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As the world faces its first flu pandemic in more than 40 years, researchers say slow, complicated ethics review processes hinder their ability to respond effectively to emerging infectious diseases.
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Taking steps now to streamline approval processes for fast-moving diseases will better prepare IRBs to handle not just the current H1N1 virus, but future viruses as well, says Raphael Saginur, MD, FRCPC, chief of the infectious disease division and chairman of the research ethics board (REB) at Ottawa Hospital in Ontario.
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Improving ease of access to potential research data while aggressively protecting identifiable patient information it's a goal that many institutions struggle with.
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It was clear to IRB coordinators that something had to be done to improve the length of IRB meetings. Some of the four biomedical IRBs at Northwestern University in Chicago, IL, were fairly fast in reviewing protocols, but others took too long.
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Hospital reimbursement is being squeezed from all sides. In the proposed Inpatient Prospective Payment System rule for fiscal year 2010, the Centers for Medicare & Medicaid Services (CMS) has proposed slashing the Medicare reimbursement update to account for improvements in documentation and coding and limiting reimbursement for readmissions.
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Hospitals are losing large amounts of money on extra and inappropriate diagnostic testing and procedures, as well as outpatient procedures performed in the inpatient setting because third-party payers frequently are denying the claims, says Brenda Keeling, RN, CPHQ, CPUR, of Patient Response, a Milburn, OK, health care consulting firm.
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By analyzing claims data to assure that the hospital was reimbursed appropriately and aggressively appealing all denials and underpayments of claims, DCH Health System in Tuscaloosa, AL, was able to generate a 1.25% increase in net patient revenue.
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Faced with a high census and backups in the emergency department, Bay Medical Center in Panama City, FL, created two discharge areas where patients who were waiting for transportation to home or a nursing home could wait, freeing up much-needed beds on the units.
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By involving patients and family members in the treatment plan and discharge process before they are admitted to the hospital for treatment, the staff at Moffitt Cancer Center in Tampa, FL, within a five-month period of time decreased length of stay by almost two days and achieved a 7% increase in the number of admissions involving hematology patients.
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As emergency department case manager, Janeice Garrison, RN, MSN, BC, sees herself as the "point guard" for the hospital in a large, mostly rural area where the population is growing by an average of 22.4% a year and the percentage of uninsured, undocumented, and homeless patients is increasing.
