Hospitals

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How Hospitals Could Step in to Help Manage GP Practices

The supply of doctors in primary care, known as 'GPs' in the UK, is falling behind a growing demand for their services, as GPs leave general practice in large numbers. One way to help struggling GP practices could be vertical integration—combining health care organizations operating at different stages along the patient pathway.

Manbinder Sidhu, Jon Sussex

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COVID Could Surge Anywhere. This Tool Helps Hospitals Prepare

The number of new coronavirus cases is growing in most states. As the pandemic continues to strain U.S. health care systems, a tool developed by RAND researchers can help hospitals prepare for the worst.

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Implement Critical Care Surge Strategies Now to Save Lives

As COVID-19 continues to spread, hospitals are bracing for a surge of patients requiring critical care. To meet the demand, U.S. health care facilities may need to fundamentally change the way they allocate space, staff, and equipment.

Mahshid Abir, Kaitlyn Entel, et al.

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Hospital Prices, Border Solutions, Sri Lanka: RAND Weekly Recap

This weekly recap focuses on hospital prices, common-sense solutions to the border crisis, myths about the Sri Lanka attacks, and more.

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Cryptocurrency, Russian Social Media, Congestion Pricing: RAND Weekly Recap

This weekly recap focuses on cryptocurrencies, Russian social media influence, congestion pricing, and more.

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On Nurse Staffing Ballot Measure, Massachusetts Voters Should Look to Evidence from California

Massachusetts residents will soon vote on the Patient Safety Act, a mandate to increase nurse-to-patient ratios in acute care facilities. Evaluating existing data on the impact of a similar nurse staffing law implemented in California in 2004 may help inform voters as they head to the polls.

Mahshid Abir, Jason E. Goldstick, et al.

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Personalized Hospital Ratings: Transparency for the Internet Age

Each annual release of hospital ratings captivates journalists, hospital leaders, and health care consumers in the United States. These ratings aggregate many measures into a single score for each hospital. But why should the opinions of report creators hold sway, if the intent is to inform patient choice? Why not ask patients instead?

Juliet Rumball-Smith, Jill Gurvey, et al.

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Community Hospitals: A Traditional Solution to Help Today's NHS?

Community hospitals could be better integrated into the current healthcare system in England and can play an important role in the middle of the patient journey between home and hospital. If done correctly, community hospitals could be a traditional solution to help address some of the modern day challenges of the NHS.

Emma Pitchforth, Edwin van Teijlingen, et al.

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Ransomware Hackers Are Coming for Your Health Records

Cyber criminals may be preying on hospitals because cyber protection measures likely have not kept pace with electronic data collection and because hospitals typically do not have backup systems and databases in place, even though such attacks can strain health care systems and potentially put patients' lives at risk.

Lillian Ablon, Mark W. Friedberg

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Electronic Health Records: Yesterday's Ebola and Today's Zika

Electronic health records in U.S. hospitals are not yet prompting for screening questions related to Zika virus. Why? The existing system is too slow to respond and when it does, it finds itself chasing the past.

Shira H. Fischer @ShiraFischer

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Saving Lives After Tragedy

Natural and man-made mass-casualty incidents are a growing threat. Evaluating successes and shortcomings after each crisis can contribute to the design and implementation of robust and resilient response systems and ensure the best possible outcomes for individuals and impacted communities.

Mahshid Abir, Christopher Nelson

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How Can Regulation Improve Quality of Care in the English Health Care System?

Inspections have become more prominent in England's approach to health service regulation as a way to identify problems before they occur. But the evidence of regulation contributing to better quality of care in different systems is scarce.

Christian Van Stolk

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A Tale of Two Deliveries, or an Out-of-Network Problem

Two mothers gave birth within weeks of each other, at the same hospital, using the same employer-sponsored insurance. Both had an epidural. But one received a surprise physician bill for anesthesiology, while the other didn't have to pay a dime. Why?

Erin Audrey Taylor, Layla Parast

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Paying for Pricey Medications: Debt Financing Options Could Provide a Solution

A new approach may be needed to finance an emerging breed of expensive but highly effective pharmaceuticals and vaccines. The health care industry could learn from other industry approaches such as equipment leases or supplier-financed credit.

Soeren Mattke

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The Winding Path to Effective Bundled Payment

It's not unusual for a demonstration to fall short of its original objectives. Learning from such cases is part of the innovation process. This is especially worthwhile for bundled payment, which has many potential benefits for patients, providers, and payers.

M. Susan Ridgely, Peter S. Hussey

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Are County Masking Requirements the Future of Influenza Prevention?

If it doesn't seem that state laws as currently written can help increase the number of health care workers vaccinated against influenza, then what can? There is evidence that imposing consequences for vaccination refusal, including the requirement to wear a surgical mask, can help.

Dmitry Khodyakov, Lori Uscher-Pines, et al.

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Saving Grady: Reflections on Kate Neuhausen's Narrative Matters Essay

It was widely assumed that Atlanta's Grady Memorial Hospital would be the next storied public hospital close its doors, but at its darkest hour, it received help from an unexpected quarter, says Art Kellermann.

Arthur L. Kellermann

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Lessons from Boston

Boston's health care providers reacted the way they did because they knew what they were supposed to do. Those who did not were smart enough to follow the lead of those who did. That's how a “ritualized” disaster plan works.

Arthur L. Kellermann, Kobi Peleg

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Paul O'Neill to President Obama: We Can Use the Internet to Address Medical Errors

Former Treasury Secretary Paul H. O'Neill, a RAND Trustee and Health Advisory Board member, published an open letter to President Obama in the Pittsburgh Post-Gazette this week in which he asks the president to use his executive power to address the problem of medical errors.

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Generation Ex

The problem is that on any given day, disaster preparedness takes a back seat to ongoing operations. The tyranny of the urgent prevents hospital administrators from making investments in preparedness, writes Art Kellermann.

Arthur L. Kellermann

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Multiple Patient Safety Events in Hospitals

A patient safety event is any event or action that could lead to a worse outcome for a patient, from bedsores to post-operative respiratory failure.

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Using Patient Surveys to Rate Hospitals

Hospitals that perform better on the survey tend to do better on clinical measures, have fewer readmissions within 30 days and have lower risk-adjusted mortality, write Marc Elliott and Alan Zaslavsky.

Marc N. Elliott, Alan M. Zaslavsky

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Provider Consolidation Key Factor in Affordable Coverage

Hospitals operating with little competition are able to charge health plans much higher prices, which are passed on to consumers in the form of higher insurance premiums, writes Glenn Melnick.

Glenn Melnick