Recent Articles
Contest winner: OPPE forms simplified
Thanks to Sharon Chaput, RN, CSHA, director of regulatory and quality management at Brattleboro Retreat in Brattleboro, VT for sending in this OPPE indicator form and OPPE master grid. We here at HCPro have heard for several years now how tricky it can be to measure physician performance, so we’re happy to share these forms, which can be adapted to meet the needs of any specialty.
“The Joint Commission surveyor told us this past June that this form is the best he has seen in the country,” Chaput writes.
Most hospitals allow physicians to hold privileges without board certification
A new study indicates that the majority of hospitals are inconsistent in tying board certification to privileges. Eighty-two percent of all hospitals whose policies require recertification allow surgeons and non-surgical subspecialists to retain privileges after their board certification expires, according to the study, “Use of Board Certification and Recertification in Hospital Privileging,” published in the August issue of The Archives of Surgery.
That means only 5% of surgeons and 3% of non-surgical physicians who are required to be board certified are at the time the hospital grants them initial privileges.
HCPro received, and still is receiving, a huge response from readers who voiced their opinions regarding board certification as a measure of physician competence. Read on for the reader comments.
Part I: Join the conversation: Board certification and competency
Part II: Board certification conversation still going!
Part III: More talk of board certification
[via Credentialing Resource Center Blog]
Heads up: Physicians are people, too
Two new studies support mysterious rumors that doctors are people, too. According to a study in the Sept. 23/30 issue of JAMA, fatigue isn’t the only factor that increases the likelihood that a physician will make a medical error. Other factors, such as financial and familial distress, also contribute. When developing a burnout prevention program, it is important to separate fatigue from other stress factors, the study suggests.
On a similar note, another study in the same issue of JAMA says that meditation may help relieve symptoms of burnout caused by fatigue and personal problems, as well as improve physicians’ relationships with patients. Physicians who participated in a mindful communication education program demonstrated sustained improvements in well-being, and their attitudes associated with patient-centered care improved.
Reform: Quality, Cost and Access… Access to what?
I have been extremely interested in watching the debate on health ______ reform. I intentionally did not fill in the blank because this has become a bit of a moving target. Of course, this debate began as a discussion on healthcare reform. But somewhere along the line, someone changed the terminology. Now, we no longer hear President Obama discuss healthcare reform, but health insurance reform. I am perfectly okay with this term because I believe it more accurately depicts what the current proposals have become.
Most would agree that early on in the reform debate, three main issues were identified as being central to any meaningful reform—quality, cost, and access. The current bills under consideration in both the House and the Senate contain some elements of all three. However, they all place heavy emphasis on access and do precious little to address quality and almost nothing to address cost (except increase the cost, but that is another blog post). But these bills also beg the question: Access to what? Access to actual healthcare or access to health insurance? Clearly, if you study these bills, they are more focused on providing access to health insurance, and thus, the appropriate shift in the terminology by President Obama and others.
Contest entry: Go paperless
Jenna Duch, medical staff coordinator at Akron Children’s Hospital in Ohio, submitted a suggestion to the Greeley Medical Staff Institute Symposium contest that we wanted to share because it will help save the environment. Duch puts all of the medical staff orientation materials onto a USB key rather than stuffing several trees’ worth of paper into cumbersome binders. She includes hyperlinks on the agenda page to guide medical staff members through all of the documents and help them find specific information. Transitioning to USB drives is a strategy any department–including hopsitalist programs–can do!
Contest entry: Promote hospitalist-case manager partnership
Stefani Daniels, managing partner at the PHOENIX: The Hospital Case Mgmt Co., submitted her entry for The Greeley Medical Staff Institute Symposium contest. At every client hospital that Phoenix works with is a plan for dedicated case managers to be assigned to hospitalist teams, in what Stefani calls a “win-win relationship.”
“For the hospitalist, it means that he or she has someone who will help manage the ‘business’ of managing care—someone who will deal with the insurers if necessary, the utilization review nurses, the documentation improvement specialists, and others who want a piece of the hospitalist’s time to ensure compliance with the rapidly escalating regulatory requirements.”
R-E-S-P-E-C-T : This is What it Means to Me
Most hospitalists were not yet born when Aretha Franklin recorded the lyric, “R-E-S-P-E-C-T – Find out what it means to me.” Still, the song remains popular and captures quite well the drive for legitimacy in hospital medicine. Many hospitalists do not feel respected, not by specialists who want to dump patient care responsibilities on them, not by hospital administrators who deny them fair compensation and appropriate staffing, and not by patients wanting to know why their doctor is not seeing them. The secret of gaining respect is to show respect to others.
Many older physicians resent the changes that have occurred in medical practice and regard hospitalists as part of the problem, not as part of the solution. The key to getting along with these doctors is to show that you value the things that they consider important, most particularly the physician-patient relationship. Start by sitting down with them in the cafeteria and the doctors’ lounge. Listen carefully to what they say, and you will learn a lot about the history and traditions of the hospital. Some things may be outdated, but you will discover that most of the rules and procedures of the medical staff were developed for very good reasons that remain valid today.
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Contest entry: Physician retention redesign plan
“A lot of time, money, and effort go into recruiting physicians,” says Medical Staff Coordinator Carrie Garity, CPMSM, at Fort HealthCare in Fort Atkinson, WI. “They fly them in, wine and dine them, show them the hospital, clinics, and community. Once the physician decides to join a medical staff, however, the royalty treatment seems to end.”
Carrie sent in a great redesign plan on physician retention for The Greeley Medical Staff Institution contest. Carrie heard from a physician on staff for about five years that he didn’t know what he was doing for months when he first started, particularly finding out about policies and procedures after the fact. The physician’s partners were simply too busy to discuss anything with him.
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Who’s speaking at the Greeley Medical Staff Institute Symposium hospitalist track?
Martin B. Buser speaks at the 2008 Hospitalist Management Program, hosted by HCPro. (Photo Karen M. Cheung HCPro, Inc.)
HCPro, Inc. and The Greeley Company are busy planning the Greeley Medical Staff Institute Symposium (November 8-9, Naples, FL)!
We’ve got nearly two dozen distinguished speakers on board for the entire symposium, and we’re proud to have the following experts speak on the hospitalist track:
- Hussein Akl, MD
Director of Inpatient and Regional Medicine
Bronson Methodist Hospital, Kalamazoo, MI - Martin B. Buser, MPH, FACHE
Founding Partner
Hospitalist Management Resources, LLC, San Diego, CA
Many physicians favor public option
I just read about a recent study conducted by the Robert Wood Johnson Foundation to gauge physician’s reactions to healthcare reform.
Sixty-three percent of physicians support some type of government-backed healthcare reform, says the study, which appeared in the New England Journal of Medicine .
Check out this article from United Press International.
I’d love to hear what physicians out there think–and why! Comment below.
Accountable Care Organizations and hospitalists
A recent article in the American Medical News Web site discusses Accountable Care Organizations (ACOs) as a potential element in healthcare reform.
Don’t feel bad if you have not heard of this delivery model. It is not yet in practice in any significant way. However, look for several demonstration projects to start during the next year or two.
Basically, ACOs are an integrated delivery system (including hospitals, primary care physicians, specialists, and probably some other providers as well) which will coordinate care across the organization in a manner designed to improve quality and decrease costs. Medicare reimbursement would most likely remain fee-for-service. However, reimbursement would probably have a “withhold” that could be returned in the form of a bonus (resulting from meeting quality benchmarks and cost savings). It will be up to an administrator to distribute the savings bonus amongst the various provider elements of the ACO.
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Bundling to hit hospitalists, says new white paper
You may have already heard that the hospitalist think tank Phoenix Group recently released a white paper, “Hospitalists Assess the Impact of Bundled Fees.” The white paper makes a bold statement, calling the proposed payment restructuring in the form of bundling fees the “cataclysmic uprooting of the traditional fee-for-service payment system.”
Although the Society of Medicine at its annual 2009 meeting declared that it has no official stance on bundling, The Phoenix Group has been vocal in assessing the effects of bundling.
