www.ohiokepro.com
Vol. 3 No. 3
March 2005
A Letter to Editors
Flu Vaccination is Still
Impor tant
The Hospital Quality Initiative:
Comparing Quality of Care
By Alice Stollenwerk Petrulis, MD, FACP
Medical Director, Ohio KePRO
As we near the end of an atypical flu
season, I find it imperative to remind
seniors that annual vaccination remains
the best available protection against
influenza for people aged 65 years
and older.
Quality healthcare is a high priority for President Bush, the Depar tment of Health
and Human Ser vices (HHS), and the Centers for Medicare & Medicaid Ser vices
(CMS). In November 2001, HHS Secretar y Tommy G. Thompson announced the
Quality Initiative, his commitment to assure quality healthcare for all Americans
through published consumer information coupled with healthcare quality
improvement suppor t through Medicare's Quality Improvement Organizations
(QIOs), including Ohio KePRO in Ohio.
The 2004-2005 flu season began with
a significant and unexpected loss of
available flu vaccine, and I am alarmed
that it stands to end on a dangerous
misinterpretation following a study
published Februar y 14 in the Archives of
Internal Medicine. This study repor ted
that vaccination of the elderly population
against influenza may be less effective
in preventing death among the elderly
than previously assumed, but subsequent
repor ting of the findings has caused
confusion about whether this population
should continue to seek influenza
vaccination.
Numerous studies have shown that
influenza vaccination works, but the
degree to which it works varies from
year to year and can be difficult to
measure. For example, influenza seasons
differ each year in length and severity,
and the health status of individuals
also matters. Nonetheless, people
aged 65 and older are at highest risk
for complications, hospitalizations, and
deaths from influenza.
The authors of the study in no way
imply that the elderly should not
receive influenza vaccine. Rather, the
study concludes that the vaccine may
prevent fewer deaths among the elderly
than previous studies would have
suggested. Therefore, the authors note
that there is room for improvement in
effor ts to prevent flu, and Ohio KePRO
encourages research that strengthens
our ability to do so.
T
he Quality Initiative was launched
nationally in 2002 as the Nursing Home
Quality Initiative (NHQI) and expanded in
2003 with the Home Health Quality Initiative
(HHQI) and the Hospital Quality Initiative
(HQI), set for launch later this spring. These
initiatives are par t of a comprehensive
strategy to improve quality of care in all
healthcare settings and to provide
consumers access to this comparison
information at www.medicare.gov or by
calling 1-800-MEDICARE (1-800-633-4227).
How Can I Use Hospital Quality
Information?
This information tells you about the quality
of cer tain hospital ser vices. It shows how
quality of care can var y between hospitals.
Currently, the quality information relates to
the care given to patients with three serious
medical conditions common in the
Medicare population:
1. heart attack (acute myocardial infarction)
2. hear t failure, and
3. pneumonia
It shows how often the hospitals provide
the type of care considered to be the
standard. Information on other illnesses
and conditions will be added later.
This information can let you see what
treatments are usually given, and how well
the par ticipating hospitals give these
treatments to patients with specific
conditions. This can help you when talking to
your doctor or other healthcare professional
about the care you are getting.
What is Hospital Quality?
Hospital quality means patients get the
right medicine, treatment, or test at the
right time, given the patient's condition. It
is impor tant to know that hospitals var y in
terms of their quality of care.
What you can do about Hospital Quality
Talk to your doctor or other healthcare
provider about hospital quality. Some
hospitals have more experience or better
results treating cer tain conditions or
performing cer tain procedures. Ask your
doctor or healthcare provider which
hospital has the best care and results for
your condition. Ask why he or she uses
that hospital.
Talk to your doctor or healthcare provider
about other patients' experiences with
the hospital. If your doctor shows a
strong preference for a cer tain hospital,
ask why.
Look at the hospital's information on
www.medicare.gov and other Web sites,
and talk to your doctor about any
questions or concerns you have.
Ask family or friends about their hospital
experiences.
Sometimes your hospital choices are
limited by your location, insurance or
medical needs. But if you have a choice,
get as much information as you can to
make it your best choice.
How Hospitals Treat Hear t Attack Patients
Here are some of the best medical
practices for treating a hear t attack. A best
medical practice is a treatment that has
been proven to provide the best results
for most patients. These treatments are
considered an impor tant par t of the
patient's overall care.
Continued
March is National Colorectal Cancer Awareness Month
An Opinion-Editorial from Alice Stollenwerk Petrulis, MD, FACP, Medical Director, Ohio KePRO
I
t is the cancer that nobody wants to
talk about.
Colorectal Cancer cancer of the colon and
rectum is the second leading cause of
cancer deaths in the United States for men
and women combined. I find it tragic that
56,290 people will die this year from a
disease that is so highly preventable. It is
estimated that 30,000 of those 56,290
lives could be saved each year if men and
women would simply get screened.
Alice Stollenwerk Petrulis
March 2005 marks the sixth annual National Colorectal Cancer
Awareness Month. It is a much-needed oppor tunity for Ohioans to
become educated about colorectal cancer and to learn how to
reduce their risk of the disease through a healthy lifestyle and
regular screenings.
Despite the widespread availability of these highly effective screening
tests, adherence to colorectal cancer screening guidelines lags far
behind screening compliance for other cancers, such as breast,
cer vical, and prostate exams. Many men and women are unaware
that once they turn 50, they should be screened yearly. Men and
women who have a personal or family histor y of colorectal cancer
or polyps or a personal histor y of inflammator y bowel disease
should be screened before age 50.
Women with a personal or family histor y of ovarian, endometrial,
or breast cancer should talk with their doctors about screening for
colorectal cancer earlier as well. African Americans are more likely
to get colorectal cancer than any other racial group. African
Americans and Hispanics are also more likely to be diagnosed with
colorectal cancer in advanced stages. As a result, the percentage
of minorities who die of colorectal cancer is higher than for
Caucasians.
Colorectal cancer can be prevented. Because most colorectal
cancer develops from polyps grape-like growths on the lining of
the colon and rectum simple screening methods can detect and
remove polyps before they become cancerous. In addition, when
detected early, colorectal cancer is up to 90% curable.
The Health Care Financing Administration, now the Centers for
Medicare & Medicaid Ser vices (CMS), expanded Medicare coverage
in 1998 to include colorectal cancer screenings, and many commer-
cial health plans also cover the cost of screening. If you are at risk
for colorectal cancer, make an appointment today with your health-
care provider to discuss which of the available procedures is best
for you and how often you should be screened.
The Hospital Quality Initiative... (cont.)
Hospitals should make sure hear t attack patients:
Take aspirin within 24 hours of arriving at the hospital unless
taking aspirin could be harmful (such as if the patient has an
ulcer). Hospitals should also make sure hear t attack patients are
told to continue to take it when they leave the hospital.
Are given a beta blocker (a medicine to treat some hear t
problems) within 24 hours of arriving at the hospital. Hospitals
should also make sure hear t attack patients are prescribed a
beta blocker when they leave the hospital.
Are given an ACE inhibitor (a medicine that treats some hear t
problems) before they leave the hospital.
How Hospitals Treat Hear t Failure Patients
Hospitals should make sure hear t failure patients:
Have their hear ts checked to see how the left chamber is
pumping (left ventricular function assessment).
Are prescribed an ACE inhibitor (a medicine that treats some
hear t problems) when leaving the hospital.
How Hospitals Treat Pneumonia Patients
Hospitals should make sure pneumonia patients:
Have an oxygenation assessment within 24 hours of the
patient's arrival at the hospital to measure oxygen levels in the
patient's blood.
Get an antibiotic, or combination of antibiotics, to treat pneumonia
as soon as possible, unless they are allergic to antibiotics.
Get a pneumonia vaccination, if they have not had one, before
they leave the hospital.
Executive Editor : Suzana C. Iveljic, MBA
Editor : Daniel B. Moss, BSBA
e-mail: dmoss2@ohqio.sdps.org
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Publication No. 4123-OH-009-3/2005. This material was prepared by Ohio KePRO, the Medicare Quality Improvement Organization for Ohio, under contract with the
Centers for Medicare & Medicaid Ser vices (CMS), an agency of the U.S. Depar tment of Health and Human Ser vices. The contents presented do not necessarily
reflect CMS policy. For more information, please call 1-800-MEDICARE (1-800-633-4227), or visit the CMS Web site at www.medicare.gov.
