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It must seem as though the number of important things to read and digest that come across a quality manager's desk is never-ending. But the 2013 Office of Inspector General (OIG) Work Plan should be at the top of your to-do list.
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At the 100-bed Morehead Memorial Hospital in Eden, NC, the journey from TJC to DNV took two years, says Susan Netherland, RN, MBA, director of quality management and compliance officer at the facility.
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The 5th annual Joint Commission (TJC) report on patient safety, "Improving America's Hospitals: The Joint Commission Annual Report on Quality and Safety 2012," presents proof positive that hospitals are getting the quality message that TJC wants them to learn.
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In the few years since DNV Healthcare became the first new company in 40 years to win deeming status from the Centers for Medicare & Medicaid Services (CMS), some 320 of the 5,800 registered facilities have opted to use the OH-based company rather than The Joint Commission (TJC).
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More than 200 people gathered in late September to discuss the problem of doing too much for patients. Physicians from the American Medical Association's Physician Consortium for Performance Improvement (PCPI) and The Joint Commission (TJC) held the symposium on overuse of five treatments or procedures:
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The history of cardiac arrest as an indication for resuscitation is "loaded with implications for current standards of care," says Daniel Brauner, MD, associate professor of medicine at the University of Chicago. At one point in time, resuscitation was used only in very limited instances, he explains.
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The evolution of "transplant tourism" drives home the point that people are willing to go to extreme lengths to procure an organ, according to Leslie M. Whetstine, PhD, an assistant professor of philosophy at Walsh University in North Canton, OH. "Despite the fact that the public overwhelmingly supports organ donation in this country, our actions unfortunately do not reflect that sentiment," she says.
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Approximately one in five (22%) out of 608 critical care physicians surveyed reported always providing surrogates of critically ill adult patients with a recommendation about limiting life support, while one in 10 (11%) reported rarely or never doing so, according to a just-published study.1 Surrogates' desires for recommendations and physicians' agreements with surrogates' likely decisions may influence whether recommendations are provided.
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Linking payment to patient satisfaction could have a profound impact on the doctor-patient relationship, argues James N. Kirkpatrick, MD, an assistant professor of medicine at the Hospital of the University of Pennsylvania who is affiliated with the University of Pennsylvania Department of Medical Ethics and Health Policy.
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Prescribing potentially addictive medications "is often a very challenging situation for physicians," says David A. Fleming, MD, MA, FACP, professor and chairman of the Department of Internal Medicine and director of the Center for Health Ethics at University of Missouri in Columbia.
