When Catheter Stabilization Isn’t Enough for Patient Safety

Posted on by Greg Dennis

1462041601658Many drivers have experienced the kind of fender-bender or sudden stop that made them glad they were wearing a seat belt. But a seatbelt can only protect us from so much — which is why airbags and more advanced safety approaches were invented.

To use another auto analogy, think of the breakaway hoses at gas stations pumps. They prevent the full hose from being pulled out of the pump when an absent-minded driver drives away without removing the nozzle from the gas tank.

Similarly in nursing care, there’s only so much that catheter stabilization can do when it comes to protecting IV lines. Given those limitations, a better safety option is now being developed to address a pain point for nurses: accidental dislodgement of IV lines. Continue reading “When Catheter Stabilization Isn’t Enough for Patient Safety” →

Why IV Lines Fail: A Crazy Little Thing Called Dislodgement

Posted on by Greg Dennis

With something like 300 million peripheral IV lines sold in U.S. each year – and a failure rate that’s often cited as being 50% – researchers continue to try to understand a problem that’s a daily headache in vascular access and infusion therapy.

4-1Common causes of line failure are dislodgement, infection, thrombosis, phlebitis and occlusion. Peripherally inserted central catheters (PICCs) and central venous catheters (CVCs) tend to be better secured than peripheral IVs, but they are also subject to high failure rates.

“Intravenous catheter dislodgement is a significant and avoidable problem,” said vascular access consultant Leigh Ann Bowe-Geddes, BSN, RN, CRNI, VA-BC, a well known vascular access clinical consultant and former president of the Association for Vascular Access. Continue reading “Why IV Lines Fail: A Crazy Little Thing Called Dislodgement” →

When a ‘Low Profile’ Is a Good Thing

Posted on by Greg Dennis

When a company comes up with something better, it typically wants a high profile for the technology. But it’s not always the case with Focal Therapeutics.

That’s because the company recently launched a low-profile version of the BioZorb® implant used in breast conservation treatment (BCT).

laidley2
Breast surgeon Alison Laidley compares the original, spiral version of BioZorb (left) to the new BioZorb Low Profile (right).

Focal’s new BioZorb LP (for “low-profile”) design means more women who need breast cancer surgery could benefit from the implantable device. BioZorb is used in “reconstructive lumpectomy” and other types of BCT. It marks in three dimensions the site from which a breast tumor is removed.

The BioZorb LP device is designed to be implanted in smaller breasts, peripheral areas of the breast, and locations with less tissue coverage.

“Everyone understands the need for delivering more personalized medicine,” said Alison Laidley, M.D., a prominent Dallas breast surgeon with Texas Breast Specialists who was among the first physicians to use BioZorb LP. “The new designs of this device enable us to provide it to many more patients.” Continue reading “When a ‘Low Profile’ Is a Good Thing” →

Does the Mammography Debate Miss a Key Point?

Posted on by Greg Dennis

Every time the US Preventive Services Task Force issues a recommendation about when women should start getting mammograms – and how often they should have these screenings – it sends shockwaves through the breast-cancer world.

modiglianiThis last time was no different.

But now two influential breast cancer experts assert that – as important as the debate is – it misses an essential point about evaluating a woman’s individual risk of getting breast cancer.

Those experts – Dallas breast surgeon Dr. Peter Beitsch and Nashville breast surgeon Dr. Pat Whitworth – say the key question is how to evaluate “risk.”

The latest recommendations from the task force call for women at “average risk for breast cancer” to begin every-other-year screening at age 50. It casts doubt on the true value of screening beginning at age 40 – citing the high number of false-positive test results in women 40 to 50, plus potential harm from overdiagnosis and unnecessary treatment. Continue reading “Does the Mammography Debate Miss a Key Point?” →

Cost Conundrum: How Accountable Are ACO’s?

Posted on by Greg Dennis

Among the many ways the Affordable Care Act tries to drive down healthcare costs is through Accountable Care Organizations.

acoJust what are ACOs? HMOs in drag? And are they working?

Here’s how we see the ACO landscape today:

  • Although their launch has been somewhat troubled, Accountable Care Organizations are here to stay.
  • The Centers for Medicare and Medicaid Services (CMS) is driving the adoption of ACOs, with some private payers joining in.
  • Data collection and analysis hold out the promise of reducing inefficiencies.
  • ACOs don’t take on a lot of risk if they can avoid it. That in turn will affect how much money they can actually save the healthcare system.
  • In a related development, some payers – including a new industry alliance – are looking closely at the role of health insurance third-party administrators (TPAs), to see if further cost can be taken out of the system there.

What Is an ACO?

First, a bit about terminology. While ACOs undertake some responsibility for the cost of delivering care, they are not “all in,” as are HMOs. (For a good video explaining ACOs, see this from Kaiser Health News.)

Here’s how healthcare economist Austin Frakt, writing in the New York Times, explains the differences between ACOs and HMOs: Continue reading “Cost Conundrum: How Accountable Are ACO’s?” →

IORT with Oncoplastic Surgery: A Beautiful Combination?

Posted on by Greg Dennis
Julie Reiland SOS 2016 (1)
Julie Reiland, MD, FACS

Breast cancer care continues to see remarkable growth in knowledge of the disease and advances in treatment. That was certainly evident at the recent School of Oncoplastic Surgery (SOS), in Dallas last month.

The school, which was founded by breast surgeon Gail Lebovic, M.D. with a grant from the Mary Kay Ash Foundation, recently had its eighth annual session in Dallas. This year’s session was sponsored by the National Consortium of Breast Centers and the American Society of Breast Disease Clinical Track.

Among the highlights of that three-day training workshop was a talk by Julie Reiland, MD, FACS. An SOS faculty member, Dr. Reiland is a breast surgeon at Avera Medical Group Comprehensive Breast Care, in Sioux Falls, SD. Speaking to a packed room at SOS, Dr. Reiland talked about the convergence of oncoplastic surgery and intraoperative radiation therapy (IORT).

In particular she talked about Continue reading “IORT with Oncoplastic Surgery: A Beautiful Combination?” →

Brighter Days for Ambulatory Surgery Centers with Innovative Breast Care

Posted on by Greg Dennis

Ambulatory surgery centers face plenty of financial (some might even say “existential”) challenges. Among these are a tightening reimbursement environment, competition from hospital systems, and high health insurance deductibles.

Cross in OR - XL-2
Dr. Michael Cross is establishing an international reputation for innovations in breast cancer surgery.

Nonetheless, breast cancer care is emerging as a bright spot for ASCs, including two centers we talked with recently.

In a large New York City surgery center, for example, breast care helps lead the way. In an Arkansas center, transparent pricing and use of a relatively new surgical marker called BioZorb are part of the story.

First, though, let’s talk about those challenges.

“The changes in healthcare have been accelerated with passage of the 2010 Affordable Care Act, a.k.a. Obamacare, the expansion of Medicaid programs, an economy that is improving at a slower than normal rate, and stagnant increases in wages,” Laura Dyrda wrote recently in Becker’s ASC Review, “Reimbursement is in flux for many surgical specialties,” and high-deductible Continue reading “Brighter Days for Ambulatory Surgery Centers with Innovative Breast Care” →

School of Oncoplastic Surgery Shows the Way to Better Breast Cancer Care

Posted on by Greg Dennis
Dr. Gail Lebovic
Dr. Gail Lebovic founded the School of Oncoplastic Surgery

Among the many improvements in the care of women who have breast cancer, one of the most promising is oncoplastic surgery.

This approach combines methods to remove cancer with reconstructive techniques to insure complete tumor control. At same time it achieves better aesthetic outcomes.

This month’s upcoming School of Oncoplastic Surgery will help surgeons develop new skills they can use when performing breast-conserving surgery (lumpectomy) on patients with breast cancer. The three-day course will be held Jan. 22-24, 2016 in Dallas.

The 2016 version of the school is sponsored by the National Consortium of Breast Centers, the Senologic International Society, and the Postgraduate Institute for Medicine.

The course provides a spectrum of skills for attendees. Through a sculpture lab, anatomy lab and interaction with live models, surgeons learn essential tools with hands-on experiences. Panel discussions and case presentations also allow surgeons to openly discuss challenges they face in their practices, and to learn various ways to address complex clinical situations in cancer care.

The founder and leader of the school is Dr. Gail Lebovic. She’s a past president of the American Society of Breast Disease, recipient of several distinguished awards and the inventor of multiple successful medical technologies in women’s healthcare.

Continue reading “School of Oncoplastic Surgery Shows the Way to Better Breast Cancer Care” →

Tigerlily Foundation Twitter Chat

Posted on by Greg Dennis

Please join us and our friends at the Tigerlily Foundation for a Twitter chat on Wednesday, Oct, 21, 2015 at 9 PM Eastern time.

The hashtag for the Twitter chat is #ybcsempowered, shorthand for “Young Breast Cancer Survivors Empowered.”

Twitter Chat 2015-10-21 FINAL

 

Team Spirit: A Vascular Access Team Is Placing CVCs and Arterial Lines – And Why That Matters

Posted on by Greg Dennis

InConnie Girgenti an earlier post, we detailed the advantages that both hospitals and patients gain when non-physician vascular access specialists (VAS’s) are allowed to place central venous catheters (CVCs) and arterial lines. Now a recently published article describes how a vascular access team at a large community hospital in Illinois expanded its scope of practice to encompass these lines.

Continue reading “Team Spirit: A Vascular Access Team Is Placing CVCs and Arterial Lines – And Why That Matters” →