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Healthcare workers and flu vaccination

At last count, 47 states were having “flu emergencies,” with a marked increase of reported influenza cases compared to recent years.  So it’s time for me to share one of my pet peeves again: influenza immunizations for healthcare workers.

This came back into the public arena again earlier this month when ABC News ran a story about eight employees who were fired from an Indiana hospital because they refused this year’s flu shot.  A former president of the National Foundation for Infectious Diseases was reportedly quoted as saying “I cannot think of a reason for any health care professional to decline influenza immunization that’s valid.”  A bit of a strong statement, but one I wholeheartedly agree with!

I feel that  it is unconscionable for healthcare workers to put the at-risk population we care for in jeopardy of acquiring a potentially life threatening illness due to our “right” to refuse immunization.  That said, what about religious convictions?  What about our right to decide what is “best” for us?

Who is responsible if a significant adverse reaction occurs to a healthcare worker that was “forced” to be immunized?  I believe the benefits of yearly influenza immunization far outweigh the risks.  Many of our employees who declined the vaccine earlier this year have now decided to get it.  I wonder what that means about their initial reasons for refusal.  What do you think?

 

New York State – the place to get really sick?

Is New York State the best place to be if you become septic?  Isn’t this the state that brought a bill to the assembly in 2011 that threatened to make “reckless infection of a patient with a communicable disease by a health care provider” a felony?  Now, the governor has mandated that all New York hospitals develop aggressive procedures for identifying sepsis.  Didn’t the “Surviving Sepsis Campaign” start in 2002?  So – better late than never, New York.

But wait – why is a state governor  mandating this?  Shouldn’t something like this come from the medical folks and not the government?  Could it be that N.Y. hospitals aren’t doing such a great job at diagnosing and managing sepsis?  As a physician I am embarrassed that the government needs to tell us that this is an issue.  I’m proud to say my hospitals have been following the sepsis guidelines for years, but I guess some hospitals haven’t.

Shouldn’t this evidence-based medicine approach to diagnosing and treating sepsis be a quality factor monitored by physicians, nurses, quality personnel, and medical staff professionals?  Should we be waiting for the government to tell us what the right thing to do for our patients is?  Should our hospitals’ credentialing and privileging process be more attuned to matters of life and death than to the number of discharge summaries not dictated in a “timely” fashion?  What do you think?

Call for submissions: Privileging forms, policies, and procedures

Want to help out your fellow MSPs and learn how other MSPs tackle their credentialing challenges?

Credentialing Resource Center is looking for member-submitted privileging forms, policies, and procedures to share with our subscribers. While we make every effort to keep our Clinical Privilege White Papers up-to-date, sometimes there are new procedures and technologies that we have not been able to address yet. Your forms could aid other organizations in solving their privileging dilemmas, and vice versa!

Whether it’s credentialing criteria for RNFAs or sample bylaws language for delineating medical staff categories, we want to see the forms that have helped your organization address credentialing issues. Examples of these member-submitted forms can be found when you log in at www.credentialingresourcecenter.com.

To share your privileging forms, please email documents, along with a brief explanation of the contents, to Katrina Gravel (kgravel@hcpro.com). Thank you!

Best regards,
Katrina Gravel
Credentialing Resource Center Blog

Happy National Medical Staff Services Awareness Week!

Did you know that in 1992, President George H.W. Bush declared the first week of November as National Medical Staff Services Awareness Week? In his proclamation, Bush wrote that the week honors MSPs for playing “an important role in our nation’s healthcare system.” The National Association Medical Staff Services (NAMSS) developed a press release for medical facilities to use in promoting this special week and explaining the role of the MSP. Let’s face it: many healthcare consumers are unaware of the medical staff services department. I will admit, I was one of those healthcare consumers who did know what the word credentialing meant before I started working at HCPro. Here is an excerpt from the NAMSS press release:

“MSPs are experts in provider credentialing and privileging, medical staff organization, accreditation and regulatory compliance, and provider relations in the diverse healthcare industry. They credential and monitor ongoing competence of the physicians and other practitioners who provide patient care services in hospitals, managed care organizations, and other healthcare settings.

“MSPs are a vital part of the community’s healthcare team. They are dedicated to making certain that all patients receive care from practitioners who are properly educated, licensed, and trained in their specialty.”

I think we can all agree that the role of MSP has expanded far beyond what can be summarized in a one-page press release. What I find amazing is how passionate MSPs remain about their work, even as their workload increases and they face greater resistance from physicians to complete all of these credentialing and competency checks. When I told two of my personal physicians what I do for work, they each responded with similar comments: “I hate that credentialing stuff. It takes up so much time and I have to fill out the same papers over and over.” I have to admit, I was kind of surprised to hear this. I guess I had hoped that physician resistance to credentialing was a myth. What I did not get a chance to ask either of my physicians about was their relationship with the MSPs at their hospitals. I will keep my hope alive that this answer would have been a lot more positive.

In honor of all that MSPs do, HCPro is offering you and your colleagues a 20% discount on all of our medical staff and credentialing products from Nov. 5-9. Visit the HCMarketplace and enter EB202434 during check out to receive your discount.

On behalf of HCPro, and as a patient who has always received great care from exceptional physicians, thanks for all of your hard work!

Difference of opinion in Texas

Public Citizen, a nonprofit organization that advocates for individual rights, says the Texas Medical Board needs to step up its game. The organization asserts that the state medical board has failed to punish many physicians in the state who have received sanctions from healthcare organizations. The Texas Medical Board disagrees, citing Federation of State Medical Boards data that often ranks Texas at the top for disciplining physicians.

According to an article from HealthLeaders Media, Public Citizen analyzed 21 years of NPDB data.The group found that almost 450 Texas physicians who had been sanctioned by a healthcare entity had yet to be disciplined by the Texas Medical Board. Public Citizen sent a letter to Texas Governor Rick Perry urging him to take “immediate action to improve the performance of the Texas Medical Board and thereby protect patients in Texas from physicians who should have been, but were not, disciplined.”

Public Citizen does not blame the medical board; it instead puts the blame on a lack of funding and staffing. In Texas, the money that is collected through physician appointments, reappointments, and fines is placed in the state’s general fund. The medical board than submits a request for funding to perform its functions.

Lee Hopper, spokeswoman for the Texas Medical Board, says the agency is not underfunded or understaffed. “Like anybody, of course we would always like more money. But we haven’t been dealing with a budget crisis so the agency is healthy and it’s effective,” she tells HealthLeaders Media.

In its letter to Perry, Public Citizen recommends letting the medical board keep more—preferably all—of the funds it collects. This raises some interesting questions to think about.

Should the medical board be entitled to all of the money collected through its processes? Should the medical board learn to do more with less, like many other businesses and citizens are currently forced to do?  Would more funding lead to more disciplinary action?

The question that really sticks on my mind is, as a healthcare consumer, how important is it that disruptive physicians be disciplined? I know the short answer is very, but at what cost? Do you want your state’s medical board to use all of the money it collects to fund its needs? Or would you like to see some of this money go into the state’s general fund to be used for other public services?

Free Form Friday: FPPE proctor evaluation form

Congratulations to Vicki Tauer, our March winner of the 15th Annual Credentialing Resource Center Symposium free seat contest. Tauer, MSM, CPCS, CPMSM, is the supervisor of medical staff services at Fairfield Medical Center in Lancaster, Ohio. Her medical staff office recently revamped its FPPE proctor evaluation form to make it more user-friendly for proctors.

Here is a copy of the FPPE proctor evaluation form.

For more information on the CRC Symposium, which takes place May 10-11 in Orlando, click here.

Free Form Friday: New Agenda Topics

Thanks to Shirley Petry, CPCS, for submitting this form showing how she keeps track of new medical staff meeting agenda items during her busy day. By keeping this form near her phone, Petry is able to quickly get the pertinent information from the requestor regarding the agenda item, and can then put it in the appropriate medical staff meeting file when she has time. To read about how this form has helped Petry, click here.

To see a copy of the form, click here.

Patient Satisfaction Blog Series for CRC 2012

Courtesy and Respect? Don’t have to; I’m the Physician!

As I mentioned in my last post, there are three physician-specific questions on the Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS survey:

  • During this hospital stay, how often did doctors treat you with courtesy and respect?
  • During this hospital stay, how often did doctors listen carefully to you?
  • During this hospital stay, how often did doctors explain things in a way you could understand?

This post will deal with tips to improve your scores on the courtesy and respect question.  Hopefully you have bought into the concept that improving patient satisfaction improves quality.  If you haven’t yet, then try these suggestions and see what happens.

Since approximately 85% of communication is non-verbal, pay particular attention to your body language. We have all been in situations where the body language was so loud, that the spoken words could not be “heard.”  Clear your mind prior to beginning the encounter.

Brush up on your polite behaviors such as:

  • Knocking on the door before entering
  • Making eye contact with the patient and visitors
  • Introducing yourself and the members of your team
  • Addressing the patient by their preferred name

Do not discuss the patient in the third person when they are present.  They are not just the “gallbladder in room 203” but actually a person, too.

These are just a few of the proven methods to improve patient satisfaction and your score on this question.  Try these out this week; next week I’ll be sharing about listening skills.

Editor’s note: William Mills, MD, MD, MMM, CPE, FACPE, CMSL, FAAFP, is a featured speaker at the 15th annual Credentialing Resource Center Symposium, May 10-11. He will be speaking on using patient satisfaction scores to drive improvement as well as how to privilege low- and no-volume practitioners. For more information, click here.

Patient Satisfaction Blog Series for CRC 2012

Pat Sat/HCAHPS/P4P – Huh?

This is the first of a series of five postings that will attempt to make sense of some the above. Patient satisfaction has risen to the top of many a list as the government and other payers are establishing pay for performance (P4P) initiatives. One of the reasons everyone is working on this is there is a clear connection between patient satisfaction and quality. Check out the New England Journal of Medicine for more information on this (2008; 359:1921-1931).

Because patients, payers, and politicians now care about patient satisfaction, the next three posts will provide tips for improving scores on the three physician specific questions on the HCAHPS questionnaire. The last post will tie it all together to show physicians and MSPs how patient satisfaction affects physician performance.

To start, what is HCAHPS? The Hospital Consumer Assessment of Healthcare Providers and Systems is a 27-question survey developed by Centers for Medicare and Medicaid Services with the following goals in mind:

  • To produce data about patients’ perspectives of care that allow objective and meaningful comparisons of hospitals on topics that are important to consumers
  • To create incentives for hospitals to improve quality of care by making public survey results
  • To enhance accountability in healthcare by increasing transparency of the quality of hospital care provided in return for public investment (also by making public the survey results)

Although this survey covers a number of areas, my blog posts will cover these three physician-specific questions:

  • During this hospital stay, how often did physicians treat you with courtesy and respect?
  • During this hospital stay, how often did physicians listen carefully to you?
  • During this hospital stay, how often did physicians explain things in a way you could understand?

Until next time, try to get your arms around the fact that improving patient satisfaction will improve quality.  For many of us, this fact will be difficult to swallow, but swallowing (internalizing) this will be critical for our success in the future.

Editor’s note: William Mills, MD, MD, MMM, CPE, FACPE, CMSL, FAAFP, is a featured speaker at the 15th annual Credentialing Resource Center Symposium, May 10-11. He will be speaking on using patient satisfaction scores to drive improvement as well as how to privilege low- and no-volume practitioners. For more information, click here.

Solving the low- and no-volume issue

If you read this week’s Credentialing Resource Center Connection e-newsletter, you know there is an upcoming webcast regarding low-and no-volume practitioners. And hopefully you all immediately clicked on the link to sign up! If you did, unfortunately, you were taken to a link for a previous webcast.
Here is the correct link. Now you have no excuse not to sign up!
Here is a reminder of what this webcast will offer:
Create strategic solutions to privileging low- and no-volume practitioners with advice from two leading medical staff and credentialing experts. In this online program, Yisrael M. Safeek, MD, MBA, CPE, FACPE, an experienced physician leader and former Joint Commission surveyor, and Sally Pelletier CPMSM, CPS, a national credentialing and privileging expert, walk medical staff leaders and medical services professionals through steps to develop a working strategy to establish competency for low- and no-volume practitioners.

Take a peek at the agenda:

  •     Contributing factors to the increase of low- and no-volume practitioners
    •         Governance documents that hamper the hospital’s ability to effectively manage low- and no-volume practitioners (i.e. link membership and privileges)
  •     How does low-volume affect competence
  •     Matching privileges with competence
  •     Building a strategic approach to low- and no-volume practitioners (e.g. intended practice plan, medical staff development plan)
  •     Working strategies to address low- and no-volume
    •         A medical staff culture that feels an obligation to the low- and no-volume practitioners
  •     Types of data sources
  •     How to compile and present the data in a meaningful way

This webcast will be presented on Tuesday, February 21 at 1 p.m. And one more time, here is the correct link to sign up.