In case you missed it, The Joint Commission added a new frequently asked question (FAQ) and updated 19 existing FAQs last week. The new question tackles the issue of physician texting medical records.
You can read the updates here.
The usual suspects topped the list of root causes for sentinel events – human factors, leadership, and communication, according to a report released by The Joint Commission on Friday, April 24, 2015. The report covered root causes for sentinel events from 2012 through 2014.
Health information technology-related (new to the report), operative care, and continuum of care rounded out the top 10 list for 2014.
Read the full report at The Joint Commission.
Tuesday, April 28, 2015
1-2:30 pm Eastern
Join us for a 90-minute webcast on how to plan and conduct an emergency drill with clear measurable objectives, and how to use the lessons learned from that drill to educate your staff.
CMS and The Joint Commission require your hospital to have plans in preparation for any emergency, but they also have two lifelike exercises per year that test your ability to respond under pressure.
Take the stress out of preparation with tips and advice provided by our healthcare emergency management experts.
The webcast is presented by expert speakers Tracy Buchman Sonday, DHA, CHPA, CHSP, and Christopher Sonne, CHE.
Click here for more information.
Unintended retention of foreign objects, patient falls, and suicide were the top three sentinel events reported to The Joint Commission in 2014. The accreditor last week released the report, which examines sentinel events from 2004 through 2014.
Of the 764 events reported in 2014, foreign objects (91), falls (91), suicide (82), delay in treatment (73), and “other unanticipated event” (73) were far and away the most common. Overall since 2004, there have been 8,645 incidents reported; that list is topped by wrong patient/wrong site/wrong procedure with 1,102 (the category was sixth on the 2014 list with 67).
Read The Joint Commission’s sentinel events summary.
In 2013 there were more than 23,000 significant injuries in the workplace due to assaults, according to a recent report by OSHA. More than 70% of these assaults were in healthcare and social service settings. Further, OSHA says that healthcare and social service workers are almost four times as likely to be injured as a result of violence than private sector employees.
The above statistics prompted OSHA to release an update to its Guidelines for Preventing Workplace Violence for Healthcare and Social Workers, also known as OSHA Rule 3148. The update recommends that all healthcare facilities develop an effective workplace violence prevention program. According to our sources, The Joint Commission is following these changes very closely.
The updated guidelines are specific in the types of workplace controls employers should consider, especially in terms of facility security and keeping track of both on-site and off-site employees. Some examples:
- The use of silent alarms and panic buttons in hospitals and medical clinics
- Providing safe rooms and arranging furniture to make sure there are clear exit routes for employees and patients
- Installing permanent or hand-held metal detectors to detect weapons, and providing staff training on the use of these devices
- Ensuring nurse stations have a clear view of all treatment areas, including the use of curved mirrors and installing glass panels in doors for better viewing, as well as closed circuit cameras to help monitor areas
- Using GPS, cell phones, and other location technology to help keep track of staff working with patients in off-site locations
- Protecting front-end triage staff using facility design elements such as deep counters, secure bathrooms for staff separate from patient treatment areas, and using bulletproof glass and lockable doors with keyless entry systems.
Recommendations also include employing administrative controls designed to track patients and visitors who have a history of violence, to better educate workers on the dangers and signs of impending violence, and to ensure better reporting procedures. Some examples:
- Providing clear signage in the facility that violence will not be tolerated
- Instituting procedures that require off-site staff to log in and log out, as well as checking in with office managers periodically
- Keeping a behavioral history of patients, including identifying triggers and patterns
- If necessary, establishing staggered work times and exit routes for workers who may be subjects of stalkers
- Keeping a “restricted visitor” list for suspected violent people, such as gang members, and making sure all staff are made aware of the list
OSHA also recommends employers provide updated training for employees, including:
- Risk factors that cause or contribute to violent incidents
- Early recognition of escalating behavior or recognition of warning signs
- Ways to recognize, prevent or defuse volatile situation or aggressive behavior, manage anger and appropriately use medications.
- Self-defense procedures where appropriate
- How to apply restraints properly and safely when necessary
- Ways to protect oneself and coworkers, including use of the “buddy system”
For further information on the updated rule, visit https://www.osha.gov/Publications/osha3148.pdf.
CMS released the IPPS proposed rule for fiscal year 2016, which includes changes to MS-DRGs and the expansion of its value-based payment quality measures as it has in the past.
Included in the proposed rule, CMS is asking for public comments regarding the implementation of bundled payments for inpatient care. As of now, CMS has not discussed how it will implement payments.
CMS is proposing removing two measures from the hospital value-based purchasing (HVBP) program:
- IMM-2, Influenza Immunization
- AMI-7a, Fibrinolytic Therapy Received within 30 Minutes of Hospital Arrival
If the measures are removed, PC-01 (Elective Delivery) to the Patient Safety domain will move to the Patient Safety domain and remove the Clinical Care—Process subdomain for FY 2018 and beyond. This change will have an increased weight in the HVBP scoring methodology in FY 2018 (from 20% to 25%).
CMS is proposing the addition of two measures to the HVPB program:
- 3-Item Care Transition Measure for FY 2018
- Hospital 30-Day, All-Cause, Risk-Standardized Mortality Rate Following Chronic Obstructive Pulmonary Disease Hospitalization beginning in FY 2021
CMS is asking for input from the hospital community. Comments are due by June 16, 2015. They may be submitted electronically or in hard copy.
Are you an accreditation specialist or handle survey preparation for your organization? If so, we invite you to take the 2015 Accreditation Professionals salary survey.
All responses are anonymous and we’ll provide the survey results in an upcoming issues of Briefings on the Joint Commission.
Click on this link to take the survey.
Yesterday, CMS officially unveiled the star ratings on its Hospital Compare website in an effort to make it easier for consumers to choose a hospital and understand the quality of care each delivers.
After the new rating system went into effect, only 251 out of approximately 3,300 hospitals have all five stars. The Hospital Compare site notes that a hospital with a one-star rating doesn’t indicate a consumer will receive poor care and encourages consumers to consider multiple factors when choosing hospitals, rather than focusing solely on the star rating.
The CMS has fined 12 Medicare Advantage plans nearly $4 million in civil money penalties (CMP) since the beginning of the year. Nearly all of the plans were cited for failing to comply with contract requirements, such as incorrect prescription information or coverage disputes.
CMPs are the lowest enforcement penalty the CMS orders, although the financial penalties can be steep. Penalties issued so far range from approximately $21,000 to $1 million. The highest penalty is plan termination.
Additionally, CMS ordered one plan to suspend enrollment and three plans were released from sanctions after correcting deficiencies.
Medical practices from the “Dark Ages” are usually discounted, but the recent discovery that a 1000-year-old remedy for eye infections may cure antibiotic-resistant infections may change that.
The recipe, found in Bald’s Leechbook (an old English text known as one of the earliest medical textbooks), contains ingredients such as garlic, onion and or leek, wine, and oxgall (bile from a cow’s stomach).
Researchers followed the recipe as closely as possible, including letting it stand for nine days before straining it. They decided to test the finished recipe on cultures of MRSA, methicillin-resistant Staphylococcus aureus. The recipe worked, while it didn’t wipe out all of the cells, it wiped out enough cells (think billions) to be considered a success.
Researchers in the United States have performed similar tests on lab mice with similar success rates. In each case, the Dark Ages medical cure performed better than the regular antibiotic treatment.