Patient ratings of Veterans Affairs and affiliated hospitals.

Objectives: Hospital Compare, a website maintained by CMS, allows comparisons of outcomes and processes of care but not of patient satisfaction for hospitals within the Veteran Affairs (VA) Healthcare System. Therefore, we sought to compare online hospital ratings between VA hospitals and their local affiliated hospitals.

Study Design: Observational analysis.

Impact of the Hospital to Home Initiative on Readmissions in the VA Health Care System.

Background: Hospital to Home (H2H) is a national quality improvement initiative sponsored by the Institute for Healthcare Improvement and the American College of Cardiology, with the goal of reducing readmission for patients hospitalized with heart disease. We sought to determine the impact of H2H within the Veterans Affairs (VA) health care system.

Methods: Using a controlled interrupted time series, we determined the association of VA hospital enrollment in H2H with the primary outcome of 30-day all-cause readmission following a heart failure hospitalization.

Facilitation of a Multihospital Community of Practice to Increase Enrollment in the Hospital to Home National Quality Improvement Initiative.

Background: Hospital to Home (H2H) is a national quality improvement (QI) initiative composed of three recommended hospital interventions to improve the transition of care for hospitalized patients with heart disease. A study was conducted to determine if enrollment of Department of Veterans Affairs (VA) hospitals in H2H and adoption of the recommended interventions would both increase following facilitation of an existing Heart Failure (HF) provider-based community of practice (COP) within the VA health care system. The VA HF COP includes more than 800 VA providers and other VA staff from VA inpatient medical centers.

A closer look at nurse case management of community-dwelling older adults: observations from a longitudinal study of care coordination in the chronically ill.

Purpose/objectives: This descriptive, exploratory study of selected characteristics of RN (registered nurse) case management utilized secondary data from a randomized controlled trial in a 5-year Centers for Medicare & Medicaid Services (CMS)-funded Medicare Coordinated Care Demonstration (MCCD) project.

Primary Practice Setting: The 1,551 older adult, community-dwelling Medicare beneficiaries in the study treatment group population had at least 1 of 5 qualifying chronic diseases (atrial fibrillation, congestive heart failure [CHF], coronary artery disease, chronic obstructive pulmonary disease, diabetes), a mean age of 75 years and an average of 4.5 comorbid conditions.

California's digital divide: clinical information systems for the haves and have-nots.

Strong barriers prevent the financing of clinical information systems (CIS) in health care delivery system organizations in market segments serving disadvantaged patients. These segments include community health centers, public hospitals, unaffiliated rural hospitals, and some Medicaid-oriented solo and small-group medical practices. Policy interventions such as loans, grants, pay-for-performance and other reimbursement changes, and support services assistance will help lower these barriers.