Hospital Ratings May Not Be True Quality Measure

From the Washington Post:

Conventional wisdom holds that one sure way to improve health-care quality is to measure it. A study being published today in the Journal of the American Medical Association comes to the unconventional conclusion that it's not necessarily so.

The study by researchers at the University of Pennsylvania's School of Medicine found
that going to a hospital that scored well on Medicare-mandated quality measures did not significantly reduce a patient's risk of dying.

Proposed Changes to JCAHO Emergency Management Standards

Proposed Changes to JCAHO Emergency Management Standards

JCAHO is seeking comments on proposed revisions to the Emergency Management Standards that would require organizations to establish a more rigorous emergency management plan in response to communitywide emergencies. The proposed standards revisions emphasize a scalable approach to emergency management. These revisions would establish specific operational requirements for planning a flexible response to emergencies that could affect a single organization, multiple organizations or an entire community or region.

The proposed revisions are applicable to 24/7 facility-based care settings. Thus, the field review seeks input on the proposed revisions from these healthcare facilities.

Proposed revisions to the Emergency Management Standards can be viewed at: http://www.jointcommission.org/AccreditationPrograms/Hospitals/Standards/FieldReview/em_stds_fr.htm Comments also can be made through January 19, 2007, by going to the same Web page.

Education About Fraud, Waste & Abuse

From the NY Times:

Starting Jan. 1, companies that do at least $5 million a year in Medicaid business must educate all employees and officers on how to detect fraud, waste and abuse. Moreover, health care providers must tell employees that if they report fraud, they will be protected against retaliation and may be entitled to a share of money recovered by the government.

Health care providers must also establish policies to make sure that their contractors investigate and report fraud. A large hospital system, whether run by a Fortune 500 company or a group of Roman Catholic nuns, typically has hundreds of contracts with doctors, billing agents and other vendors.

The new requirement will also apply to many pharmacies, health maintenance organizations, home care agencies, suppliers of medical equipment, physician groups and drug manufacturers.

The Joint Commission will now be officially called...

From Health Decisions:

Beginning in January, the Joint Commission on Accreditation of Healthcare Organizations--for decades commonly referred to as “The Joint Commission”--plans to change its name to “The Joint Commission.”

A December 11 memo from JCAHO President Dennis O’Leary, MD, to all JCAHO employees reveals the name change plans. “This change is simply intended make our name more memorable than the current 18-syllable Joint Commission on Accreditation of Healthcare Organizations,” reads O’Leary’s memo, which was obtained by Briefings on JCAHO, a newsletter published by HCPro Inc., which also publishes HealthLeaders.

Congress Eliminates Medicare Pay Cut to Doctors

Despite the predictions that it wasn't going to happen, House and Senate negotiators reached a compromise that rescinded the scheduled 5% Medicare rate cut for physicians in 2007 and established a 1.5% incentive increase - beginning July 2007 - for doctors who report on quality measures. The measure also creates a fund to stabilize physician payments in 2008. On average, ED physicians will receive a 7% increase for 2007. The House passed the measure on December 8 with the Senate following suit on December 9. The bill now goes to the White House, where President Bush is expected to sign it.

Watchful Waiting

From CNN.com

Sometimes, his doctor prescribes antibiotics. But in many cases, his parents have waited it out, using Tylenol, warm baths and some extra tender loving care to ease him through it. And he recovers on his own.

More than ever, many parents and doctors these days are taking a "watchful waiting" approach with children older than 2 who have ear infections, the most common childhood illness. Many are forgoing antibiotics because of worries about drug resistance and evidence that most ear infections will heal on their own.

"My experience is that parents are often the driving motive behind not giving antibiotics. Parents are very, very concerned about the use of antibiotics," said Dr. Richard Rosenfeld, director of pediatric otolaryngology at Long Island College Hospital in Brooklyn, New York, and a consultant who helped write national guidelines on antibiotic use for ear infections.

2007 Medicare Physician Fee Schedule

December 11, 2006 -- Late in the evening on Saturday, December 9, the U.S. Senate passed the "Tax Relief and Health Care Act of 2006" (H.R. 6111) by a vote of 79-9 with 12 not voting.  The legislation, passed by the House on December 8 contains a fix of the 2007 Medicare Physician Fee Schedule, among other Medicare items.  The bill, sponsored by current House Ways and Means Committee Chairman Bill Thomas (R-CA), tied medicare items to another legislative vehicle not related to health care.  The next step for this bill is forwarding to the President's desk where it is expected to be signed into law. 

Medicare Rate Compromise

From Modern Healthcare:

House and Senate negotiators reached a compromise bill that would eliminate a scheduled 5% Medicare rate cut for physicians in 2007 and establish a 1.5% incentive increase for doctors who report on quality measures. A House vote on the bill is expected later today, while the Senate may vote late tonight or tomorrow.

Failure to Ascertain Signs of Life?

From the Reno Gazette-Journal:

PAHRUMP, Nev. (AP) — Two emergency medical technicians were facing felony charges after police say they failed to provide medical aid to a man with a self-inflicted gunshot wound to the head.

Carrol L. Meeks and Rod Fernandes were arrested Nov. 30, six days after the death of 64-year-old Linus Windler, Nye County sheriff’s officials said.

According to a sheriff’s report, Meeks and Fernandes heard a gunshot as they arrived at Windler’s trailer home in Pahrump on a 911 call about a man having trouble breathing. Inside, Meeks and Fernandes found Windler with a self-inflicted gunshot wound to the head.

The EMTs allegedly told officers at the scene that Windler was dead, but a deputy noticed Windler was breathing and had a pulse.

Nye County Sheriff Tony DeMeo told the Las Vegas Review-Journal that Windler went without treatment at the scene for at least 30 minutes, and almost an hour passed before an ambulance delivered him to Desert View Regional Medical Center in Pahrump.

Windler’s trailer is four miles from the hospital.

Windler was pronounced dead within 30 minutes of arriving at the hospital, officials said.

Fernandes and Meeks were each charged with one count of felony criminal neglect of a patient and felony neglect of an older person. Each was freed on $10,000 bail.
Pahrump Fire Chief Scott Lewis said he could not comment about the case.

Medtronic Spinning Off Physio Control

From Medgadget:

Medtronic has announced the spinning off of its external defibrillator business into a publicly traded company called Physio-Control, Inc. According to Medtronic, Physio-Control is already in many ways an independently functioning entity, with its own manufacturing facilities, headquartered in Redmond, Washington.

Press release

New Laryngoscope

From Medgadget:


The Airway Scope AWS-S100 newly released by PENTAX makes possible to perform an tracheal intubation easily.The AWS-S100 has an imaging CCD and LED light attached to its tip. AWS-S100 is paired with an Intlock blade with curved shape. These features allow the operator to verify conditions in the oral cavity and the intubation status during tracheal intubation on a 2.4-inch color LCD monitor. With this device, there is no need to extend the patient's neck or apply excessive force. By placing the airway scope under the epiglottis and raising it lightly, it is possible to insert an endotracheal tube into the trachea. The Airway Scope AWS-S100 supports even less experienced operators can perform fast and accurate tracheal intubation, thus greatly reducing the burden on the operator and the patient alike...

The angle of the built-in monitor screen can be adjusted for easier viewing. This makes it possible to perform tracheal intubation while comfortably viewing inside the patient's mouth cavity from various position, regardless of whether the patient is in a cranial position, on his side, or facing upright..

"E Really is for Emergency"

From the Florida Times-Union:

Its waiting rooms and stretchers increasingly filled with complaints that run more toward "I don't feel well" than "I can't breathe," another hospital is cracking down on people who use its ER as a walk-in clinic.

In mid-November, Orange Park Medical Center became the second Northeast Florida emergency room in recent months to ask the least sick of its patients to turn elsewhere for care or face a $100 fee.

Memorial Hospital in Jacksonville started the policy in August. Both facilities are operated by Hospital Corporation of America.

Tom Rounds, Memorial Hospital's director of emergency service, said the policy began in Houston emergency rooms years ago. It started at Memorial Hospital in a pilot program and expanded to Orange Park Medical Center this month to ease overcrowding and make room for seriously ill patients, he said.

"There really is a national push to get ERs back to their original intent," he said.
Of the 5,500 patients who went to Memorial Hospital's ER in October, about 500 were told they would be better off being treated at an urgent care center, a clinic or a doctor's office, according to the hospital. Since mid-November, 236 people at Orange Park Medical Center have fallen into the non-emergency category, hospital statistics show.