According to a study recently published in IIE Transactions on Healthcare Systems Engineering, a conceptual framework that maximizes staff-to-patient ratios by ensuring that high risk patients come into contact with the lowest number of nurses and physicians may help reduce patient infection rates in hospitals. The study, conducted by two researchers at the University of Maryland and one researcher at American University, used computer models to simulate interactions between patients and healthcare workers to assess whether these interactions are a source for spreading multidrug-resistant organisms. To do so, they tracked and manipulated the dynamics of the social network created when healthcare workers share responsibility for several patients in a mid-Atlantic hospital's intensive care unit. They found a correlation between a "sparse social network structure" (in which each healthcare worker has contact with just a few patients) and low infection transmission rates, and recommended strategies for reducing infection rates, including hiring more nurses, creating a strategy for patient sharing, and limiting patient contact to only when medically necessary.

The U.S. Food and Drug Administration (FDA) states that it plans to submit in early December a formal recommendation package to the U.S. Department of Health and Human Services (HHS) to reclassify hydrocodone combination products into Schedule II. The agency states that it has "become increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States." In 2009, the U.S. Drug Enforcement Administration asked HHS for a recommendation regarding whether to change the classification for hydrocodone combination products from Schedule III to Schedule II. After an analysis of scientific literature, review of hundreds of public comments on the issue, and several public meetings, FDA has elected to recommend the reclassification of hydrocodone combination products to a different and more restrictive schedule.

Findings in a report released by the HHS Office of Inspector General (OIG) raise questions about whether devices sold by physician-owned distributorships (PODs) cost less than those of other suppliers. The authors reviewed a sample of 1,000 claims that included spinal fusion surgery and were billed to Medicare during FY 2011. Hospitals were asked about physician ownership of spinal device suppliers and spinal devices used in each surgery. They found that PODs supplied devices used in nearly one in five spinal fusion surgeries billed to Medicare. Spinal surgeries with POD devices used fewer devices, but did not have lower per surgery device costs than surgeries that did not use POD-supplied devices. The authors noted that when hospitals in the sample cohort began buying from PODs, their rates of spinal surgery grew faster than the rate for hospitals overall. In addition, surgeons performed more spinal surgeries at hospitals that purchased from PODs, and those hospitals experienced increased rates of growth in the number of spinal surgeries performed in comparison to the rate for hospitals that did not purchase from PODs.

Information released by the nonprofit The Leapfrog Group suggests that as many as 440,000 Americans die each year from preventable hospital errors, placing medical errors as the third leading cause of death in the United States. The fall 2013 update to the organization's Hospital Safety Score finds that many hospitals have made improvements to address errors, accidents, injuries, and infections that harm patients, but overall progress remains slow. Among the most recent findings:

* With the exception of hospital adoption of computerized physician order entry, there was, on average, no improvement in hospitals' reported performance on measures included in the score.

* Overall, hospitals reported little improvement in safety, although 3.5 percent displayed improvements of two or more grade levels.

* Of 2,539 general hospitals issued a Hospital Safety Score, 813 earned an A, 661 earned a B, 893 earned a C, 150 earned a D, and 22 earned an F.