RSSAuthor Archive for Brian Ward

Brian Ward

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

Tell us what you’re looking for in Accreditation Books

Hi there!

I’m working on the newest batch of Accreditation books out and I need your help!

This year we’re planning on writing books on:

  • Mock Tracers
  • CMS Compliance Crosswalks
  • Suicide Prevention
  • Survey Readiness

These book will come with with the newest updates to CMS and other Accrediting Orgs. Plus tools, checklists, and quizzes, and more! But before we can get started, we need to get your feedback.

Please answer this 3 minute survey so we can write the best books we can!

Thanks!

Brian Ward, Associate Editor

Public comments open for NFPA active-shooter standards

Preparing to respond to an active-shooter event, whether that involves a surge of patients to your facility because of an incident off-campus or a hostile intruder inside your building, has become a major concern to most hospital officials.

For only the second time in its history, the National Fire Protection Association (NFPA) is fast-tracking development of a standard to help first responders, healthcare providers, facility managers and others to prepare for an active shooter incident, and they are looking for public input.

NFPA 3000, Standard for Preparedness and Response to Active Shooter and/or Hostile Events, could be ready as early as April, so public comments must be submitted by Feb. 23.

A draft copy is available online but you may be required to register with the NFPA first. To comment on draft of NFPA 3000 go to www.nfpa.org/3000 . And to read the NFPA 3000 fact sheet  go to https://tinyurl.com/NFPA-blog-active-shooter.

Tell us what you think about PSMJ and BOAQ

Dear BOAQ & PSMJ Subscribers,

We’re making much needed overhauls to BOAQ and PSMJ’s website this year. But before that happens, we want to hear your thoughts on how we can improve in 2018. Please share your feedback by taking this quick survey:

BOAQ Survey: https://goo.gl/kCPSER

PSMJ Survey:  https://goo.gl/kCPSER

Your responses are invaluable to us and if you have ideas or suggestions for us, send them our way!

Brian Ward, Associate Editor

CMS Inpatient-Only List: Preparing for Critical Changes in 2018

Each year CMS revises its inpatient-only list of approximately 1,700 procedures. The most notable changes to the list that went into effect January 1, 2018 include the addition of coronary revascularization during an acute myocardial infarction and the removal of total knee arthroplasty. Knee replacements, according to CMS, now may be performed on either an inpatient or an outpatient basis.

These list revisions are vital for hospitals to track and take into account. For example, “removing knee replacement surgery from the inpatient-only list is going to cause major changes for hospitals and physicians who do these procedures,” says Kurt Hopfensperger, MD, JD, vice president of compliance and physician education at Optum Executive Health Resources. Moving forward, they will have to apply utilization review processes more rigorously.

Keeping pace with change

Hospitals that closely follow and interpret the CMS inpatient-only list benefit in several ways. The list follows evidence-based medicine and looks at the average length of stay, as well as typical risks and comorbidities, for each procedure. Thus, correctly placing a patient in inpatient status is a clinically good decision, and it helps organizations stay in compliance with Medicare rules.

Hospitals also protect revenue by making sure every patient undergoing a procedure on the inpatient-only list has a correct status determination, says Hopfensperger. As procedures drop off of the list, hospitals must do the same to avoid potential revenue integrity issues. “You want to make sure you are appropriately compensated for those patients who are high risk or who require a longer stay in the hospital,” he notes.

Continued at Health Leaders Media

Surgeon sued for double booking surgery

There’s a reason why the American College of Surgeons (ACS) recommends asking patients if they’re okay with a concurrent surgery before operating. A Manhattan doctor found that out the hard way, after two former patients sued him last month for $14 million, according to the Boston Globe.

The patients claim that David B. Samadi, MD, chief of urology at Lenox Hill Hospital, allowed doctors-in-training to perform their prostate surgeries, and was only present for 25 minutes for one of the surgeries. Further, they claimed they were put kept under general anesthesia longer than necessary to hide Samadi’s absence, and that the operations were botched.

Last year, a review of more than 2,000 neurosurgical cases published in the Journal of the American Medical Association found no greater risk of postoperative complications for patients operated on by surgeons conducting overlapping surgeries. That said, the ACS guidelines are clear that patients need to know about and consent to an concurrent surgery before a provider does one.

Bradley T. Truax, MD, principal consultant of the Truax Group, says that patients should absolutely be informed if you plan to do their surgery concurrently.

“It is one thing for the surgeon to discuss with the patient that other personnel (residents, fellows, surgical assistants, etc.) will be participating in their surgery,” he says. “But the surgeon needs to make it clear what their roles will be and that the attending surgeon him/herself may not be present for the entire procedure.”

CDC Director Brenda Fitzgerald resigns

Just two days after Alex Azar was sworn in as the new head of the Department of Health and Human Services (HHS), Azar accepted the resignation of his CDC director.

Brenda Fitzgerald resigned this morning, a day after POLITICO reported that she bought shares in a tobacco company not long after taking the job — a serious conflict of interest considering that as CDC director she was tasked with reducing tobacco use.

She also bought stock in Merck & Co., Bayer, and Humana, per the POLITICO report.

From the official HHS statement: “Dr. Fitzgerald owns certain complex financial interests that have imposed a broad recusal limiting her ability to complete all of her duties as the CDC Director. Due to the nature of these financial interests, Dr. Fitzgerald could not divest from them in a definitive time period. After advising Secretary Azar of both the status of the financial interests and the scope of her recusal, Dr. Fitzgerald tendered, and the Secretary accepted, her resignation. The Secretary thanks Dr. Brenda Fitzgerald for her service and wishes her the best in all her endeavors.”

Dr. Anne Schuchat will serve as CDC’s active director, according to the agency’s website, while a permanent replacement is sought.

Fitzgerald’s departure comes as CDC combats one of the most severe flu seasons in recent memory, with dozens of deaths across the country.

It also means more changes at HHS, which figures to be under the scrutiny of President Donald Trump. When swearing in Azur on Monday, Trump vowed that his new HHS secretary was “going to get those prescription drug prices way down.” Azur and Fitzgerald’s eventual replacement must also take on the opioid crisis — a topic Trump touched upon again during last night’s State of the Union address.

Joint Commission to roll out new maternal care and infectious disease requirements

On July 1, 2018, The Joint Commission will implement three new elements of performance (EP.) The EPs are intended to reduce the risk of diseases like HIV and syphilis being passed from mother to child during birth. The accreditor made the announcement in the latest R3 Report, with the aim of protecting both the mother and child from harm.

“The requirements will help improve maternal and neonatal health in Joint Commission accredited hospitals and critical access hospitals across the country,” Kathy Clark, MSN, RN, Joint Commission associate project director specialist, Division of Health Care Quality Evaluation, said in a press release. “If left undiagnosed or untreated, infectious diseases can be extremely dangerous and even life-threatening, so it is critical that testing and treatment for both the woman and baby is completed according to clinical practice guidelines.”

The EPs require providers to test pregnant women for certain diseases that could be transmitted to the child during birth: HIV, hepatitis B, group B streptococcus and syphilis. The results are then documented in the patient’s medical record for providers to act upon.

CMS: Physicians and nurses can text, just not medical orders

CMS is clearing up recent confusion on what medical providers can text each other. The agency confirmed care team members are allowed to text patient information over a secure messaging app. However, texting medical orders is still verboten.

Some providers have taken to secure messaging platforms as a way to contact providers during emergency, to consult on medical cases, or send photos of the patient. The confusion started on December 18 after an article by the Health Care Compliance Association (HCCA) cited emails CMS had sent to two hospitals saying that “texting is not permitted.” People thought this meant “texting is never permitted” instead of “texting medical orders isn’t permitted.”

“Secure texting is an integral part of a community platform for organizations,” one manager told the HCCA. “If you pull secure texting out of that pathway, you have disrupted a huge chain of communications that will have a broader effect.”

Luckily, CMS explained this wasn’t the case in its newest S&C memo, and that it knows the value of instant messaging in the workplace.

“CMS recognizes that the use of texting as a means of communication with other members of the healthcare team has become an essential and valuable means of communication among the team members,” wrote David R. Wright, director of CMS’ Survey and Certification Group. “In order to be compliant with the CoPs or CfCs, all providers must utilize and maintain systems/platforms that are secure, encrypted, and minimize the risks to patient privacy and confidentiality as per HIPAA regulations and the CoPs or CfCs. It is expected that providers/organizations will implement procedures/processes that routinely assess the security and integrity of the texting systems/platforms that are being utilized, in order to avoid negative outcomes that could compromise the care of patients.”

Prepping hospitals for winter storms

With the biting cold and heavy snow that struck the East Coast this month, and with more on the way healthcare organizations should take a look at their preparation plans for blizzards and snowstorms.  The following tips come from Allina Health in Minneapolis, MedStar Montgomery in Olney, Md., and University of Maryland Medical Center (UMMC) in Baltimore.

1.    Plan for the long haul. Plan out sleeping accommodations for staff who will be working on-site during the storm. Also ask all scheduled staff to arrive ahead of the storm.
2.    Expect travel and road conditions to be treacherous well after the storm. Different travel routes often receive different priority when it comes to plowing and clearing, and there can be a large difference in travel conditions even just a few blocks down the road.
3.    Remember that staff are people, too. Make sure staff is taken care of as well. Movies, popcorn, and other entertainment can go a long way toward allowing your staff some rest and relaxation.
4.    Review your business continuity plan. If the storm damages your facility and requires repairs or relocation of services, make sure you have a business continuity plan to keep revenue moving.
5.    Emphasize smooth communication. Outside lines of communication are often disrupted during a storm or emergency. Healthcare organizations’ internal communication should be on point in order to pick up that slack.
6.    Review and practice your disaster management protocols. The regular review and execution of the disaster drills required of your hospital by The Joint Commission is important to stay prepared for when a disaster finally does happen—and it will.

For more articles like this, check out our sister publication Inside the Joint Commission. https://www.codingbooks.com/inside-the-joint-commission 
 

Joint Commission: Life Safety revisions for behavioral healthcare

The Joint Commission has revised its Life Safety standards LS.04.01.20 through LS.04.02.50 for its Behavioral Health Care Accreditation program. The changes apply to residential behavioral health care facilities and go into effect July 1, 2018. The revisions change the “residential occupancy” requirements so they align with the 2012 edition of the National Fire Protection Association’s NFPA 101: Life Safety Code®.

The accreditor says these changes aren’t major, and they mostly address two things:

•    Updating the NFPA chapter references used in the elements of performance
•    Making it easier to discern between the requirements for existing and new buildings and for small and large organizations.

You can read the prepublication standards here.