John S. Hughes
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View article: Complications of Ambulatory Procedures: Prevalence and Hospital Outpatient Department Variation
Complications of Ambulatory Procedures: Prevalence and Hospital Outpatient Department Variation Open
Ambulatory procedures performed electively in hospital outpatient departments are of increasing complexity and constitute a growing share of total procedure volume. Despite their importance, little is known of the prevalence of complicatio…
View article: Model Based Definition – Recommendations for Supply Chain Integration
Model Based Definition – Recommendations for Supply Chain Integration Open
Model-Based Definition is a term that is gaining more recognition and use by manufacturers across various industries. MBD models are 3D CAD models that contain all the necessary information to produce a part, including information that wou…
View article: Supply Chain Network Design in Connected-oriented Business: How Does Supply Chain Function?
Supply Chain Network Design in Connected-oriented Business: How Does Supply Chain Function? Open
In the upcoming connected-oriented business society, the flexible Supply Chain Network (SCN) design with capability to managing highly fragmented organization, and, the cost structure optimization in value chain finance, risk mitigation ov…
View article: DNR Orders Known at the Time of Admission Can Improve Hospital Mortality Ratings
DNR Orders Known at the Time of Admission Can Improve Hospital Mortality Ratings Open
Research Objective The Center for Medicare and Medicaid Services (CMS) publishes measures of risk‐adjusted hospital mortality rates that are meant to guide consumers and to contribute to Value‐Based Payment (VBP) quality ratings used to re…
View article: Problematic Risk Adjustment in National Healthcare Safety Network Measures
Problematic Risk Adjustment in National Healthcare Safety Network Measures Open
This article reviews the risk-adjustment models underpinning the National Healthcare Safety Network (NHSN) standardized infection ratios. After first describing the models, the authors focus on hospital intensive care unit (ICU) designatio…
View article: Nursing Home Compare Star Rankings and the Variation in Potentially Preventable Emergency Department Visits and Hospital Admissions
Nursing Home Compare Star Rankings and the Variation in Potentially Preventable Emergency Department Visits and Hospital Admissions Open
Measurement of the quality of US health care increasingly emphasizes clinical outcomes over clinical processes. Nursing Home Compare Star Ratings are provided by Medicare to help select better nursing home care. The authors determined the …
View article: Will Hospital Peer Grouping by Patient Socioeconomic Status Fix the Medicare Hospital Readmission Reduction Program or Create New Problems?
Will Hospital Peer Grouping by Patient Socioeconomic Status Fix the Medicare Hospital Readmission Reduction Program or Create New Problems? Open
Hospital peer groups may create unintended redistributions of penalties through distortion of peer group medians. An observed relationship between lower-volume hospitals and fewer readmissions for medical conditions requires additional res…
View article: Quality Improvement Initiatives Need Rigorous Evaluation: The Case of Pressure Ulcers
Quality Improvement Initiatives Need Rigorous Evaluation: The Case of Pressure Ulcers Open
The Partnership for Patients (PfP) and the Agency for Healthcare Research and Quality (AHRQ) have reported a 23.5% decline in hospital-acquired pressure ulcers (HAPU) over 4 years resulting in a cumulative cost savings of more than $10 bil…
View article: Rethinking Medicare Payment Adjustments for Quality
Rethinking Medicare Payment Adjustments for Quality Open
Payment reforms aimed at linking payment and quality have largely been based on the adherence to process measures. As a result, the attempt to pay for value is getting lost in an overly complex attempt to measure value. The "Incentivizing …
View article: Comparison of the Properties of Regression and Categorical Risk-Adjustment Models
Comparison of the Properties of Regression and Categorical Risk-Adjustment Models Open
Clinical risk-adjustment, the ability to standardize the comparison of individuals with different health needs, is based upon 2 main alternative approaches: regression models and clinical categorical models. In this article, we examine the…