Tag Archives: Las Vegas

Allen looks at present, future of Nev. transparency

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Writing for the Las Vegas Sun, reporter Marshall Allen put a fitting cap on an award-winning investigative run at the paper with a story rounding up the state’s first steps toward transparency in medical error reporting. Through the lens of former Beth Israel Deaconess chief, transparency pioneer and blogger Paul Levy, Allen demonstrates just how much transparency in Nevada could benefit both hospitals and their patients. It’s potential that was created, in no small part, through the reporting that Allen and Alex Richards have done.

Over the course of the Sun’s two-year investigation, most Las Vegas hospitals refused to discuss patient safety issues. The Nevada Hospital Association has since 2002 lobbied against mandated public reporting of patient harm. But since the Sun’s investigation, and with legislation pending, the association has said it will begin posting patient injury and infection data on its hospital quality website.

Throughout the piece, Allen paints a sunny picture of a more transparent future, and uses examples from Massachusetts to dissolve any reservations readers might have.

Dr. Tejal Gandhi, Partners’ director of patient safety, said at first there was panic over posting on the hospitals’ websites the infections and injuries suffered by patients. People worried there would be a media frenzy or a rise in malpractice lawsuits, she said.

When the information became public, in 2009, The Boston Globe published one story but there was little other reaction, she said.

The hospitals have seen no increase in malpractice lawsuits. But it has brought a new focus on reducing certain infections and injuries, including the formation of task forces and establishment of standardized safety protocols.

Allen, who recently took a job with ProPublica, completed part of this series while on an AHCJ Media Fellowship on Health Performance, supported by the Commonwealth Fund. The series, which was reported with Richards, won a 2010 Award for Excellence in Health Care Journalism, the investigative reporting category in the 2010 Scripps Howard Awards, best in show for the print category of the National Headliner Awards and the 2011 Goldsmith Prize for Investigative Reporting.

Las Vegas Sun caps series by showing solutions

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In the Las Vegas Sun reporter Marshall Allen wraps up his wide-ranging Do No Harm series on hospital quality by showing how Nevada hospitals could be approaching medical errors differently.

lasvegassunHis focus is the Seven Pillars program at the University of Illinois at Chicago, which should be familiar to Covering Health readers. The key to the program is a commitment to admitting errors and discussing them with patients, an approach that improves the patient experience and reduces the risk of malpractice suits.

To cap off the series, the Las Vegas Sun included the thoughts of Allen’s boss, Publisher and Editor Brian Greenspun.

Related

The Chicago chapter of AHCJ recently hosted a discussion about medical errors and transparency, which included David Mayer, M.D., who, with Tim McDonald, M.D., has co-founded an organization dedicated to the prevention of patient harm. Most recently, McDonald and Mayer were awarded a $3 million federal grant to implement and evaluate patient safety efforts on a larger scale. AHCJ members can read about the discussion and listen to Mayer’s comments.

Editor’s note:

Allen completed part of this series while on an AHCJ Media Fellowship on Health Performance, supported by the Commonwealth Fund

Hospital infections on rise in Nev., reporters find

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

lasvegassun

Part two of Marshall Allen and Alex Richards’ Las Vegas Sun hospital investigation series “Do No Harm” takes on hospital-acquired infections. Even though no agency in the state tracks such things, the duo managed to find 2,010 instances of drug-resistant bugs in local hospitals between 2008 and 2009. That number included 647 instances of hospital-acquired MRSA.

In the story, the explain how they overcame industry resistance to dig up the data themselves:

No health agency tracks these cases. In fact, hospitals derailed proposed legislation in 2009 that would have required them to publicly report cases of MRSA in their facilities.

However, hospitals are required by law to submit to the state billing records based on each patient visit. The Sun obtained that information from 1999 to 2009 and analyzed the 2.9 million hospital billing records as part of its two-year investigation, “Do No Harm: Hospital Care in Las Vegas.”

Because of how the records are coded, the Sun was able to identify the number of infections by the two bacteria, and for the years 2008-09 further identify the cases in which the records say the patients acquired the bacteria while hospitalized.

While it’s hard to put their numbers in a national context because of widely varying methods of measurement and reporting, the duo can say that such infections jumped 34 percent from 2008 to 2009. Allen and Richards then establish two facts:

  1. Some institutions have developed ways to keep MRSA and friends under control.
  2. None of those institutions are in Las Vegas, where inspections show that hospitals could be doing a lot more.

Efforts to force Nevada hospitals to disclose MRSA cases withered under heavy industry opposition, though the legislature is now considering a watered-down version that would not public the MRSA rates of specific facilities.

It’s worth noting that the paper has published responses from readers who have plenty of their own hospital horror stories. The website includes their input both in text and through excerpts of some of the voicemails Allen has  received since the first part of the series was published. They are heart wrenching but serve as an excellent example of how reporters can involve readers in a project.

Bariatric patient’s story shows potential savings

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Las Vegas Sun reporter Marshall Allen follows one man’s story to look into the ultimate cost (or savings) of bariatric surgery and discusses why insurance companies don’t always cover the procedure.

The narrative alone makes the story worth reading, and when Allen adds the numbers it draws a particularly compelling picture.

• In the first five months of 2008, taxpayers provided Daswell (who topped out at 380 pounds) with 17 medications for obesity-related health problems at a cost of $8,374.19.

• In the first five months of 2009 (after the surgery), taxpayers provided Daswell with 13 medications for obesity-related health problems, many at reduced dosages, at a cost of $5,106.54.

It’s a simple measure, but shows a savings of $3,267.65 in the five months, a 39 percent reduction in expenses in drugs alone.

Daswell’s surgery cost about $16,000 for the procedure and first year of follow up. If the pharmacy costs were the only savings realized, the expense could be recouped in just over two years. That does not count the costs Medicare would presumably save in doctor visits and medical equipment — he barely uses the sleep apnea machine he once depended on every night. The equation would also have to factor in the long-term chance that Daswell could contribute to the economy by getting a job and going off Medicare disability.

Marshall goes on to say that while Daswell’s case is somewhat exceptional, the results and savings are, for the most part, generalizable to the population at large. Bariatric surgery, Marshall found, usually pays for itself within a few years.

New Vegas center aims to cure Alzheimer’s

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Marshall Allen of the Las Vegas Sun covered the planned opening of Cleveland Clinic Lou Revo Center for Brain Health. When it opens later this year, the center’s 65,000-square-foot building, designed by architect Frank Gehry, will provide space for both researchers and patients in an effort to battle Alzheimer’s disease.

The $100 million facility … looks on the outside like five stories of stacked — and not perfectly aligned — building blocks. It houses 27 patient suites suitable for examinations and interviews, a blood lab, neuroimaging rooms and research labs. The facility will be a one-stop shop with every service necessary for patients with brain disorders and their caregivers.

The center’s research and clinical side will be run by the Cleveland Clinic, a top-ranked national hospital known for research and attention to patient comfort. The Cleveland Clinic is partnering with the Lou Ruvo Brain Institute, giving “both groups the ability to tackle neurological degeneration in a new way.”

Funds for the project were raised by Vegas businessman and philanthropist Larry Ruvo, who became involved in the fight against Alzheimer’s when the disease claimed his father, Lou Ruvo, in 1994. Allen writes that “Ruvo wants to make Las Vegas – which has a dismal reputation for health care – the world leader in dementia and Alzheimer’s clinical care and research.”