Chef Eric has struggled to manage his weight his entire life, and blogs on the Swedish website about food, his weight loss journey, eating in public, and more.

Dr. Richard Lindquist, a specialist with Swedish’s Weight Loss Services, provides some holiday eating tips to help you avoid those extra calories.

Spiced Hot Toddy

Serves 6 — 5oz drinks

Ingredients:

• 1 quart Light Soy milk
• 1 vanilla bean — split with seed scraped out
• 2 cinnamon sticks
• 1 TBSP honey
• 1 whole Nutmeg

Preparation:

1. Place soy milk w/vanilla bean and cinnamon sticks in sauce pan, bring just to simmer, insuring not to boil. Remove from heat. Add honey.
2. Allow the spices to steep for 10 minutes.
3. Transfer all the ingredients to a French press and press all spices down to the bottom.
4. Froth the toddy by carefully pumping up and down on the press, divide among 6 tea cups
5. Grate fresh Nutmeg over the Toddy, serve immediately.

Nutritional Information:

• 100 calories
• 1.5 grams of fat
• 6 grams of protein
• 12 grams carbs

Green Tea & Rosemary Sparkler

Makes 1 — 12 oz serving

Ingredients:

• 1 bag – Favorite Green Tea
• 2 inch stalk of Lemongrass (can substitute a lemon wedge)
• 1 stem of rosemary — small sprig removed from the top reserved
• 4 oz hot water
• 8 oz favorite sparkling water
• Ice cubes (optional)
• Artificial sweetener (optional)

 Preparation:

1. Steep the tea bag in the 4 oz of hot water with the lemongrass and the rosemary. Remove the teabag after 3 minutes let the herbs remain until the water reaches room temperature.
2. Strain tea into a tall glass over ice and sweetener (optional)
3. Add the 8 oz of bubbly water and a sprig of rosemary for garnish

Nutritional Information:

• 0 calories

Viewers will be able to watch a deep brain stimulation surgical procedure, accompanied by a live web chat led by Drs. Ryder Gwinn and Ron Young of the Swedish Neuroscience Institute.

Essential tremor is a common condition whose cause is unknown. It is more common in the elderly but can occur at any age. The tremor sometimes runs in families, in which case it is called familial tremor.

In some cases, essential tremor can occur with other brain and nervous system disorders, such parkinsonism.

Essential tremor usually consists of small, rapid movements that typically affect the hands but can also affect other parts of the body, including the head and face.

The shaking can cause serious disability, making it impossible, for example, to perform such simple tasks as writing and eating.

In deep brain stimulation surgery, an electrode is placed in part of the brain called the thalamus and then connected to a pacemaker-type device that is implanted under the skin.

When successful, electrical stimulation from the device stops the tremor. The pacemaker device can be turned on and off, as needed, by the patient with a hand-held magnet.

Viewers of tomorrow’s live stream will be able to submit questions about essential tremor and deep brain stimulation surgery and any other essential tremor treatment options, during the live stream using an embedded chat feature or via Twitter using the hashtag #SwedishDBS.

Dr. Jennifer Witt, a movement disorders neurologist with the institute, will also be joining the conversation to discuss the medical management of essential tremor.

WHEN:

Friday, Dec. 16, 2011, 9 a.m. to 12 p.m.

WHERE:

The webcast can be viewed online at www.Swedish.org/DBSLive.

Those interested may also join the conversation via Twitter by using the hash tag #SwedishDBS.

To learn more:

• Visit the National Institute for Neurological Diseases and Stroke’s webpage on tremor.

• Visit the National Library of Medicine’s Medline Plus page on deep brain stimulation.

This is the sixth year in a row that Virginia Mason has made the Top Hospital List, and the second year in a row for Swedish First Hill.

This year sixty-five hospitals have earned The Leapfrog Group’s annual “Top Hospital” designation for delivering the highest quality care:

• by preventing medical errors,

• reducing mortality for high-risk procedures like heart bypass surgery,

• and reducing hospital readmissions for patients being treated for conditions like pneumonia and heart attack.

The 2011 Top Hospital list was culled from a field of nearly 1200 hospitals that voluntarily and publicly report their performance by participating in the Leapfrog Hospital Survey, which focuses on three critical areas of hospital care:

1. How patients fare
2. Resources used to care for patients
3. Management practices that promote safety and quality

In each of the three areas, Leapfrog asks hospitals to report on nationally standardized measures so healthcare consumers can compare hospitals in their community and across the country.

University and other teaching hospitals, children’s hospitals, and community hospitals in rural, suburban, and urban settings were all represented in the 2011 rankings.

To learn more:

• A complete list of 2011 Leapfrog Top Hospitals and the survey results for all participating hospitals are posted on a website at www.leapfroggroup.org.

“Hospital-industry leaders say they’re doing what patients want and what makes good business sense,” Ostrom writes, but critics say the free-standing emergency rooms are “cash cows for hospitals, strategically built in affluent areas to lure busy, well-insured patients and collect fat reimbursements.

Hospitals say the new ERs will streamline care and help reduce costs, but Ostrom points to research that suggests the opposite:

Last year, the Center for Studying Health System Change, a national research group, noted concerns that increased competition around Seattle could increase overall costs. It found hospitals invading one another’s turf with free-standing ERs and vying to provide big-ticket specialty procedures in cardiac, cancer and orthopedic care.

To learn more:

• Read Ostrom’s article: ER building boom is wrong prescription, critics say.

Photo: Steve Woods

By Jordan Rau
This story was produced in collaboration with 

Medicare has begun publishing patient safety ratings for thousands of hospitals as the first step toward paying less to institutions with high rates of surgical complications, infections, mishaps and potentially avoidable deaths.

The new data, available starting last week on Medicare’s Hospital Compare website, evaluate hospitals on how often their patients suffer complications such as a collapsed lung, a blood clot after surgery or an accidental cut or tear during treatment.

The measures also include specific death rates for patients who had breathing problems after surgery, had an operation to repair a weakness in the abdominal aorta or had a treatable complication after an operation.

In addition, Hospital Compare is evaluating rates of some specific medical errors, such as giving patients the wrong type of blood, leaving surgical implements in patients’ bodies during surgery and falls that occur during their stay.

Survey of Patients’ Hospital Experiences

About the survey: HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a national survey that asks patients about their experiences during a recent hospital stay. Use the results shown here to compare hospitals based on ten important hospital quality topics. Read more information about the survey of patients’ hospital experiences.

The evaluations are part of Medicare’s broad move from paying hospitals a set amount for each procedure. That change was directed by last year’s health care law, which set up new “value-based purchasing program” that will begin in October 2012.

Over time, hospitals with the lowest quality—as judged by a variety of metrics, not just the new patient safety measures—will be at risk to lose up to 2 percent of their regular Medicare reimbursements under the health law.

The new data on patient safety moves Medicare further along toward its ultimate goal, which is to base payments on the actual medical outcomes for patients. To rate hospitals, Medicare is comparing them to the national rates for medical complications and hospital acquired conditions.

For instance, on average, 2.1 out of every 1,000 patients discharged suffered an accidental cut and tear from medical treatment. Out of 100 patients, 4.4 on average died after surgery to repair a weakness in their abdominal aorta.

By looking at how a hospital compares to the national average on this and other complication statistics, Medicare has come up with overall evaluations of how good hospitals are at avoiding complications and hospital-acquired conditions. Medicare is aiming to incorporate the new patient safety data into payments in the second year of the program.

Making this information public has been long favored by patient safety advocates. “This is pulling the curtain back on preventable health care harm to older Americans,” said Rosemary Gibson, co-author of “The Treatment Trap” and editor of a series of articles on overtreatment in the Archives of Internal Medicine. “These are really good things to know. We are really getting into the meat of what can happen to patients in hospitals.”

But the latest data is intensifying objections from the hospital industry and some academic researchers that Medicare is using dubious and unfair measurements in ways that will hurt some hospitals, particularly those with sicker patients. The data is based on billing claims that hospitals submit to the government, not clinical medical records.

One concern held by hospitals and researchers is that hospitals categorize the same things differently when billing Medicare, skewing comparisons.

“Medicare claims data is the thing a lot of people judge from, but it’s a large database and frankly I’ve always wondered if apples and oranges are being mixed,” said Dr. Gerald Healy, a senior fellow at the Institute for Healthcare Improvement, a Massachusetts nonprofit, and past president of the American College of Surgeons.

Hospital officials said their initial review of the new data has exacerbated their concerns that Medicare’s calculations do not fully take into account the fact that some hospitals do more surgeries or treat sicker patients.

“We believe the data is fairly seriously flawed in the way it’s calculated,” said Nancy Foster, a vice president at the American Hospital Association. “When inaccurate data is out there, it both misleads the public and generates a lot of activity that is unproductive in the hospital.”

Atul Grover, head of advocacy for the Association of American Medical Colleges that represents teaching hospitals, said some of Medicare’s measures also make teaching hospitals look worse.

“If you’re not appropriately risk-adjusting on this, you’re already selecting a patient population that’s more likely to die,” he said. “That’s why they come to us, because other people are reluctant to operate on those complex cases.”

Officials at the Agency for Healthcare Research and Quality, which designed many of the measures, referred questions to Medicare. Officials there were not immediately available to discuss the new measures. Dr. Patrick Romano, a professor at the University of California, Davis School of Medicine who helped the government design the measures, said the measures do take the sickness levels of patients into account, although not as thoroughly as Hospital Compare’s existing evaluations of readmissions and hospital-wide mortality rates.

Still, he said the measures were a good addition to the overall view of how well hospitals are doing. “We’re trying to understand a large animal like an elephant or a whale,” he said. “To do that, we take pictures from a variety of perspectives, with different cameras and different techniques.”

Hospital Compare was originally designed to be a helpful consumer tool, but to date it has not been widely used by patients choosing hospitals. Experts caution about drawing dire conclusions from the raw rates of hospitals, as some of the measures are complex and differences not statistically significant.

For some of the measures, Hospital Compare categorizes most hospitals simply as “average,” “above” or “below” the national norm, which experts say is a better way for consumers to know whether a hospital is an outlier.

To find a hospital on the site, type in the city and state, click on the hospital name and then select the “Patient Safety Measures” tab at the left. Hospital Compare also gives patients the option of choosing several hospitals at once. The new data covers the period between October 2008 and June 2010.

Medicare last week also announced 18 more measures it is considering for inclusion in the value-based purchasing program.  Many of these measures look at how hospitals handle stroke patients and what steps they take to protect patients from blood clots. Others are intended to address two bacterial infections that can spread through hospitals: Clostridium difficile and Methicillin-resistant Staphylococcus aureus.

Illustration: Steve Woods Photography

Contact Jordan Rau: jrau@kff.org

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.