department of health

NJ, PA hospital mistakes not being reported

Anne Zieger — Fri, 12 Sep 2008 10:03:34 -0400

While hospitals in Pennsylvania and New Jersey are supposed to be reporting serious mistakes, it appears that too often, they aren't doing so. That, at least, is the conclusion drawn by observers in those states who argue that the hospitals' failure to comply with regs is compromising ongoing efforts to boost patient safety. In theory, hospitals in both states have been required to report mistakes and complications to state monitoring agencies for a number of years. But in practice, it doesn't always happen.

For example, researchers found several major errors and complications at hospitals in Pennsylvania last year, none of which had been reported to the Pennsylvania Department of Health. In New Jersey, five of the state's 80 hospitals didn't report any preventable mistakes at all last year, and in Pennsylvania, some facilities didn't report any serious mistakes or even near misses. While good safety records are admirable, it's unlikely that these facilities had absolutely perfect records, which suggests that something is wrong, observers say.

Such reporting gaps, in part, can be solved by training more staff members and working to improve treatment, according to hospital associations in both states. However, reporting gaps like these also suggest that it may be quite some time before the large number of states requiring such reporting--a total of 26 at present--can actually have a shot at making the impact they'd hoped to make. (Whether such reporting can really help hospitals make appropriate changes in the first place, of course, is a discussion all its own.)

To learn more about this issue:
- read this Philadelphia Inquirer piece

Related Articles:
By 2008, Medicare won't pay for hospital errors
RI lawmakers propose medical error tracking system
HHS proposes confidential medical error reporting
Indiana hospitals see 24 percent more errors

HIV spreading rapidly in New York

Anne Zieger — Fri, 29 Aug 2008 13:29:29 -0400

Particularly among gay minority men, a perennial high-risk group, the HIV virus is spreading rapidly in New York city. HIV is spreading through the city at three times the national rate, or about 72 new infections for every 100,000 people, according to a study released this week by the city's Department of Health and Mental Hygiene (DHMH). That's compared with 23 per 100,000 nationally. Using a CDC formula, the DHMH report estimated that 4,762 New Yorkers contracted HIV in 2006.

Some additional statistics from the study:

* Men accounted for 76 percent of new HIV infections and women 25 percent (figures over 100 percent due to rounding).

* Blacks made up 46 percent of the newly-infected, Hispanics 32 percent and whites 21 percent.

* Homosexual sex between men was the main cause of 50 percent of new infections, high risk heterosexual sex 22 percent, intravenous drug use 8 percent and unknown causes 18 percent.

Gay minority men were especially at risk. For example, of new HIV infections among men under age 30 who have homosexual sex, 77 percent were in black or Hispanic men, along with 59 percent of new HIV infections among men ages 30 to 50. In fact, almost two-thirds of the city's new infections occurred in people 30 to 50 years old.

To learn more about this report:
- read this piece from the New York Times

Indiana hospitals see 24 percent more errors

Anne Zieger — Tue, 26 Aug 2008 13:09:36 -0400

While the absolute numbers are still small, they're moving in a questionable direction. The number of serious medical mistakes taking place in Indiana went up 24 percent last year, from 85 in 2006 to 105 in 2007, according to a new report from the state's Department of Health. The most common mistakes--accounting for 27 percent of errors---were cases where patients developed severe bed sores. Surgeries where sponges or other objects were left inside of patients ranked second, with 24 cases, and wrong-body-part surgeries were third with 23 occurrences, up from 11 such errors found in 2006.

About 18 percent, or 51 of the 291 health facilities reporting, disclosed at least one error for 2007. Hospitals accounted for 101 of the errors, and ambulatory surgery centers reported four.

To learn more about this report:
- read this Chicago Tribune piece

Related Articles:
SC Medicaid plans to stop paying for errors
Business say 'no pay' for major mistakes
PA hospitals won't charge for 'never events'
CIGNA stops paying for its list of never events

MN hospital cited after disturbed ED patient gets Tasered

Anne Zieger — Mon, 16 Jun 2008 08:55:50 -0400

When the staff at Northfield (MN) City Hospital's emergency believed that a disturbed patient was about to become violent, they called the local police, as their facility didn't have the security staff to deal with the situation. When the patient remained threatening, the police Tasered the man, after which hospital staffers were able to medicate the man and transfer him to a psych unit at a different facility. Now, federal and state health officials have cited the hospital for violating the patient's rights. The Minnesota Department of Health says the hospital failed to protect the patient safety, a charge that theoretically could cause it to lose its CMS certification unless it is addressed.

The Minnesota Hospital Association and other industry observers say that Northfield did nothing wrong. However, regulators say that the hospital should have been better prepared to deal with the man even before the police arrived, given that they see drugged and psychiatrically-disturbed patients every day. What's more, hospital staffers shouldn't have let the situation escalate for five hours, between the patient's arrival at 2 a.m. and the arrival of the police at 7 a.m., reviewers said.

To learn more about this incident:
- read this Minneapolis Star-Tribune article

Colonoscopies increase in New York City

Fri, 06 Jun 2008 06:59:54 -0400

A new study suggests that the number of New York City residents 50 and older who have had colonoscopies has risen sharply--by about 50 percent--over the last five years. The survey, which was conducted by the city's Bureau of Chronic Disease Prevention and Control of the New York City Department of Health and Mental Hygiene, was based on a survey conducted by the city from 2003 through 2007. It showed that 1.25 million people were screened in 2007, a significant increase from the 826,000 in 2003, with the biggest rates of increases among minority communities.

Much of the increase seems to have been generated by a group of stakeholders including doctors, hospital administrators, union workers, insurers and city health officials called the New York Citywide Colon Cancer Control Coalition. The group's efforts focused simply on getting colonoscopies performed every 10 years for anyone 50 or older without a family history or higher risk for colon cancer, and more often for those who do have risk factors. The group helped foster this goal in several ways, including the use of so-called "patient navigators" who call people over 50 and encourage them to make an appointment.

To learn more about the program:
- read this New York Times article (reg. req.)

Tenet finally back on track

Mon, 17 Mar 2008 07:59:58 -0400

Things seem to be looking up for once beleaguered Tenet Healthcare these days. After years of financial and legal troubles, the company's stock is taking a turn for the better, according to the Chicago Tribune. Admissions rates have been rising since Tenet's fourth quarter ended, while the Department of Health and Human Services has given the company quality ratings since changing management and closing investigations. "Regarding the turnaround, based on the 4Q07 results, it's no longer a question of 'if,' but 'when,' we will see that translate into positive earnings and cash flow," said Sheryl Skolnick, senior vice president of CRT Capital Group LLC. All of this is a far cry from its $900 million settlement with the Justice Department for problems including billing fraud that marred 2003.

For more on Tenet's rise from the ashes:
- read the Chicago Tribune article

Related Articles:
Tenet may be ready for a comeback. Article
Tenet begins doctor-investment program. Article
Tenet fights bankruptcy rumors. Article
Tenet to pay $725M in settlement. Article

RI lawmakers propose medical error tracking system

Tue, 26 Feb 2008 06:59:56 -0500

Rhode Island lawmakers have introduced a bill that would create a system tracking medical mistakes and near misses, spurred in part by incidents in which brain surgeons at Rhode Island Hospital operated on the wrong side of patients' heads three separate times. Right now, the state Department of Health requires hospitals and nursing homes to report major mistakes, but not near-misses, information that could be used to drive improvements before patients are harmed.

The bill would create a Rhode Island Patient Safety Organization, which would be tasked with finding the causes of medical errors at hospital and nursing home, then making recommendations for change. Under the terms of the bill, the system would be voluntary, and clinicians wouldn't be punished for reporting mistakes to the new organization.

To find out more about the bill:
- read this article from The Boston Globe

Related Articles:
HHS proposes confidential medical error reporting. Article
SPOTLIGHT: PA looks at how no-pay-for-errors would work. Article
PA hospitals won't charge for 'never events.' Article

HHS OKs MI infection checklists

Wed, 20 Feb 2008 06:59:58 -0500

The U.S. Department of Health and Human Services' Office for Human Research Protections has ruled that hospitals in Michigan can keep using checklists to manage infection risks. The checklists, which are designed to make sure all appropriate procedures are performed, can cut the rate of catheter-related infections in ICUs, research suggests. HHS had demanded that the Michigan hospitals stop using the checklists, developed based on a Johns Hopkins University study, arguing that using them was unauthorized research activity. The hospitals pushed back hard, arguing that using them was a quality-improvement activity, not research. Now, HHS officials have come around to the hospitals' way of thinking. The agency is now rethinking how it applies its regulations to evidence-based quality improvement projects. Makes sense--why on earth would HHS discourage infection controls, particularly given that Medicare won't pay for some hospital-acquired infections?

To learn more about the HHS decision:
- read this Modern Healthcare article (reg. req.)

Related Articles:
HHS shuts down MI infection-control program. Report
Bill would make U.S. hospital infection rates public. Report
By 2008, Medicare won't pay for hospital errors. Report
PA first to report hospital-specific infection rates. Report

PA hospitals won't charge for 'never events'

Wed, 23 Jan 2008 06:59:58 -0500

Pennsylvania's hospitals said yesterday that they won't charge for care related to serious medical mistakes that occur during an inpatient stay at an acute care hospital, such as wrong-body-part surgery and substantial medication errors. The announcement, which follows similar stands by hospitals in Massachusetts and Minnesota, takes effect this month. Unlike some initiatives, it only applies to patients who are on public healthcare coverage, in this case the state's Medical Assistance program. The move, which was announced by the Hospital & Healthsystem Association of Pennsylvania, comes on the heels of pressure from the state's Department of Health and Human Services, which would like to refuse payment certain never events.

To find out more about the announcement:
- read this Healthcare Finance News piece

Related Articles:
MN hospitals won't charge for major errors. Report
Many MA hospitals waive charges for errors. Report
By 2008, Medicare won't pay for some hospital errors. Report
Other payors may follow CMS's 'no pay' lead. Report
Business say 'no pay' for major mistakes. Report

Validity problems may delay SC infection reports

Mon, 10 Dec 2007 06:59:58 -0500

Hospitals in South Carolina may not release their reports of infection rates to the public in February 2008, as promised. Though the hospitals are complying with 2006 state law that requires all hospitals in South Carolina to report preventable infections to the state, the Charleston Post and Courrier reports that public release of the statements may be delayed on account of concerns about its validity.

Several members of an advisory panel have suggested delaying the infection reports until July 2008, in order to fully validate the hospitals' reports. Currently, South Carolina hospitals use a CDC Internet system to report infections. Later this month, "the CDC is expected to release standard to validate the hospital," according to a Department of Health and Environmental Control official.

To find out more:
- read this iHealthBeat report

Related articles:
PA first to report hospital-specific infection rates. Article
Bill would make U.S. hospital infection rates public. Article
Hospitals struggle with infection control. Study