We have all heard about the turmoil surrounding malpractice suits. An on-line database that tracks patients, their attorneys, & expert witnesses involved in malpractice cases aimed at reducing “frivolous” cases. In order to help deal with this, Dr. John Jones, a Dallas-area radiologist, created DoctorsKnow.Us. However, patient advocates insist that patients have the right to sue for compensation and that this database could potentially be used to deny patient care.
The database has around 50 members and contains about 100,000 patient names, and Dr. Jones stated that in most cases it does not provide the outcome of the suit. Dr. Jones also stated that, “People are going to find if they sue doctors, they are going to find their access to health care may be limited.” To me, I think this should not be the case. As a patient, I would want to know that I had the right to access information regarding my physician’s malpractice history. This information could potentially sway a patient’s decisions on receiving care from a certain provider, however; I believe it is their right.
Another point brought in regard to this database, is that it might have a “chilling effect” on patients bringing cases who have been harmed from malpractice, states David Casey Jr., president of the American of Trial Lawyers of America. Personally, I don’t see that happening. If I was a victim of malpractice that was truly the physicians fault due to his/her negligence, I would follow through with a lawsuit not necessarily for compensation, but to ensure that it would not happen to any other patients.
The quality tool I selected this week discussed the concerns surrounding surgery. It mentioned several key questions a patient should ask their provider before surgery in the areas of to avoid infection, blood clots, and heart attacks.
Out of all the recommended questions, there was a couple that I never thought about. For example,
1) If I need antibiotics before surgery, when will I receive the antibiotic and for how long?
2) What will you do to prevent blood clots?
As far as antibiotics go, a patient should be given them 60 minutes prior to surgery and stopped within 24 hours in most cases. I wasn’t aware of this, and honestly never thought to ask. Also, blood clots, which are caused from not moving while under anesthesia, should be addressed. A patient should express concern to their surgery team, and they should explain to the patient the precautions they will take to address this.
I enjoyed this quality tool because I thought it was informative and provided easy tips for patients.
This week I decided to comment on Kim’s blog concerning dual-eligibility for Medicare & Medicaid. I had never really thought that people could qualify for both. I do know that some people truly need Medicare & Medicaid, but I do not approve of those that abuse the system. This problem is one that is contributing to our economic crisis. For example, in order to provide the care for those with both, the government has to spend 40% of its entire Medicaid budget. I liked Kim’s points about the issues, and what is the real problem behind this.
Report: Lack of Standards Hinders Quality Data Collection
We all know the role that quality data collection plays in the healthcare industry. This report, “Collecting & Reporting Data for Performance Measurement: Moving Toward Alignment”, focused on how health IT could reduce the financial impact of data reporting, but the lack of accepted standards remains a barrier for hospital performance data extraction.
One suggestion provided in the report that I agreed with was that EHR vendors need to have a clear & consistent picture of the functional requirements & standards surrounding the capture of data for quality measures. Most organizations rely on their data collection to make decisions that are best for their facility, and it would help improve the process if vendors were on board.
Another issue affecting data collection, is the financial impact which is “significant and going higher.” It pointed out that often it is the hospital’s HIM department performing the process of extracting data. I agreed with the point that the lack of documentation & quality make this process harder. HIM professionals often get stuck trying to fix others problems, and I believe our field should focus on developing the necessary standards to correct this issue.
Linda Kross, CEO of AHIMA, stated that “the data only need to be collected once & could be used by multiple stakeholders for various issues.” This applies to the need for a set of basic uniform measures that could be captured electronically at the point of care. This should be the focus since HIM is headed into the electronic era of capturing data.
The ultimate goal of performance reporting initiatives is to provide better care, rather than to achieve “better and faster reporting” says AHRQ Director Carolyn Clancy. This is absolutely true. Often, people get carried away with trying the find the fastest way to complete a process, when they should be focused on its quality and how it affects the patient’s care.
Self-Management Support Tool: Healthy Changes Plan
The quality tool I selected this week focused on how to develop your personal “Healthy Changes Plan”. The tool is easy to use and provides a list of questions to help the user develop their plan. The questions include:
1) The health change I want to make is (very specific: what, when, how, where, how often)
2) My goal for next month is
3) The steps I will take to achieve my goal are
4) The things that could make it difficult to achieve my goal include
5) My plan for overcoming these difficulties include
6) Support/resources I will need to achieve my goal include
7) My confidence that I can achieve my goal: (scale of 1-10 with 1 being not confident at all, 10 being extremely confident)
Out of all of the questions listed, I really think number four and five could really help a person meet their goal. For example, we often don’t think about what could prevent us from losing weight or how we will overcome those distractions/issues. Also, number six would help because you need to have a support system and resources to go to when needed.
Overall, I really thought this was a practical tool that could be easily adapted to meet anyone’s needs.
I really liked the article that Amanda chose this week. I agree that organizations should not occasionally think about quality, instead they should have a “continuous improvement and accountability”. I know that I rather go to hospitals or other facilities that have a reputation for providing the best quality service around. People need to change their outlook from money to improvement of care.
We are all familiar with the accreditation process offered through The Joint Commission (JC), but the article I read this week had some interesting facts not found in our textbooks. For instance, approximately 91% of the nation’s hospitals are currently accredited by JC. This includes 4,250 general, children's, long-term acute, psychiatric, rehabilitation & surgery specialty hospitals, as well as 358 critical access hospitals.
After entering this program, I became familiar with JC, but was never fully aware of the eligibility requirements that hospitals must meet in order to apply for accreditation. For instance, an organization must:
Be in the U.S. or its territories or, if outside the U.S., is operated by the U.S. Government under a charter of the U.S. Congress
Accesses & improves the quality of its services
Identifies the services it provides, indicating which services it provides directly, under contract, or through some other arrangement
Provides services addressed by The Joint Commission’s standards
We have all heard how strict JC was, but I was never familiar with all the requirements an organization must meet in order to apply.
We are all familiar with some benefits that JC accreditation can provide for an organization such as providing a competitive edge in the marketplace, deemed status for Medicare certification, fulfillment of regulatory requirements in some states, among others. Besides the obvious, there were several benefits mentioned in this article that I was not aware of. For instance, hospitals seek to be JC accredited because it can enhance their recruitment and development process, may reduce their liability costs, provides a framework for organizational structure and management. Another interesting fact I learned from this article was that the objective of JC surveys is not only to evaluate the hospital, but to provide education & guidance that will help staff continue to improve the hospital’s performance. When the JC comes on-site to survey a facility, their team can consists of physicians, nurses, life safety code specialists, or hospital administrators. It was interesting to learn that the JC has more than 400 surveyors.
This article was full of interesting information about the JC’s accreditation process, but I found the cost of accreditation to be the most interesting. The JC’s annual fees for a facility are based on their size & the services offered & range from $1,780 to $36,845, and are paid at the beginning of the year. I was also unaware that the JC charged facilities per day that their surveyors were on-site. For example, in 2008 the on-site hospital survey fees were $2,500 per surveyor for the first day & $1,030 per surveyor for the second and subsequent days. Another interesting fact in this article was that small hospitals, (fewer than 26 beds & less than 50,000 visits) pay $1,090 in annual fees and $4,580 per on-site surveyor. I found this interesting because you would think that larger facilities would be charged more, instead smaller facilities take the hit when it come to the surveying process.
Well, after this semester we should all be familiar with the importance of quality care. This tool present resources & information that can help you get better quality healthcare. It is broken down into five sections:
What affects health care quality & how you can become involved
Measuring health care quality & Where to find measurement tools
Tips to help you make more informed health care decisions
Information on how you can find out about clinical trials
List of resources
As we have heard before, everyday millions of people receive high quality health care at the right time & in the right way. However, occasionally something goes wrong. It is then left up to the patient to take charge of their health care in order to reduce their risk of medical errors. The fact is, health care quality varies depending on where you live, who you are, & how much is known about treating your condition.
Out of the five sections, the one I found most interesting was “Tips to help you make more informed health care decisions”. As a patient, you can never learn enough tips to help improve the health care you received. This section discussed tips on how to include quality in your health care decisions. Most people don’t consider quality as an issue when deciding on a health plan, a doctor, when choosing a treatment, a hospital, or a long-term care facility. For me, the following tips stood out:
Health Plan
Has been given high ratings by its members
Does a good job on helping people stay well & get better
Doctor:
Has the training & experience to meet your needs
Takes steps to prevent illness
Can get you admitted to or treat you at the hospital of your choice
When choosing a treatment, make sure you understand:
Your diagnosis
How soon you need to be treated
Your treatment choices
The costs
How much experience your doctor has in treating your condition
A hospital:
Is it accredited by the JC
Is one where you doctor can practice
Has a lot of experience & success with your condition
Monitors quality & safety of its patients
A long-term care facility:
Provides a level of care, including staff & services, that meets your needs
Overall, this was an interesting tool that everyone should read. We often forget that WE make the decisions when it comes to our health & health care.
This week I read Rajni’s quality tool “Rural Area Health’. I found it interesting since I heard someone peak on telemedicine while at the AHIMA convention. It is true that the use of this new technology is taking off in the U.S. I agree with her that the main reason is due to Medicaid. Despite Medicaid paying for most of the fees surrounding telemedicine, there is still room for improvement. Medicaid still does not pay for many aspects of telemedicine that could improve the quality of care offered to patients in the rural areas of America.
"People are often unreasonable, illogical, and self-centered; Forgive them anyway. If you are kind, people may accuse you of selfish, ulterior motives; Be kind anyway. If you are successful you will win some false friends and true enemies; Succeed anyway. If you are honest and frank, people may cheat you; Be honest and frank anyway. What you spend years building, someone could destroy overnight; Build anyway. If you find serenity and happiness, they may be jealous; Be happy anyway. The good you do today, people will often forget tomorrow; Do good anyway. Give the world the best you have, and it may never be enough; Give the world the best you've got anyway You see, in the final analysis, it is between you and God; It was never between you and them anyway."- Mother Teresa
