All Entries Tagged With: "California"

A dozen CA hospitals fined over patient safety issues

The California Department of Public Health (CDPH) has fined 12 hospitals for patient safety-related noncompliance, according to a CDPH release. The fines are for putting patients in “immediate jeopardy” of harm.

Out of 14 fines, eight were for failure to follow proper surgical safety protocol that resulted in objects left inside patients. A portion of the funds received from the fines will go toward improvement projects that focus on preventing this particular type of adverse event.

Hospitals that were cited in 2008 were fined $25,000, but a new law requires hospitals cited in 2009 and beyond to be fined $50,000 for the first citation, $75,000 for the second, and $100,000 for the third.

A detailed run down of each adverse event can be found at HealthLeaders Media. Other events include medication administration errors, medication storage errors, and failure to properly treat pressure ulcers. One patient fell out of bed, causing cardiac monitor to become disconnected. She later died.

Study: Improved nurse-patient ratios could reduce mortality rates

A recent study authored by renowned nurse investigator Linda Aiken, PhD, FAAN, FRCN, RN, found that California’s nursing ratio laws, which went into effect in 2004, have helped improve quality outcomes, especially when compared with states that do not have as strict ratios, reports HealthLeaders Media.

The study, published in the journal Health Services Research, compared outcomes data reported to the state for patients in California, Pennsylvania, and New Jersey. Analysis showed that the 30-day adjusted patient mortality rate was significantly lower in California than in the other two states. Researchers found that had Pennsylvania and New Jersey implemented staff ratios equivalent to California’s, they would have seen 10.6 and 13.9 % fewer deaths, respectively.

The study was anxiously awaited by many, as the debate in California over mandated nurse-patient ratios remains. The law requires that a nurse must care for no more than five patients on a medical-surgical unit, four pediatric patients, two in intensive care, six in a psychiatric unit, and three in labor and delivery, reports HealthLeaders Media. This is the first major study to illustrate that the nurse ratios mandated in California have helped lower mortality rates.

I know this is a “hot button” issue around the country, and I’m wondering what strategy your facility has taken? Have you had to convince leadership to hire more nurses as a quality improvement strategy? Are you waiting for more evidence?

California penalizes 13 hospitals for putting health and safety of patients in ‘immediate jeopardy’

The California Department of Public Health (CDPH) has fined 13 hospitals for placing the health and safety of patients in immediate jeopardy on 16 occasions in 2008 and 2009. The facilities were fined because their noncompliance with state regulations “has caused, or was likely to cause, serious injury or death to patients,” according to a news release.

California changed its law on January 1, 2007, to allow for monetary fines for these types of incidents, which was $25,000 per incident through 2008. Starting on January 1, 2009, that amount rose to $50,000 for the first incident, $75,000 for the second, and $100,000 for the third and any subsequent incidents at the same facility. Most of the fines announced today are from 2009. The CDPH did not announce them until now because there is a review process that each incident must go through.

To find a complete list of the incidents for which facilities were fined, click here to find a story from HealthLeaders Media.

What do you think about these state charges for adverse events? Since the fines were imposed, the state has assessed $3.675 million in fines, which according to the CDPH, will be used to prevent the events from occurring in the future.

CA hospitals fined for health code violations

The California Department of Public Health this week fined 10 hospitals for a number of health code violations including leaving foreign objects inside patients, medication errors, having faulty anesthesia equipment, and failure to prevent a patient fall. The hospitals were fined $25,000 per violation. All cited hospitals must submit a plan of correction to the state.

The state has issued 71 violations to 49 California hospitals since January 1, 2007.

The violations handed down this week include the following, according to the Associated Press:

• Marin General Hospital in Greenbrae was cited for failing to follow its own policy to count sponges used in surgery, which resulted in a lap pad sponge being left in a patient’s abdominal cavity. The state report said the patient had to undergo another procedure to remove the sponge. The hospital has revised its sponge accounting procedure using sponge counting bags and a dry-erase board in operating rooms to track sponges.
• Ventura County Medical Center’s Santa Paula Hospital also left a sponge inside a patient and needed a second procedure to remove it. An x-ray of the patient’s abdoment five days after the initial surgery discovered the sponge. The facility said it would conduct random audits to monitor compliance with its sponge count policy.
• Fountain Valley Regional Hospital and Medical Center did not follow its medication safety policies when a nurse administered an oral anti-seizure drug to a patient intravenously on May 1, 2008. The error resulted in the patient suffering swelling of the brain from low blood oxygen levels, following a cardiac arrest. The hospital said it provided training to all nursing and pharmacy staff and would increase monitoring.
• Northbay Vacavalley Hospital in Vacaville failed to follow its fall prevention procedures and left a patient unattended. The patient fell off a bedside commode and re-fractured his left hip. The hospital is providing additional staff training.

Go here to read the full list of violations.

ED docs sue California

A group of emergency department (ED) physicians have filed a class-action lawsuit against the state of California, claiming the state’s low Medicare reimbursement rates are strapping EDs with long wait times and endangering patient safety, reports the Los Angeles Times.

Physicians say reduced reimbursement rates are placing an unfair burden on ED physicians, who must accept all Medicare patients under federal law. They say rising numbers of  local hospital closures as well as the rising number of patients unable to find primary care physicians have greatly increased ED crowding. Specialists can also opt-out of on-call assignments, creating longer wait times for care.

These factors combined, they say, are creating a storm of poor patient care in which patients are dying as they wait for treatment.