Risk & Quality Management
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Biden Administration Expected to Expand Enforcement; Pandemic Grants Targeted
The enforcement of white-collar crime laws in the healthcare sector is likely to expand under the Biden administration, particularly regarding fraud associated with the billions of dollars in grants Congress allocated to hospitals and other health providers for pandemic relief.
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Closed Claims Study Shows Pain Management Risks as COVID-19 Contributes
An analysis of closed medical malpractice claims related to pain management identifies common areas of risk and reveals the COVID-19 pandemic has created new possibilities for liability. A top contributing factor in 90% of all closed claims was insufficient consent between the physician and the patient or family.
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Changes to Stark Law Create Leeway for Inadvertent Errors
Proposed changes to the Physician Self-Referral Law (Stark Law) and other laws would give healthcare organizations more ability to avoid self-disclosure and refunds. The changes are expected to be finalized soon.
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Physician Judgment Case Might Mean More Risk from FCA
Clinicians make judgment calls every day that do not always turn out to be correct, even when they are made in good faith. A recent court decision regarding the medical necessity of hospice care could put clinicians and hospitals at risk of False Claims Act allegations when judgment calls turn out wrong.
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Ethics Services Want to Know How Consult Data Compare to Other Hospitals
Ethics services often struggle to obtain data to improve the quality of consults even at their own hospitals, let alone outside institutions. Yet some ethicists are forging ahead with this challenging proposition, trying to move from the qualitative to the quantitative.
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Diagnostic Errors Continue, Technology Part of Solution
Diagnostic errors continue to plague the healthcare system, but some progress is happening thanks to technology that can reduce the chance of an error reaching the patient and causing harm. Optimal results may require a more deliberate training program for those using the technology.
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Insulin Pen Project Improves Patient Safety with EMR Modification
Staff at a Maryland hospital discovered a patient safety issue with insulin pens that was traced to the electronic medical record’s (EMR) inability to generate patient-specific labels efficiently. A root cause analysis revealed the process gaps, and staff developed a solution that ensures patients receive insulin doses only from their own pens.
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Be Serious About Promoting Successes
Quality improvement professionals put a great deal of work in improving quality of care and patient safety, with projects both grand in scale and small but significant. But once an organization achieves success, how do leaders make sure the right people know about it?
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Keeping It Together: Hospital Consolidation
Whether for financial reasons, to improve integration of care, decrease duplication of clinical services, or to mitigate the financial effect of COVID-19, more hospitals are choosing to consolidate into larger systems. What can hospital case managers do to prepare for this, and how can they handle the transition with grace?
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Hospital Cuts COPD Readmission Rates with Bundle Checklist
The development of a bundle checklist for patients with chronic obstructive pulmonary disease has helped a Maryland hospital sharply reduce its readmission rates for these patients. Overall care quality improved for these patients while admitted.