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Highlights of the important and the interesting from the world of health care:

Meet the new boss: Potentially feeling pressure from the recession, turnover among hospital chief executives last year equaled the highest on record. In 2009, 18 percent of nonfederal acute-care hospitals saw turnover in their top job, up from 14 percent the year before, according to the American College of Healthcare Executives. The group has compiled the statistic since 1981. Much of the reason may simply be demographics, as many Baby Boomers approach retirement age. Increased public scrutiny may also contribute, as hospital boards are now under more pressure to make changes if financial or quality goals aren’t met. Finally, one under-noticed factor is scrutiny from bond raters, who can hold great sway over hospitals in a tight credit market, Modern Healthcare reports.

Nonetheless, the group says the trend is expected to continue for the foreseeable future, which underscores the importance of succession planning to hospitals.

Why the doctor isn’t in: At the same time the U.S. faces a shortage of medical providers, physicians are cutting the hours they work, according to data from the Journal of the American Medical Association. From 1996 to 2008, hours worked per week by physicians decreased 7.2 percent, from 55 to 51 hours. That’s in stark contrast to the 20-year-period ending in 1996, in which hours held steady. The reason can at least partly be attributed to one familiar factor: money. During that same period of declining hours, physicians fees also dropped about 25 percent.

That reduces doctors’ incentive to work long hours, though cash likely isn’t the only reason for the declining hours. Productivity increases–which allowed physicians to get more done in less time–could be a factor, as could physician burnout, the researchers suggest. In any case, the numbers don’t bode well for wait times at the doctor’s office when, or if, another 3o to 40 million Americans get insurance coverage as a result of the federal health overhaul.

Questions about insurance and access: The University of Michigan is trumpeting research that could brings smiles to the faces of health reform opponents in a press release titled “Survey reveals health insurance and access to care not sot closely linked.” If that’s true, then it would follow that one of the basic tenets of reform–providing insurance coverage to tens of millions of currently uninsured–won’t actually do that much to help people obtain care. The researchers seem to base their conclusion on data that showed that while 40 percent of those who lacked insurance delayed seeking needed care, so did 17 percent of those with health insurance ’ mostly due to cost concerns. While a survey of 1,000 people obviously isn’t adequate to give a definitive answer, it still seems specious to draw even the tentative conclusions that the researchers have.

Certainly, having insurance coverage doesn’t simply guarantee access to care, but it sure helps. Perhaps the researchers set up a straw man of sorts by saying that the survey “challenges the long-held assumption that having health insurance is synonymous with having access to health care.” It’s highly unlikely anyone thought the two things were “synonymous,” yet it’s often an effective rhetorical device to defeat an argument that no one is making. Still, the survey’s researchers should be careful that they don’t unwittingly become a tool for those who seek to preserve the status quo in U.S. health care.

How one hospital combats infections: Hospital-acquired infections have been a vexing problem that likely lead to the deaths of tens of thousands of Americans per year, including Rep. John Murtha recently. One hospital in Murtha’s home state of Pennsylvania, however, instituted a simple and easy program that one hopes would cut down on those infections. Abington Memorial Hospital recruited staff members to be “spies” who tracked whether staffers washed their hands entering and exiting patients’ rooms, the Philadelphia Inquirer reports.

The results, in terms of handwashing at least, have been hugely successful. The percentage of staff washing hands rose from a dismal 31 percent in December 2007 to 88 percent in September 2009. Unfortunately, the Inquirer doesn’t tell us whether infection rates took a similar tumble, but the “spy” or “secret shopper” program looks worthwhile. It’s a relatively easy and efficient step most hospitals could take that wouldnt’ be of much cost to them, but would undoubtedly benefit their patients.

Photo from flickr user Seattle Municipal Archives