mistakes

BCBS plans phasing out pay for errors, 'never events'

Tue, 13 Nov 2007 06:59:58 -0500

Though they won't implement this change immediately, the Blue Cross and Blue Shield plans have decided that they won't pay for serious errors and "never events" like wrong surgical procedures and leaving foreign objects in the body after surgeries. Over the next several years, the nation's 39 Blue plans intend to begin changing coding systems to make such events easier to identify in claims, according to Kevin Shanklin, executive director of the Office of the President at Blue Cross and Blue Shield Association. At present, no Blue plans are currently refusing such payments. However, other major insurers are taking this tack, and CMS will stop paying for never events starting October 1, 2008.

To learn more about the Blues' plans:
- read this Modern Healthcare article

Related Articles:
Businesses say "no pay" for major mistakes. Report
CMS's McClellan tells Congress that Medicare shouldn't reimburse for never events. Article
Other payors may follow CMS's 'no pay' lead. Report
By 2008, Medicare won't pay for hospital errors. Report

Others payors may follow CMS's 'no pay' lead

Fri, 31 Aug 2007 06:59:58 -0400

Hospitals are still trying to get their head around new Medicare rules that will ban reimbursement for certain "preventable" conditions by late 2008. And that's enough to absorb for now.

The truth is, however, CMS's decision could be just the beginning. With Medicare blazing the trail, Medicaid is likely to quickly follow, as are private payors. In Pennsylvania, for example, where error reduction is a major part of the state's reform efforts, officials already are saying Medicare's decision could trigger changes in their Medicaid program's payment policy. And private health plans, already under pressure from some employers not to cover preventable illness, will have a good excuse to follow suit.

To learn more about this trend:
- read this Philadelphia Inquirer article

Related Articles:
Business say 'no pay' for major mistakes. Report
Study: Wrong-site surgeries, close calls are common. Report

Study: Wrong-site surgeries, close calls common

Tue, 26 Jun 2007 20:01:34 -0400

Wrong-site surgeries happen or almost happen every other day in Pennsylvania healthcare organizations, says a new study. And, researchers suggest, those findings mirror what's taking place in other states.

Officials of the Pennsylvania Safety Authority, which conducted the survey, said in a 30-month time period stretching from June 2004 to December 2006, they received 427 near misses or reports of wrong-site surgeries. Of those, 253 were near misses. Of the remaining surgeries, which actually involved harm to a patient, 69 percent were wrong-side surgeries, 14 percent were wrong body part surgeries, 9 percent were wrong procedures and 8 percent were wrong patient cases.

Common risk factors included multiple procedures and/or surgeons, time pressure, incomplete pre-op assessments and problems with teamwork. When errors were prevented, meanwhile, it often was the patient's family, not the hospital staff, who sounded the alarm.

To gather more information from the study:
- read this Philadelphia Business Journal article

Related Articles:
Study: Pre-op briefing can lower surgical error rates. Report
Businesses say "no pay" for major mistakes. Report
Keep alert for potential errors. Editorial

Study: Long intern shifts pose safety risks

Sun, 17 Jun 2007 20:01:34 -0400

More evidence from the "tired interns make mistakes" front. A new study presented at a professional conference suggests that extended shifts pose a threat to patient safety, not to mention the health of the interns themselves. Researchers collected more than 17,000 monthly reports from a group of more than 2,700 interns. Study author Laura Barger of Brigham and Women's Hospital then conducted a data analysis to see whether 24-hour-plus shifts were associated with reported medical errors and intern stress. The results: when interns worked five or more extended shifts in a month, they were seven times more likely to report at least one significant medical error that harmed a patient. Even more troubling, they were 300 percent more likely to report fatigue-related errors causing patient deaths. Not too surprisingly, the interns reporting that they'd harmed a patient were three times as likely to report high stress in the same month.

To find out more about the study:
- read this article from HealthDay News

Related Articles:
The doctor scheduling dilemma. Editorial
Study: Long hospital shifts boost mistakes. Report

Hawaii approves no-fault condolence law

Wed, 23 May 2007 20:01:35 -0400

It's a shame that such things are necessary, but there's no getting around it--malpractice liability counts when doctors speak with the families of deceased patients. Hoping to make the task just a bit easier, Hawaii has passed a bill allowing doctors to express sympathy and offer condolences without fearing that their gesture can be used against them in court. On the other hand, the new law's language specifically notes that a doctor's apology or admission of fault can indeed by used against them. This puts the bill at odds with national trends. Right now, at least nine states are now considering laws which would allow doctors to apologize for mistakes without fearing that the apology will be used against them in court. What's more, 27 other states have already passed similar laws.

To find out more about this trend:
- read this Pacific Business News piece

Related Article:
Laws would protect physicians who apologize. Report

Laws would protect physicians who apologize

Thu, 12 Apr 2007 20:01:38 -0400

Lawmakers in nine states are considering measures which would allow physicians to apologize for mistakes without fearing that their apology would be used against them in a malpractice suit. According to American Medical Association research, at least 27 other states have already passed such laws in recent times. The laws are designed to encourage doctors to explain what happened when something goes wrong, inform patients of their options and apologize. Right now, many doctors are warned by attorneys never to admit error, as such admissions can be used against them in court. These "I'm sorry" laws vary from state to state. In some states, including Arizona, Connecticut, Idaho and Maine, doctors can apologize however they see fit. Vermont law only protects doctors who make oral apologies, not written apologies. And Illinois only gives doctors a 72-hour window in which they can safely apologize.

To learn more about this trend:
- read this Houston Chronicle piece

ALSO NOTED: BCBS of MN launches employer wellness program; DC area blood donations falter; and much more...

Mon, 19 Mar 2007 20:01:30 -0400

> Blue Cross and Blue Shield of Minnesota has announced that it will begun funding employee wellness programs for 20 of the state's mid-sized employers. Article

> DC-area blood donations have fallen to a "crisis" level, experts say. Article

> A new study suggests CDHPs that couple the new structure with other benefit design improvements are better at saving money. Article

> Even in Canada's publicly-funded health system, health officials who don't apologize for mistakes are more likely to get sued. Article

> An emerging San Francisco-based vendor has struck a deal with search giant Google to distribute Google text ads within its EMR, a step which may mark the first time that an EMR vendor has financed its offering this way. Report

And Finally... Which healthcare jobs made the list of the year's most sought-after careers? Article

Pharmacists a valuable asset in the ER

Tue, 09 Jan 2007 19:01:36 -0500

In the high-intensity atmosphere of the ER, nurses and physicians must make quick decisions often without patient's medical history. This can lead to mistakes, such as misdosing and miscalculation of the amount of drug needed. In Pasadena, however, several hospitals have brought pharmacists into the ER to cut down on these mistakes. Having a pharmacist on board can help hospitals cut down on errors and streamline the way drugs are distributed. "There is a lot of evidence in the literature to support (the idea) that with a pharmacist involved in patient care, the safety is improved and the effectiveness of the medication is also improved," Jean Pallares, director of pharmacy at Huntington Hospital in Pasadena, told the Star-News. Only one to three percent of hospitals have a specialized pharmacist on hand in the ER.

For more:
- check out this Pasadena Star-News article

Related Articles:
How to fix the nation's ERs. Editorial
Overcrowding in the ER. Letters

Study: Patients confused by medication labels

Mon, 11 Dec 2006 19:01:35 -0500

Doctors, maybe it's worth spending a few extra moments telling patients how they should take their medicines. According to a study which will be published next week in the Annals of Internal Medicine, patients with inadequate reading skills often make mistakes with their drugs because they have trouble reading prescription labels. At greatest risk are people with below sixth-grade literacy levels and people with multiple prescriptions to manage, researchers concluded. To conduct the study, researchers interviewed 395 English-speaking adults who were waiting in clinics to see their doctors. They found that when patients made mistakes in interpreting prescription labels, 52 percent of the mistakes concerned dosing levels. Also, they noted that less than 10 percent of patients paid attention to warning stickers such as "may cause drowsiness" which appear on prescription bottles.

Learn more about the study:
- read this USA Today piece

SPOTLIGHT: New tech simulates practice management

Sun, 29 Oct 2006 19:01:32 -0500

Not sure you're running your practice efficiently? Well, instead of hiring a big-ticket consultant, perhaps you'll want to give the Medical Group Management Association's new medical practice management tool a spin. The MGMA's Web-based simulator lets physicians try out management scenarios without paying a heavy price for mistakes. The simulator uses historical data collected by MGMA to fuel the simulation results. Article