(k) process optimally protect patients and promote innovation in support of public health? If not, what legislative, regulatory, or administrative changes are recommended to achieve the goals of the 510(k) process?

The $1.3 million IOM review is slated for completion in 2011.The IOM will hold two public workshops during the next nine months as part of its review, and will publish a final report in March 2011. www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm183497

The Association for Healthcare Resource & Materials Management (AHRMM) has announced the winners of its 2010 Board of Directors elections. Newly elected officials include: President-Elect William Stitt, CMRP, FAHRMM; Region 2 Representative John Brede, CMRP; Region 7 Representative Edward Lewis, CMRP; and Region 8 Representative Michael Hildebrandt, CMRP. The new board representatives will begin their terms on January 1, 2010.

President-Elect Stitt is Corporate Director of Materials Management for University Community Health, a five-hospital IDN located in Tampa, FL, and brings more than 18 years of materials management experience to the AHRMM Board of Directors. Stitt has been a member of AHRMM for more than nine years, and has served as the Region 5 National Board Representative, Chair of the Publications and President-Elect Criteria Task Forces, and currently serves on the Membership Committee and Chapter Relations Committee. In his capacity as AHRMM president-elect, Stitt’s responsibilities include serving on both the AHRMM Executive and Nominating Committees, developing the Association’s strategic plan and budget, and in the absence of the president, assuming the duties of that office.

The new regional representatives, Brede, Lewis, and Hildebrandt are responsible for advocating for their constituents by conveying regional issues to the Board as well as carrying out the mission of the organization. In Region 2, Brede is the Director of Materials Management, Southern Ocean County Hospital in Manahawkin, NJ, and brings over 34 years of experience in the resource and materials management field and 11 years of AHRMM membership experience to the board. In Region 7, Lewis is the Assistant Director Supply Chain, Texas Children’s Hospital, in Houston, TX, and brings over 30 years of experience in the resource and materials management field and three years of AHRMM membership experience to the board. In Region 8, Hildebrandt is the Associate Vice President of Supply Chain at Scottsdale Healthcare in Scottsdale, AZ, and brings 33 years of experience in the resource and materials management field and eight years of AHRMM membership experience to the board. For more information visit www.ahrmm.org.

Two interactive computer tools released by HHS’Agency for Healthcare Research and Quality will help emergency planners and responders select and run alternate care facilities during disaster situations. In such instances, hospitals experiencing a surge in seriously ill patients requiring acute care may need to transfer less ill patients efficiently to alternate care sites.

Alternate care facilities are locations that can easily and quickly be equipped to augment or replace health care services when hospitals and other traditional care sites are inoperable or overwhelmed. Potential alternate care sites include college campuses, gymnasiums, schools, community centers, health clubs, convention centers or climate-controlled warehouses.The two tools are available on AHRQ’s website at http://www.ahrq.gov/prep/acfselection/. 

Rutgers University launches RFID Research Center

The Healthcare Information and Management Systems Society (HIMSS) Federal Health Community and the Association for Healthcare Resource & Materials Management (AHRMM) are once again teaming up to share best practices on healthcare supply chain technologies at the HIMSS 2010 Annual Conference.

HIMSS is collaborating with AHRMM with input from the HIMSS Supply Chain Management Special Interest Group to provide an informative, one-day pre-conference symposium on "The Supply Chain without Walls: Actionable Strategies for Evolving Healthcare Informatics and Technology." The progam will take place at the Atlanta Convention Center, Sunday, February 28, 2010, from 8:15-4:30 pm.

This event has been structured to provide information on evolving trends that will require new technologies and processes to ensure the ability to deliver quality patient care at an optimal cost and with optimal efficiency.

This symposium is designed for anyone responsible for developing supply chain strategies to meet the changing needs of healthcare and for those whose work depends on an effective supply chain from the point of manufacture to the point of care. This includes individuals working in materials management, clinical areas, finance and informatics, as well as representatives of supplier organizations, group purchasing organizations and technology companies.

Supply chain optimization is becoming increasingly important, as well as more complex. The battle cry in reform is "meaningful use!" The industry is working to adopt and utilize supply chain standards and enable technology and other supply chain solutions that will improve patient care and lower costs. Add to that, the fact that supply chain professionals are increasingly required to support patient care outside the traditional acute care setting.

This complexity is leading to a "Supply Chain Without Walls." As information and supply chain professionals, you will be sought out as experts to meet the demands on these evolving trends. Are you ready?

The cost for the Supply Chain Symposium is $275. HIMSS is ofering a $100 savings when you register for the full conference and any symposium. This special discount applies to full paid conference registration (Sunday-Thursday) only. The discount will be applied automatically during the registration process. AHRMM members will receive the HIMSS member rates. To register, visit www.himssconference.org/registration/default.aspx

The U.S. Department of Health and Human Services (HHS) issued an interim final rule with request for comments to strengthen its enforcement of the rules promulgated under the Health Insurance Portability and Accountability Act (HIPAA). The Health Information Technology for Economic and Clinical Health (HITECH) Act, which was enacted as part of the American Recovery and Reinvestment Act of 2009, modified the HHS Secretary’s authority to impose civil money penalties for violations occurring after Feb. 18, 2009.

Prior to the HITECH Act, the Secretary could not impose a penalty of more than $100 for each violation or $25,000 for all identical violations of the same provision. A covered healthcare provider, health plan or clearinghouse could also bar the Secretary’s imposition of a civil money penalty by demonstrating that it did not know that it violated the HIPAA rules. Section 13410(d) of the HITECH Act strengthened the civil money penalty scheme by establishing tiered ranges of increasing minimum penalty amounts, with a maximum penalty of $1.5 million for all violations of an identical provision. A covered entity can no longer bar the imposition of a civil money penalty for an unknown violation unless it corrects the violation within 30 days of discovery.

This rulemaking becomes effective on Nov. 30, 2009, and HHS will consider all comments received by Dec. 29, 2009. Additional information about HIPAA and several related rulemakings may be found on OCR’s website: www.hhs.gov/ocr/privacy/.

The Rutgers Center for Innovative Ventures of Emerging Technologies (CIVET), together with RFID TagSource, announce the launch of the new Rutgers University RFID Research Center. The center is located on the Rutgers Busch Campus in Piscataway, NJ.

The newly established Research Center combines laboratory facilities with real world insight into how RFID is being utilized across the globe to provide real business value. This provides the Rutgers community and industry sponsors with the tools required to support research activities that have near term commercial value and host industry seminars and executive forums to support industry RFID initiatives. For more information on CIVET visit www.civet.rutgers.edu.

For more on RFID TagSource see www.rfidtagsource.com.