Part A)

This week we're going to be looking at the issuance of guidelines as a group effort and probing into one of two hospital compare websites as surveys and data are driving change in policy because the questions asked of patients after their stay in the hospital are about nurses. You'll have to go to your individual groups to see what guideline your group is assigned to research and what questions have already been answered for the second part (if any). In addition to guidelines which are created by different groups and implemented these recommendations with policy, here are the instructions for your own data investigation into hospital comparisons.

Data, data and more data. Is it any good?

I want you to explore either of the websites presented.

The Government's website Hospital Compare is based on a hospital receiving Medicare funds. This link will take you to the homepage. http://www.medicare.gov/hospitalcompare/search.html

The other website is a bit more mixed. I'm finding the safety grade is quite current just released 10/31/ 2017 and based on multiple data points whereas the voluntary submission reports are from 2016 and not every hospital has submitted. So check out this site to compare hospitals http://www.leapfroggroup.org/ratings-reports

It's a bit overwhelming with what information you can find on both sites.

I want you each to investigate an aspect of the surveys and numbers to be found within the pages, but it's complicated to make you do so individually, fairly, and equitably. Some of you don't work in the hospital. Some of you may work at the same one so how/ what do I ask you to delve into that will also interest you to make you learn new information? I can give you free choice and just hope that your postings will be appropriate and beneficial instead of just busy work. I'll prescribe just a bit.

So it's your choice of which hospital you investigate. Whether you work there, whether you had your children there (or were born there yourself), it doesn't matter.

Compare the numbers provided by the hospital to the national and state numbers also provided if you're on the Medicare Hospital compare. If you've chosen the leapfrog website, compare the selected hospital to another in the area.

Analyze by comparing the numbers on 3 points of interest/ shock/ curiosity. Share the numbers and your thoughts. Why did you pick each one?

Here’s an example:

Category	Hospital	State Average	US Average
Interest	99%/ 65%	95%/ 87%	93%/ 88%
Shock	Not available	94%	95%
Curiosity	Greater than National Average payment	NA	$16,190

The hospital I’m reviewing is Seton Medical Center in Austin- a Magnet facility since 2000. My first interest was preventive care. The first % is for the # of patients vaccinated against influenza vs. the second # is for staff. Patients are well vaccinated above the State of Texas and national averages, however the staff number is MUCH lower.

The shock I got was investigating Timely care for suspected MI. The number of patients receiving an aspirin within 24 hours was too low. This is shocking to me as I worked on the telemetry floor which at the time had 64 beds and has since expanded. How can the numbers be too low to report?

Finally, I was curious about the new hospital in Austin associated with the new medical school that my tax dollars funded. This brand new facility that has robots getting the warmed blankets for the patients only has received an overall 2 star rating. Anyway, I also wanted to see the payments for heart failure patients so back at Seton, they do charge more than the national average for heart failure, but it doesn’t say how much more. At least their death rate for HF patients was no greater than the national rate at 11.9%.

PART B)

I want your group to investigate guidelines on the use of antibiotics for acute respiratory tract infections.

The actual guidelines are available through a web search. If you have any problems locating them, please contact me through course messages.

Here's a link to an article announcing the recommendations.

https://www.acponline.org/acp-newsroom/acp-and-cdc-issue-advice-for-prescribing-antibiotics-for-acute-respiratory-tract-infections-in

Everyone answers these next 3 questions

1. How do you learn about the latest evidence-based practice that impacts your practice or knowledge of status quo?
2. Do these guidelines affect your current practice? Elaborate
3. How would you recommend to your patients/ families/ colleagues/ community to implement the guidelines? (i.e. Convince them that the virus making them miserable won't be treated with antibiotics.