RSSAuthor Archive for Brian Ward

Brian Ward

Brian Ward is an Associate Editor at HCPro working on accreditation news.

Joint Commission seeks input on infection prevention NPSG

Between October 4 and November 15, hospitals and critical access hospitals (CAH) are being asked to give input on newly proposed requirements for the healthcare-associated infections (HAI) National Patient Safety Goal (NPSG). The proposed requirements now cover central line-associated bloodstream infections (CLABSI) and surgical site infections (SSI). The Joint Commission is asking that hospitals and CAHs read the proposed requirements then provide feedback via online survey, online form, or traditional mail.


Pediatric quality measures receive $13.4 million from AHRQ and CMS for testing

Six Pediatric Quality Measures Program (PQMP) grantees have been given $13.4 million to test new pediatric quality measures over the next four years. The money is being provided by CMS and The Agency for Healthcare Research and Quality (AHRQ) with funds from the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).CMS Logo

“Medicaid and Children’s Health Insurance Programs (CHIP) give millions of children in the United States a healthy start,” said Vikki Wachino, director at the Center for Medicaid and CHIP Services, in a press release. “Through efforts such as this PQMP funding, we are able to advance states’ efforts to measure and report meaningful improvements in the quality of care for children.”

The pediatric measures were created by the PQMP Centers for Excellence with the goal of creating a portfolio of evidence-based, consensus pediatric quality measures available to public and private purchasers of children’s health care services. Grantees will be expected to test the feasibility and usability of the measures in in real-world settings at the state, health plan, and provider levels.

“The PQMP Centers of Excellence provided us with valid measures of children’s health care quality. This next step of research will help us test these measures in real-world settings,” said AHRQ director Andy Bindman, MD. “The ultimate goal is to improve children’s health throAHRQ-logough better health care, at lower costs, at both the federal and state level.”



Joint Commission unveils 2017 requirements for ORYX reporting

The Joint Commission released its 2017 reporting requirements for ORYX, a performance measurement and improvement initiative for which facilities are required to collect and submit data on six sets of core measures. As of January 1, 2017, hospitals and critical access hospitals (CAH) will be expected to:

•    Report on five required chart-abstracted measures.
•    Report on six of the 13 available electronic clinical quality measures. Facilities will get to choose which six they want to report on.
•    Report on all of the chart-abstracted perinatal care measures if the facility has at least 300 live births annually.
•    Hospitals with an average daily census of 10 patients or fewer and CAHs will report on a choice of six available measures.

Meanwhile, freestanding children’s hospitals, long-term acute care hospitals, and inpatient rehabilitation facilities won’t have to follow these requirements. However, freestanding psychiatric hospitals will have to document and report back on four required hospital-based inpatient psychiatric measures.

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Medication Reconciliation: Improve Compliance Across Healthcare Settings

Presented on:
Tuesday, October 18, 2016
1:00–2:30 p.m. Eastern

Presented by:
Molly Clark, PharmD, MHA
Megan Maddox, PharmD, BCPS, CDEHCPro Webcast Icon

Level of Program:

Medication reconciliation continues to be a problem for hospitals and other healthcare facilities. This program will provide attendees with the tools they need to improve the medication reconciliation process, which has increased involvement from CMS and is of crucial importance during discharge as well as transfer.

Join expert speakers Molly Clark, PharmD, MHA, and Megan Maddox, PharmD, BCPS, CDE, to learn how to launch, educate, implement, and monitor a successful medication reconciliation program that meets all Joint Commission and CMS requirements and reduces medication errors across the continuum of care.

At the conclusion of this program, participants will be able to:
•    Understand the current regulations for both hospital and ambulatory settings
•    Learn various models to achieve and sustain a successful medication reconciliation process
•    Implement innovative strategies to improve compliance with medication reconciliation

To order the webcast on demand, call HCPro customer service at 800-650-6787 or visit the HCPro Marketplace.

UN declares drug resistance a global threat to humanity

The fight against antimicrobial-resistant (AMR) infections has become a hot topic in 2016, and the United Nations (UN) has now joined the fray. This year, The Joint Commission and CMS making antimicrobial stewardship programs (ASP) mandatory for all healthcare facilities. At the World Economic Forum in Davos, 74 drug makers, 11 diagnostic test manufacturers, and nine industry groups signed “The “Declaration on Combating Antimicrobial Resistance.” Two different disease strains were found to be resistant to the “last-resort” antibiotic colistin.

During the 71st session of the UN General Assembly in New York City last week, the world’s governments discussed the increasing dangers posed by AMR infections and doubled down on the need for national and international AMR action plans. This makes AMR infections the fourth health issue in history to be taken up by the U.N. General Assembly after HIV, noncommunicable diseases, and Ebola.

“Antimicrobial resistance threatens the achievement of the Sustainable Development Goals and requires a global response,” said H.E. Peter Thomson, president of the 71st session of the UN General Assembly, in an address to delegates. “Member states have today agreed upon a strong political declaration that provides a good basis for the international community to move forward. No one country, sector, or organization can address this issue alone.” [more]

ECRI: Most wrong-patient errors are preventable

Despite the onset of electronic medical records and other ways of identifying patients, wrong-patient procedures still occur with distressing frequency. In a newly published analysis, the ECRI Institute reviewed 7,600 wrong-patient events in 181 hospitals. Roughly 9% of those errors resulted in a patient being hurt or dying, despite the fact that most of the identification mistakes were preventable.

“Although many healthcare workers doubt they will actually make a mistake in identifying their patients, ECRI Institute [Patient Safety Organization (PSO)] and our partner PSOs have collected thousands of reports that show this isn’t the case,” says William M. Marella, MBA, MMI, ECRI Institute executive director of PSO Operations and Analytics. “We’ve seen that anyone on the patient’s healthcare team can make an identification error, including physicians, nurses, lab technicians, pharmacists, and transporters.” [more]

Joint Commission announces new EP deletions

On January 1, 2017, The Joint Commission will delete 51 Elements of Performance (EP) from its hospital accreditation standards. The deletion is part of an ongoing effort to remove similar, duplicative, or unneeded EPs from the accreditation process.

Click here to see the deleted EPs. 

Finding the causes of EHR failure

Despite the many promises to the otherwise, electronic health records (EHR) haven’t simplified physicians’ lives. Instead, the average physician today spends twice as much time working with EHRs than interacting with patients.

One study by the Office of the National Coordinator for Health Information Technology (ONC) found that 14% of physicians have experienced a potential medication error due to their EHR in the past month. Another 14% said that the excessive amount of alerts had caused them to overlook something important.

To solve this problem, the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Pew Charitable Trusts held a summit with 70 EHR systems experts from across the medical field. The group discussed the best possible solutions of preventing EHR medical errors, improve care quality, and improve workflow. The group published a fact sheet on their findings this month, outlining three major problems and their solutions.

“By raising the bar on testing for usability, measuring performance, and opening up ways to share learning on problems and solutions stakeholders can make progress on EHR usability and safety and help clinicians deliver safe, patient-centered, high-quality care,” they write.

Problem: Inadequate testing requirements
Sometimes EHR vendors fail to conduct rigorous enough testing on their products before they are released. Whereas a small bug, glitch, or unexpected change would be a minor annoyance in other fields, improper testing of systems can result in patient harm.
Solution: Create minimum requirements for EHR testing
Currently, only summative testing (which is done after the EHR’s design process) is mandated by the ONC. The summit agreed that additional requirements be made for both formative testing (while the system is being developed) and post-implantation testing (after it’s been installed.)

Problem: insufficient measures of HER safety and usability
The group pointed to a lack of a universally accepted metrics of EHR performance as a major issue. Without them, there’s no way to set quality benchmarks or see if an issue is specific to one system or popping up everywhere.
Solution: Create and disseminate recommendations to the healthcare field
The National Quality Forum has come up with a list of recommended measures for hospitals, vendors, and patient safety organizations to use when improving EHR safety and usability.

Problem: Poor communication of EHR failures between facilities
Between fear of infringing on EHR vendor intellectual property clauses, and a lack of clear communication system, facilities are often unable or unwilling to discuss problems they’ve had with their EHRs. This results in hospitals having to reinvent the wheel every time there’s an issue, even if the same problem was already solved in a different facility.
Solution: Create an organization to examine and manage all EHR-related issues
This step is recommended by the ONC and the Institute of Medicine. The organization would be able to share providers’ experiences without violating copyright gag orders.

Study: Quality isn’t affected by physician employment

A new study published in the Annals of Internal Medicine found that between 2003 and 2012, the number of hospitals hiring physicians jumped up by 13%. Despite this, the authors caution that the glut in physicians will have little impact on care quality.

Forty-two percent of hospitals were employing physicians in 2012, the majority of which were teaching hospitals, nonprofits, and larger facilities. The study’s authors then looked at key quality metrics between 803 hospitals that switched to the employment model vs. 2,085 hospitals that didn’t. They wanted to see if there was a noticeable difference in length of stay, patient satisfaction, mortality, and 30-day readmissions when hospitals changed their employment style. What the researchers found was that hiring physicians had almost no impact on any of these metrics. Mortality rates, for example, were only 0.1% better in hospitals that switched compared to those that didn’t. The only exception was for pneumonia (secret and public) which saw a 0.6% improvement in switched hospitals.

“Our study, which used contemporary national data, suggests that a fundamental improvement in care delivery will require more than mere changes in hospital-physician integration, and if physician employment is a key ingredient, it must be linked to other key goals, such as hospital prioritization of quality, to be successful,” the authors wrote.
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CMS: Hospital readmission rate drop nationwide

Between 2010 and 2015, hospital readmission rates have dropped an average of 8% nationally, with 100,000 unnecessary patient readmissions avoided in 2015 alone. CMS reported the news on its blog, stating that 49 states and the District of Columbia have seen reductions in avoidable 30-day readmissions of Medicare patients over the past five years.

Readmissions reduction has been a major goal for CMS, with an estimated $17 billion in Medicare spending spent annually on avoidable hospital readmissions.  The agency also announced that it would be increasing its fines for high readmission rates in fiscal 2017. While hospitals may look to this new data as a sign of hope, a study in The New England Journal of Medicine  cautions that the continuing the drop may not be possible.

“Presumably, hospitals made substantial changes during the study period but could not sustain such a high rate of reductions in the long term,” the authors wrote. [more]