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:
http://www.hfap.org/.

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:
http://www.jointcommission.org/NewsRoom/NewsReleases/nr_11_30_09.htm.

Question of the Week: Should Facilities Use Surveillance to Ensure Compliance?

An article in today's American Medical News highlights how Maryland is using $100,000 in federal stimulus funds to train volunteers who will secretly monitor hand washing in 45 of the state's 47 acute care hospitals.

Maryland isn't the only state turning to surveillance methods. Rhode Island Hospital requires surgeons to participate in at least two video-recorded surgeries a year after five wrong-site surgeries were reported in the past two years. In 2007, the Massachusetts Legislature considered mandating video recorded surgeries.

There are those who support the use of surveillance and those who don't. Dr. Mark Chassin, president of The Joint Commission says that if surveillance helps hospitals determine what is affecting performance, then it can be an aid. However, Chassin cautions against the improper use of surveillance data as ammunition against individuals in their personnel files.

Dr. Mark E. Rupp, professor of infectious diseases at the University of Nebraska Medical Center and president of the Society for Healthcare Epidemiology of America believes that some providers will not like the "Big Brother" feeling that this system may impose.

What do you think? Is surveillance an effective way to boost compliance and help facilities identify practices that need improvement? Or do you think that this oversight method will cause more provider stress and anxiety?

Let us know what you think by taking this week's poll and providing your comments below.


Source: amednews.com
http://www.ama-assn.org/amednews/2009/11/30/prl21130.htm

One in Ten Surgeons Believe They Made a "Major Error" Recently

A study published in the Annals of Surgery shows that one in ten surgeons believe that they made a major medical error in the past three months.

The survey showed that surgeons experiencing burnout as a result of exhaustion, depersonalization, and personal career dissatisfaction were more likely to report an error. 40 percent of respondents said that they were experiencing "burnout," and 30 percent reported experiencing symptoms of depression. The study did conclude whether the burnout was a result of the errors, or if the errors were a result of the burnout.

The results reflect the feedback of 7,905 surgeons who completed a survey by the American College of Surgeons.

If it turns out that burnout is a link to medical error, then it looks like hospitals will have to figure out ways to boost physician morale as a way to maintain patient safety.


Source: Wall Street Journal Health Blog
http://blogs.wsj.com/health/2009/11/23/nine-percent-of-surgeons-have-made-major-errors-recently/

Senate Democrats Propose $848 Billion Health Bill

Senate Majority Leader Harry Reid (D-NV) unveiled a healthcare proposal yesterday that would cover 94 percent of all Americans and cost $848 billion over 10 years. Estimates from the Congressional Budget Office predict that the bill will cut the federal deficit by $127 billion in its first year, and $650 billion over the next decade.

While the bill has wide Democratic support in the Senate, Republicans are hesitant to believe that the bill will be budget-neutral. The plan will be paid for by Medicare cuts and increased taxes, such as a tax on high-premium "Cadillac plans."

Some provisions of the bill include:

• A public health care plan, with an option to the states to opt out of the system if they want to;
• Employers under the House bill (except some small businesses) would be mandated to provide coverage to their employees; under the Senate bill, employers who do not offer coverage will only be fined $750 per employee;
• Individuals (except illegal immigrants) who do not have access to affordable coverage through their employers would be able to purchase it from a multi-state exchange;
• 5 percent excise tax on elective cosmetic surgery; and
• A firewall segregating private insurance funds used to cover abortion from public funds; the HHS Secretary will be given discretion to determine whether or not public funding will be available for abortions.

The Senate is expected to hold a vote this Saturday to introduce the bill for debate.

$54.2 Billion Spent on Medicare Fee-for-Service Errors in 2009

Peter Orszag, Director of the Office of Management and Budget, reported that Medicare and Medicaid spent $54.2 billion in improper payments in 2009. Orszag also reported that the rate of Medicare fee-for-service errors doubled in the past year.

Orszag attributes the doubled rate to a new system of counting errors, which counts incidents such as an illegible signature or submitting a claim without sufficient documentation as errors.

To address this problem, President Obama will issue an executive order requiring greater agency oversight, the creation of a website that allows the public to track and report improper payments, and penalties for those who do not return payments received in error.

This is another example of how billions of dollars are being spent with no contribution to improving healthcare. As healthcare reform continues to develop, let's hope that the government figures cost-effective ways to improve the administrative side of healthcare delivery and increase accountability for errors. $52.4 billion could go a long way toward patient-centered improvements.

Click here for the full article:
http://www.modernhealthcare.com/article/20091117/FREE/311179968.



Source: Modern Healthcare

DNV Releases First Annual Report

DNV has released its first annual report to the public on its hospital accreditation program.

The report includes comments from several hospitals that have switched to DNV accreditation. There are almost 100 hospitals accredited by DNV.

The report also includes new initiatives, including DNV's application for deeming authority to accredit critical access hospitals.

To view the report, click here:
http://www.ebookdnv.com/hcannualreport/.