Thursday, December 31, 2009

Physician Ethics and Industry Relationships

Earlier this month, Medscape interviewed Amy Brodkey, MD, an adjunct associate professor of psychiatry at the University of Pennsylvania. Dr. Brodkey discussed how physician interactions with industry representatives, such as the receipt of gifts, free drug samples, and funded CME programs, can lead to conflicts of interest.

As we enter the new year and consider good habits to adopt, we might want to take Dr. Brodkey's advice and encourage our physicians to be transparent in their interactions with industry representatives. This will help to maintain the integrity of their patient care and to eliminate the appearance that the treatment they provide is merely the result of a business relationship.

To read the full article, click here:

Thursday, December 17, 2009

MS.01.01.01 Out for Field Review

How does one articulate the basic tenets of an effective working relationship between hospital governance, medical staff leadership, and the medical staff itself? The Joint Commission, in attempting to do just that, has in the past produced new versions of the standard addressing the issue, formerly known as MS 1.20 and now called MS 01.01.01. But these versions, when made available for comment, drew criticism from physicians and hospitals that pointed to the potential for substantial unintended consequences.

A new version, which is attached for your review, has been crafted by a special Task Force assembled by The Joint Commission in January 2008. The Task Force includes hospital executives, physician leaders, physician and hospital counsel, representatives of those who staff the medical staff functions, and others. Throughout its work, the Task Force was guided by three fundamental principles:

A well-functioning relationship between the governing body, hospital leadership, and the medical staff is essential to the delivery of high quality, safe care.

Effective communication is the lubricant that keeps relationships functioning well; it therefore is important that structures and processes support it.

Well-functioning relationships also depend on all parties knowing what is expected of them, and being able to live up to those expectations.

The Task Force worked with The Joint Commission staff to incorporate its suggestions into the revised language of MS 01.01.01. The American Hospital Association, American Medical Association, American College of Surgeons, American College of Physicians, American Dental Association, NAMSS, and other interested organizations believe this revised version appropriately articulates the elements of a productive relationship between a hospital and its medical staff. It also allows as much flexibility as possible in how and where a hospital and its medical staff choose to articulate these responsibilities.

The Joint Commission Board has approved distributing this version for field review.

NAMSS will be posting our comment letters on the NAMSS Homepage in the coming days to provide you with background on the proposed revision. We encourage all members to participate in this field review.

NAMSS has suggested that The Joint Commission offer substantial implementation time for this standard once it is finalized. During that period, NAMSS will work to bring you educational programs and materials to help you properly implement this standard.

Tuesday, December 15, 2009

Sixteen Houston Hospital Workers Fired for HIPAA Violation

Sixteen employees of the Harris County Hospital District were terminated last month after accessing the medical records of a first-year medical resident who had become a patient.

The employees had accessed the records of Stephanie Wuest, a doctor who had been admitted after being shot in a supermarket parking lot on October 29. One terminated employee stated that the records were accessed out of concern for the colleague, and that they were just trying to locate Wuest.

HIPAA requires that a hospital issue "appropriate sanctions" when an employee violates the law. The Harris County situation is one example of employers setting a firm rule against access to medical records without the consent of the patient or patient's guardian.

Some have argued that incidents of mistake, or access to records out of concern for a colleague should not be considered severe enough to warrant termination. Others argue that the privacy risk to the patient is too great and that hospitals should punishing HIPAA violations with a firm hand, especially if employees are provided sufficient education in the law and in what constitutes a violation.

This incident serves as a reminder that when it comes to HIPAA, make sure your colleagues and members of the medical staff know the law and are aware of the consequences enforced at your facility.

Source: Houston Chronicle

Monday, December 14, 2009

Question of the Week: OPPE, FPPE, and Allied Health

As this year comes to a close, many of us are looking for ways to make things more efficient and less complicated in both our lives and our work.

One area that gets complicated for MSPs is how to track OPPE and FPPE for allied health professionals (AHPs). We are supposed to monitor the performance of AHPs, but this is difficult to do since all AHPs have a sponsoring physician and credit for procedures are usually recorded in the physician's name, not the AHP's name.

Some facilities have addressed this problem by developing activity logs that allow their AHPs to keep track of procedures they performed. If your facility has implemented a best practice, we'd love for you to share it in the comment field.

The question of the week is, do you currently track OPPE and FPPE for allied health professionals? Provide your answer in the poll on the NAMSS Blog homepage.

Friday, December 11, 2009

Improper Background Checks by Staffing Firms Are Connected to Hiring of Unfit Temporary Nurses

A report from ProPublica and The Los Angeles Times shows that hospitals may be using temporary RNs who are unqualified because of poor screening by staffing firms.

The report shows that many nurses with criminal histories, histories of poor performance, and improper credentials were able to acquire employment with a hospital because the staffing agency failed to perform a thorough background check or listen to warnings from other facilities. Some nurses were able to avoid being caught with unfit qualifications by moving to a new hospital before an investigation into their performance background could be performed.

Some attribute the rise in unqualified nurses to the nursing shortage. With hospitals needing to quickly hire nurses to meet their staffing needs, some facilities are relying solely on the background check performed by the staffing agency, without performing their own check.

While there are many quality temporary staffing agencies out there, this should also serve as a call to hospitals to do their due diligence when working with one. Your facility should always try to verify the credentials of temporary nursing staff. If this is not possible, then make sure that the staffing agency you work with has a proper credentialing system in place.

There may be a staffing shortage, but it is better to take the time to hire quality staff, than to meet staffing numbers with unqualified individuals.

To read the full article, click here:,0,1174984.story.

Source: The Los Angeles Times

Tuesday, December 8, 2009

New Hampshire Attorney General Investigating Alleged HIPAA Violation

The New Hampshire Attorney General's Consumer Protection and Antitrust Bureau announced that they are investigating an alleged breach of 1,500 patient records at Wentworth-Douglass Hospital in Dover, NH.

Two doctors at the facility reported the violation, saying that a former employee altered the records between 2006 and 2007. The doctors, Cheryl Moore and Glenn Littell, also claim that for reporting the violations, the hospital retaliated against them by ending their contract with their pathology practice.

The Attorney General's office is expected to spend a few weeks investigating the claim before determining if any additional action is required.

Tuesday, December 1, 2009

HFAP Announces New Standards for Ambulatory Care and Office-Based Surgery

The Healthcare Facilities Accreditation Program (HFAP) has announced new accreditation standards for Ambulatory Care and Office-Based Surgery. The new standards focus on "in-office requiring general anesthesia, deep sedation and moderate (conscious) sedation."

The standards require the physician administering or supervising the administration of general anesthesia to demonstrate knowledge of the risks involved and how to correct adverse consequences that may occur, including the rescue of a patient that becomes sedated beyond the intended level.

Accreditation for offices using local anesthesia, topical anesthesia, superficial nerve blocks, or minimal sedation is optional.

For more information, visit:

CMS Renews TJC's Hospital Deeming Authority

The Centers for Medicare and Medicaid Services (CMS) has renewed The Joint Commission's deeming authority its hospital accreditation program through July 15, 2014.

Organizations with "deemed" status have standards that meet or exceed those of the Medicare and Medicaid program.

To read TJC's full announcement, click here: