People & Progress

Can a hospital improve outcomes and its bottom line simultaneously? Yes. But sometimes it requires putting up some cash first.

We asked that question in the context of PCI, where technological and procedural advances have paved the way for better outcomes and efficiencies. Interventional cardiologists now have tools for identifying high-risk patients and applying treatment strategies that reduce complications. Patients who experience complications such as bleeding remain in the hospital longer. They need more resources, and even when they don’t need them, they may receive them in the form of unnecessary tests and consults.

Better devices and medications also have helped shorten hospital stays to the point that an uncomplicated PCI patient with proper support at home may be discharged within eight hours. This is efficiency at its best, since it is good for the patient and frees up resources for the sickest patients.

Hospitals may nonetheless balk. These efficiencies require infrastructure and staffing. Until recently, Medicare reimbursement policy made same-day and shorter-stay PCIs a less attractive option, financially. The Two Midnight Rule may change that.

Those who have invested in same-day PCI programs probably have found a return on the investment not only in open beds but also more satisfied patients and staff. Heart failure units may want to take note.

We also are taking a look at nurse staffing and hospital readmissions. Heart failure, one of the conditions in Medicare’s cross hairs for readmission penalties, has a challenging patient population. Research points to lower readmission rates for hospitals with nurses who are adequately trained and staffed.  

To provide good and efficient patient care, hospitals need quality staff. That is a cost, but one that seems well worth the cash.

On another note, we are ushering in 2014 with a new look. We are implementing a cover redesign to better reflect our commitment to top business standards and to complement Radiology Business Journal. Our new sister publication has joined us this month. Please let us know what you think.