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Nowadays, review sites for hospitals and healthcare providers are everywhere. To make themselves stand out from the pack, and to promote transparency, some hospitals have created their own review process, allowing patients to rate their doctors through the facility’s website.
While hospitals don’t usually have reviews of their doctors on their websites, the number of facilities that offer this feature is steadily growing.
The latest hospital to start posting its own doctors’ ratings online is North Shore LIJ Health System, based in New York.
According to a Wall Street Journal article about the hospital’s new ratings system, other hospitals that provide reviews about their doctors include Cleveland Clinic, Wake Forest Baptist Health and University of Utah Health Care.
Hospitals who add a ratings section to their site tend to make the move not only to increase transparency, but to provide patients with more credible ratings than those on other sites, such as Yelp and Healthgrades.
Patients can only rate a doctor at North Shore LIJ if they’ve recently visited the hospital. Other review sites don’t ask for that level of authentication, so their reviews may not be genuine.
In addition, North-Shore LIJ’s site only shows a rating for a provider in one of two scenarios:
- the doctor opts in to the rating system, or
- at least 30 patients have provided ratings for a doctor.
The hospital goes to great lengths to ensure the reviews on its website are as balanced as possible. Doctors are given detailed scorecards showing how they rank among patients. They have the right to appeal any online comments they don’t find fair, and the hospital won’t publish any comments or reviews with vulgar language.
Future picture for hospital reviews
Experts quoted in the WSJ article predict that more hospitals will start providing their own ratings system for doctors and providers, especially since so many other organizations are publishing ratings about hospital care already. What better way to counter negative reviews on other sites than to publish your own patients’ positive experiences straight on your website?
Plus, since patients have such easy access to third-party rating sites and other info about hospital quality via the Internet, it only makes sense for hospitals to put their own rating systems in the mix.
Hospitals that want to create their own online review system need to establish posting and ratings guidelines to keep inaccurate reviews from skewing ratings. It’s a good idea to take a page from North Shore LIJ and have patients verify that they recently stayed in the hospital.
Facilities must also take steps to provide patients with the most unbiased reviews possible, being careful not to automatically flag every less-than-glowing review for deletion. Honest, verifiable opinions should be presented to patients – positive or negative.
In order to meet the demands of the changing healthcare environment, hospital management will need to evolve to support frontline workers.
Since its implementation, the Affordable Care Act has significantly changed the standards providers must meet, particularly in the area of patient-centered care.
However, old management models may not be sufficient to meet these new requirements.
Switch to ‘bottom-up’ management
For example, in a recent article for the Health Affairs Blog, John Toussaint, CEO of the ThedaCare Center for Healthcare Value, believes hospitals must adjust management in order to thrive in the new healthcare environment.
Rather than rely on the traditional “top-down” management style most organizations have used, Toussant believes leaders should switch to a management by process model which empowers frontline clinicians and staff.
Toussant and Thedacare suggest a management framework which includes several important factors:
Applying the Plan-Do-Study-Act cycle
This refers to a scientific problem solving method designed to create solutions for day-to-day issues quickly.
For example, Toussant points to a Minnesota health system where frontline nurses and providers have daily morning huddles to identify and solve problems. Recently, the organization used the method to address delays from missing equipment, creating taped-off areas in supply rooms for equipment, which then serve as visual cues to restock equipment if a worker sees the taped area is empty.
Using ‘model cells’
A model cell is any area where care is redesigned, usually to streamline operations. Creating a model cell may create new duties for staff and leaders.
As Toussant noted, the Palo Alto Medical foundation recently used this method to improve care and reduce costs. The facility created a model cell at one of its clinics, and performed tasks like opening up previously private offices, developing dyads between doctors and assistants, and implementing daily morning huddles, all of which drastically improved care and patient experience at the clinic.
Creating ‘Lean’ management
This management style is designed to identify inefficiencies in healthcare settings, and focuses on continued improvement through small, incremental changes to processes.
This includes creating visual management boards that highlight key performance metrics for a department to strive for, and encouraging staff to propose possible improvements. Additionally, lean managers train staff to identify and solve problems, as well as how to map care processes to evaluate which steps may be improved or don’t provide value to the patient.
Toussant also suggests that organizations make sure roles, responsibilities and competencies for managers are clearly defined and standardized when possible.
As the quality of care and patient satisfaction continue to be priorities in the new healthcare landscape, hospital leaders will have to spend more time considering strategies like these to empower the frontline workers responsible for positive outcomes and good patient experiences, or risk struggling to keep up with the rest of the industry.
Nowadays, most hospitals place a high priority on improving patient satisfaction. Happier patients translate to happier customers who tell two friends and so on. But there’s one patient population who may not be happy with their hospital stays unless you’ve altered your facility recently – obese patients.
If you haven’t made any physical accommodations to your facility yet, you’re going to need to soon. It’s a trend right now with hospitals. More and more are altering their patient rooms, buying new equipment, even building new wings to better accommodate this important patient population.
A 2014 survey of hospitals nationwide by Novation LLC, found a quarter of respondents had made renovations to accommodate morbidly obese patients in the past year.
It’s clear why, when you face the facts that more than one-third (35.7%) of adults are considered to be obese and 6.3% have extreme obesity, according to The National Institute of Diabetes and Digestive and Kidney Diseases.
Often morbidly obese patients will put off going to the doctor and getting certain health tests because of their weight, so when your facility gets them, they’re much sicker. And they need special equipment like larger and sturdier beds and wheelchairs, special heavy duty lifts, longer needles for drawing blood, larger pressure cuffs, special imaging equipment, bigger operating tables, etc.
5 changes worth making
Altering your facility isn’t cheap – specialized equipment comes with higher price tag – but it’ll pay off in the long run. And you don’t have to fix every room, but you should alter a few rooms on every floor/specialty area.
Here are five things from ConscienHealth you can do to make obese patients easier to treat, more comfortable with their stay and safer:
- Make doorways in patient rooms and bathrooms wider to accommodate wider beds, walkers and wheelchairs.
- Replace toilets with larger, sturdier ones that can safely hold excessive weight.
- Purchase beds and furniture that are specifically designed to accommodate morbidly obese patients.
- Acquire lifts made to safely move and transfer morbidly obese patients. Not only will they keep your patients safe, they will help protect your staff from injuring themselves.
- Purchase proper diagnostic equipment that can accommodate excessive weight such as scales, larger blood pressure cuffs, CT scanner, etc. There’s nothing more humiliating than taking obese patients down to the loading dock to get weighed (which has been done) because you don’t have a scale to accommodate them.
Making these changes is a necessity now that hospital see morbidly obese patients routinely.
St. Joseph’s Hospital in Tampa, FL, on average treats patients who weigh more than 400 lbs. once a week. However, while patients who weigh more than 600 lbs are a rarity, the facility’s still prepared to treat them.
When St. Joseph’s unveiled its new emergency room, what stood out was its treatment room for obese patients that included a larger bed, floor-mounted toilets and scales, and a lift that can hoist a person weighing almost 1,000 lbs.
When Parkland Hospital in Dallas, was remodeled, it was done with the obese patient population in mind.
“The bariatric population” – typically defined as patients having a body mass index of 40 or higher – “wasn’t an afterthought,” said Kathy Harper, vice president of clinical coordination, new campus construction, at Parkland, in a New York Times article. “They’re a very special population. We thought a lot about their needs and how to accommodate them.”
Now, each one of the 862 single-patient rooms in the new 17-story tower can accommodate obese patients.
“Most hospitals we are building are providing an increasingly larger percentage of rooms that can accommodate the larger person,” said Nancy Connolly, a senior executive at Hammes Company, a hospital consulting group, in the same article. “In the last five to 10 years, maybe two rooms could accommodate them. Now, 15% to 20% of rooms can accommodate them.”
It wasn’t just obese patients Parkland Hospital kept in mind for its redesign. It also thought about obese visitors. Chairs in each room can hold a 400-lb person, and the love seats in each room unfold into visitors’ beds that can support 750 lbs.
Not unrelated to the dream of quitting a 9-5 job to work from home, a strong education in affiliate marketing is something many bloggers place on a pedestal.
But in today’s era of online training, the noise can take away from core concepts we need to grasp before churning dollars out of webpages.
So if you’re just starting out, this webpage is a good place to start your journey.
Below are 10 cornerstone concepts in affiliate marketing interrelated and explained with a few other healthy snippets of advice too.
If you think I missed a core concept or term, please explain it in the comments!
Affiliate marketing concepts, definitions and relationships
- Backlink – “the guest post contained two backlinks to her website, one in the post and one in the bio” An incoming or outgoing hyperlink connection from one website to another webpage or vise versa. You ideally want high ranking websites to create backlinks pointing to your content in order to rank that content higher in Google Search Engine Results Pages (SERPs). Backlinks and popularity often hold reciprocal meanings.
- Clicks – “his affiliate link received 14 clicks on Wednesday but no conversions” The physical and deliberate action a user takes to visit your link or advertisement. More clicks will often result in more actions, and thus more commissions.
- Actions – “as clicks increased on her advert, so did customer actions” The decision a user makes based on your review and content to make a monetary purchase on some 3rd party website. Tracked alongside clicks.
- Conversions – “persuasive copy – as well as clearly explaining problems and solutions – can result in increased conversions”
“writing longer content increased conversions”
“changing the color of the buttons decreased sign up conversions by 25%”A conversion is a desirable form of action for any affiliate marketer. It often refers to the complete process of taking a user from reader to follower to potential buyer to buyer. Affiliate websites may convert via any number of online marketing strategies and content styles – what works should be unique to you.
- Commission – “she reached 100 commissions for the month of May and bought a new television” The dollar value paid to you per action, which can be tracked to your efforts. Commissions are often counted in real time and paid out at the end of the month. Commissions may be increased in amount or amount-per-action based on increased performance.
- Payout – “payouts are made at a $ 100 threshold on the first of the month” A set time period window during which the 3rd party company pays you as their affiliate and other affiliates too, who have eligible commissions. Often monthly.
- Disclosure – “content may be penalized if there is no clear affiliate disclosure” An FTC mandated statement you write letting your readers know you stand to receive a commission from a 3rd party company. Could often be any appropriate means of letting readers know there is a material connection between you and a firm which the reader should be aware of and factor into their decisions to buy or not buy.
- Referral – “after 1 year in the industry, she discovered a new stream of referral traffic” A new customer you send to a 3rd party firm. Referrals are commonly sent via tracking links and coupons which are unique to the affiliate marketer.
- Tracking – “he loved the old tracking system, but the new system let him better understand the results” The process your affiliate network or 3rd party firm uses to understand your performance each month. You login to see your statistics and other numbers, all of which are likely subject to tracking.
- SERP – “a jump from #3 to #2 in the SERPs resulted in a 4% increase in click thru rate” A Search Engine Results Page. This term is often misunderstood to mean a more complex aspect of SEO, however a SERP is simply a list of results returned by a search engine like Google in response to a keyword query. Such results often consist of 10 or more blurbs containing titles and short descriptions, linked to the original piece of content. A unique piece of content you create can only appear in several SERPs for various, related keyword queries. It would also be possible for two pieces of unique content to be returned by a search engine like Google in one single SERP. The knowledge of how to “beat” SERPs by rising higher in them is how affiliate marketers gain more visibility for their content – thus SERP ranking is a heavily important variable in any affiliate marketing strategy.
But oh, there are more! Please note that explanations may vary source to source and it is wise to consult many sources to gain a well-rounded understanding!
Got questions on how this all works? Need to drop off your burning advice?
Hit up the comments and thanks for reading!
The post Discover These 10 Concepts Before You Start Affiliate Marketing appeared first on Dear Blogger.
Now that data breaches are becoming so common among providers, hospital leaders have to learn from the mistakes of others if they want to protect their own systems.
This is especially important since hackers and cyberattacks are now the leading cause of data breaches in health care.
Finding out where others skimped on security can help hospitals create more effective protection for their own systems and patients’ protected health information (PHI).
And two recent breaches at government offices give providers good insight on steps their own facilities need to be taking.
Lessons from the OPM
Recently, the Office of Personnel Management (OPM) experienced a breach due to a cyberattack and a lack of security provisions. The attack exposed the information of 4 million federal employees, and the event is being linked to similar attacks on Anthem and Premera.
Now, a new report commissioned by Congress and performed by the Institute for Critical Infrastructure Technology, highlights some of the areas where the OPM’s security fell short, as HealthITSecurity reports.
For example, Parham Eftekhari, co-founder of the institute, points out that the OPM didn’t have a multi-layered security system in place. This lets organizations defend against outside intruders, and gives them a better chance to discover attacks before PHI is exposed if a hacker is able to infiltrate the system.
He also noted that the agency lacked a solid cybersecurity strategy in place, particularly to govern data and access credentials. According to Eftekhari, the OPM should have had policies in place to address regularly changing passwords, and manage and disable employee accounts when a worker leaves the organization.
The OPM needed wider use of encryption to protect data. For example, Eftekhari recommends facilities consider using split-key encryption, where half of the access keys go to the organization and the other half stays with the vendor, in addition to typical device encryption.
The report highlights that, regardless of an organizations’ size and access to resources, certain security precautions must be implemented. These steps are especially important as hospitals continue to implement new health IT and expand the number of locations where PHI is accessed and stored.
Keeping up with security maintenance
A Colorado State agency also recently experienced a breach due to an IT area which had become outdated.
As Health IT News reports, the Colorado Department of Health Care Policy recently exposed the PHI of nearly 3,000 residents after a technical glitch.
A “very old code” in the agency’s record system exposed a vulnerability, causing a glitch when it was finally updated. That glitch then inadvertently sent out letters with people’s PHI to the wrong households.
Several healthcare facilities have also been penalized for similar breaches, and the cost for these kinds of errors is often steep.
Last year, New York Prsbyterian Hospital and Columbia University Medical Center agreed to settle a similar HIPAA violation for a records setting $ 4.8 million after 7,000 patients’ PHI was accidentally put on Google.
These kinds of incidents highlight the importance of routine system maintenance, such as upgrade and security patch management. However, many health organizations lack the resources to manually oversee this task on top of addressing other security and health IT issues.
In these cases, facilities’ best bet is to consider finding ways or systems that can automate these processes, freeing staff for other projects.
Preventable medical errors are one of the top causes of death in the United States. To help change that, the feds are starting to make hospitals directly responsible for patient outcomes. Some say accountability should go a step further, though, and they’re pushing to have cameras installed in the operating room.
A recent article in the Washington Post discusses this phenomenon. The rise in interest in recording surgeries has been driven in part by technological advances – and partially from family members’ desires for answers after loved ones experienced serious complications.
Mandates for cameras
In the past, states have received pushback from healthcare organizations and hospitals when trying to mandate the use of cameras in surgery. So laws weren’t getting anywhere. Massachusetts has unsuccessfully tried to pass a law requiring hospitals to record surgeries for years.
But now Wisconsin may be the first state to successfully implement a law requiring cameras in operating rooms. The legislation was introduced after the death of a woman who received excessive anesthesia during breast-enhancement surgery. One of her family members co-sponsored the law, and it’s currently before the state legislature.
If this law passes, it could turn the tide for allowing procedures to be recorded in hospitals across the country. Lobbyists in Wisconsin are already testing the waters to see if members of Congress would be willing to sponsor a national bill in the same vein.
As of now, facilities that record procedures (mostly for educational purposes when training medical students) opt for traditional methods, using cameras that pick up video and audio. However, other methods are available that paint a clearer picture of a procedure.
The newest technology: a “black box” created by a Canadian surgeon that simultaneously records patients’ health data and the surgical team’s actions and speech.
Essentially, the black box creates a “play-by-play” rendition of the entire procedure and how it affected the patient. This can help a surgical team pick up errors that wouldn’t even be caught by merely reviewing a video alone.
Two hospital systems in the U.S. will be piloting the black box system in the coming months to evaluate its effectiveness in the operating room.
Considerations with cameras
The biggest question that arises from recording surgeries: How will this affect HIPAA compliance in hospitals?
If hospitals decide to record patients, they’ll have to expressly let patients know they’re being recorded and get their consent before procedures take place. Then, they’ll need to take additional security steps when storing the footage. This raises the potential for a data breach – which can cause big legal hassles.
But the upside is that footage can be airtight proof for other lawsuits – especially malpractice cases. If all surgical procedures are followed, and there’s evidence on camera, this can keep hospitals out of hot water when an angry patient or family sues.
Surgeons may feel as though Big Brother’s watching, but cameras in the operating room could keep them from making careless mistakes – or making unprofessional remarks that could also land a hospital in trouble.
A patient in Virginia won $ 500,000 in a lawsuit because his cell phone inadvertently recorded medical staff saying inappropriate things about him during a colonoscopy – including purposely misdiagnosing his condition. Cameras could stop similar shenanigans from happening in your operating rooms.
Plus, reviewing footage could help surgeons refine their techniques – like athletes, they can use the video and audio recordings to point out deficiencies and create a better strategy for the next procedure. And in case a mistake happens, the footage could be used a training tool to prevent similar issues with future surgeries.
Recording surgeries as a routine practice has numerous benefits and drawbacks. But it has the potential to revolutionize health care by reducing never-events and preventable harm to patients. So don’t be surprised if it becomes common practice (or even a requirement) in the near future.
What do you think of using cameras in the operating room? Is it a good idea, or too risky to be considered? Let us know in the comments.
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Besides the switch to ICD-10, hospitals have another looming deadline to worry about in October. That’s when stricter reporting standards for sepsis recognition and treatment will be enforced by the Centers for Medicare & Medicaid Services (CMS).
Hospitals that participate in the inpatient quality reporting program will be expected to report all instances of the condition to CMS, along with the steps taken to diagnose and treat patients with severe sepsis or septic shock.
With the help of the National Quality Forum (NQF), the agency is adopting a new measure called the Severe Sepsis and Septic Shock Management Bundle.
The measure’s already causing controversy, with some providers noting that it redefines what’s typically considered sepsis or septic shock in a clinical setting, making the condition broader, according to an article in MedPage Today. This may require hospitals to screen more patients for sepsis than they would normally, potentially exposing them to unnecessary treatment.
However, supporters of the new measure have stated, because sepsis is such a deadly condition (killing between 20% and 25% of patients who develop it in the hospital), more thorough screening protocols have the potential to save many lives.
5 steps to fight sepsis
Facilities that want to get a jumpstart on what’ll be expected of them with the updated reporting requirements can look to new guidance designed to reduce negative outcomes from sepsis.
The University of Pittsburgh’s School of Medicine just released a list of best practices hospitals can follow to ensure patients with sepsis are treated as thoroughly as possible, and it was published in a recent issue of the Journal of the American Medical Association.
Using data from several studies conducted about sepsis treatment, University of Pittsburgh researchers developed a general approach based on what’s worked well in clinical trials over the past few years.
Prompt treatment of sepsis is crucial to positive patient outcomes. However, a surprising result from the University of Pittsburgh analysis was that rigorous and aggressive one-size-fits-all sepsis approaches may not be the best bet.
While there are general best practices providers should follow when diagnosing sepsis, individual assessment and treatment choices still need to be made on a case-by-case basis for each patient.
The five-step process developed by the University of Pittsburgh researchers will help hospitals administer treatment for sepsis as quickly as possible, while still leaving room for personalized decision making from clinical staff:
- Identify. Clinical staff should identify the presence of a sepsis infection by looking for the accompanying signs of shock, including low urine output, confusion, and cool and clammy skin.
- Administer. Clinicians need to administer antibiotics, IV fluids and blood tests to patients with signs of sepsis as soon as possible to determine how severe the infection’s gotten.
- Ultrasound. The next step is for patients to receive a focused ultrasound. Intravenous catheters should also be placed for fluids and blood pressure monitoring.
- Vasoactive. Patients need to receive vasoactive medications to bring their blood pressure readings back within normal rates.
- Repeat. Providers should repeat assessments of these patients every four to six hours in intensive care.
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