Posted on 01/24/2015 1:27:06 PM PST by LucyT
Nationally, 724 hospitals have had their Medicare funding reduced after the Centers for Medicare and Medicaid Services found that each had high rates of potentially avoidable “hospital-acquired conditions,” including falls, bed sores, and certain infections, including ventilator acquired pneumonia and catheter-associated urinary tract infections.
CMS scored hospitals on the prevalence of three risk factors to their Medicare population patients: central line bloodstream infections, catheter-associated urinary tract infections, and serious complications, a catch-all group made up of eight types of injuries, including blood clots, falls, and bed sores.
Funding can be reinstated for hospitals whose scores improve in the targeted areas.
(Excerpt) Read more at inquisitr.com ...
So where is the link to the list?
Best food for any person, but especially a recovering patient is boiled carrots, boiled peas, broiled chicken breast, whole wheat bread, and desert made of ground sesame seeds. Tasty food has nothing to do with recovery.
Then why is one of the lowest scores across the board, in most every hospital, that nurses do not communicate the status of tests or follow up instructions.
I am sure everyone works hard. Everyone, everywhere work hard.
But they may not be working hard on the things that matter.
Not going to get into it with you, but the quality statistics speak for themselves.
well, maybe this will force them to hire enough nurses.
Handwashing sounds so simple, but it’s more than that (a lot of these things are never touched without gloves on, so handwashing is not an issue).
With enough properly trained nurses, you will reposition a person so that he doesn’t get bedsores. You will evaluate their nutrition and make sure they eat so that they are less likely to get infected. And you will clean the areas more often.
Alas, with regulations, often the nurses are too busy filling out paper work to actually see or talk to the patients. 20 years ago, I was hospitalized in one of the “Best” hospitals in the USA (In Boston) for routine female surgery, and during recovery, I rarely saw a nurse. Indeed, when I decided it was time to get out of bed and walk by myself (luckily I didn’t fall) I was stopped by several patients who found out I was a doc and who wanted information on their diseases.
Ah but if the paperwork isn’t done, you don’t get paid.
http://www.medicare.gov/hospitalcompare/search.html?AspxAutoDetectCookieSupport=1
Put in your zip code.
If you are not measuring against those standards, your reimbursements are going to go down.
Anyone who understands quality management could walk into a hospital and develop a standards program in about six months.
All of the issues you mention could very easily be put into a matrix that would adjust the morbidity or acuity. Those things are ALL considered in the metrics.
My wife does this stuff for a living. Do you?
Are you asking for the link to a list of the 724 Hospitals?
It wasn’t provided in the article, and I don’t know where to locate it.
I would love to see them hiring more nurses.
But part of the problem is getting the nurses to do anything new.
In the hospital where my wife works she is on the negotiating committee with the nurses unions. They are worse then the communications workers union I used to work with.
The discussion to get them agree to a commitment for 100% flu shot this year took two months. The final meeting ended up with managament just saying that any employee not getting the flu shot would have to wear full face masks when on the campus. And the union finally agreed to that.
Simply insane.
There is a lot wrong with the hospital days. They remind me of my days in small community banks that were just about ready to get bought up. These days, you have huge banks or very very small banks. Hospitals are going that way.
Everyone has a story. But the problem is the prices and insurance crap were out of control. Here we are trying to “manage” them, and everyone gets upset.
If the taxpayer is going to foot the bill, then basic quality standards have to be met. Its really pretty simple.
I looked and looked. Evidently it is privileged information.
I got my flu shot, but some nurses have issues with being forced to take an injection. How would you like to be told that you had to take the HPV vaccine? Some nurses have concerns about the flu shot.
It wasn’t an HPV shot. It was a freakin’ flu shot. A well established injection.
There are injections and inhalations. Pick one.
This is simply one area where the MNA simply drags their feet about any changes in the favor of patient care.
Unions are unions are unions. I understand they have a right to exist. They are NOT enhancing patient care.
Do you really think a flu shot is going to prevent the flu? This years shot was useless. If that is the only issue bothering your wife in regards to the nursing staff, then that is pretty good. They could strike over nurse patient ratios, a much bigger issue.
Please take a breath and read what I am saying in conversational tone, and not an argument. Because part of the problem we are discussing has to do with “traditional hospital” administration and management. This is not about YOU. I have had this conversation with my wife a thousand times, and the management does not want to consider that the “way it has always been done” doesn’t apply.
One of the things I did in my career is review communications procedures, and your answer shows me is that there had been a failure in the way you were taught to communicate to patients. (The generic “you”, not you specifically.)
To say that if the patient doesn’t understand instructions they are not listening is a bad answer for someone who communicates life altering information.
Your patient might not understand because they a) Dont speak English, B)Hard of hearing, C)Are scared to death (well not to death), or D) the message is rushed and full of jargon and medical terms that YOU use every day, but they do not.
Your patients are afraid of the medical professionals. They see you all as smarter than them, you are rushed, you are easily frustrated with having to explain the thing for the 10,000th time, or, the patient is just stupid and wants to go have a smoke or another fluffernutter.
Because we are “anonymous” here, I will bet you a thousand dollars (imaginary of course) that you can tell when a patient is leaving that they have no idea of what you just told them. They have doll eyes and just nod.
The national rate on this particular item, “Patients who understand their care when they leave the hospital” is at 51% nationally. That is not YOUR problem (and by that I mean you specifically) but rather an institutional problem.
And we all know if you do not know what to do upon leaving, they will be back. And there goes your reimbursement.
My wife explains to me they are instituting a new care plan where someone “follows” the patient through recovery. The key is to make sure they follow up correctly and do their post care work. Talk about expensive!
But the key thought is that it will reduce re-admits, and thus keep reimbursements at a higher level.
But I think that they are looking at it wrong. And I think you are looking at it wrong. You seem to think that service industries do not have their customers screaming at them and throwing stuff at them. I managed field service operations for a telecom company. Not only did people throw dog feces at us, or scream at us. They shot at us. Really. People died disconnecting cable and telephone lines.
So, lets get rid of the “we work harder than anyone” crap.
The way to solve this particular problem is to look at the problem. The problem is that the message is not getting through. No one seems to be figuring out why that is. Rather, now it seems they will send someone out to keep giving them a message they don’t understand.
I suggest that the messages should be delivered by someone else, somewhere else. The someone should be someone trained to communicate in a way that is meaningful, and by people who can confirm understanding. It should be done in an environment that is not pressure ridden, nor intimidating. And yes, nurses can be intimidating.
As someone who trained direct service agents to explain the same thing over, and over, and over again to people who could be idiots (You don’t need a degree to get a phone...anyone can get them. And they do!) It takes a particular set of skills to get that done.
I guarantee you that it would be done cheaper and with better results than any of the other money dumps I hear about hospitals.
Finally, and I hope you have gotten this far, as a person with nurses in my family and with a wife who brings this stuff home every day...and as someone who has been a patient with wonderful nurses...you and your profession has my respect. You have to be a special person to do what you do. I understand the training and time it takes.
But the time has come for EVERYONE to accept the facts and understand we have to change the way we are doing things.
This is but one example.
I appreciate your time. I hope you have a wonderful weekend....it is snowing like hell here. And my Pats are under fire for their balls. Its not looking good here.
You are missing my point.
Clearly, you only want to talk about your union points.
Lets talk about patient outcomes.
And, show me where a higher nurse-patient ratio has increased any of the items where, nationally, hospitals suck.
People bitch about hospitals because the bills are confusing, the communication sucks, and they get horrible MRSA infections.
Your nurse-patient ratio isn’t going to cure that, because even where the ratios are good, the numbers suck. All higher nurse-patient ratios work is to get the dues to the Nurses Unions higher.
It is amazing that on a conservative web site everyone is about cutting government costs, until it hits close.
This Medicare reimbursement issue is going to make care better, more efficient, and with fewer re-admits.
without question, my mother in law died of persistant urinary tract infection resulting from a catheter during a hospital stay.
Her diagnosis was systemic infection but it had been there several months before it over whelmed her
All the points you make sound really good....on paper. Unfortunately, caregivers and patients are humans, and mistakes will be made. Maybe the herd just needs to be thinned. If people can’t comprehend their discharge instructions (due to language problems, low IQ, or whatever) that’s not an overworked nurse’s problem. People need to take responsibility for their wellbeing or else they die. Simple as that. And what guarantee will there be in the future that reports won’t be falsified or made up? Especially if hospital funding is dependent on a rosy scenario?
Have you ever been through a complicated discharge process with an elderly relative after pretty comprehensive hip and knee replacement surgery?
Your comments sound like someone with a lot of theory and not a lot of experience.
Perhaps I am wrong.
But, the real world part of this is that hospitals will not get paid if that score doesn’t rise.
And trust me, go ask a nurse or doctor if they feel comfortable submitting falsified reports. Hospitals, States, and Medicare take that stuff very seriously.
Ping
The one point I DO agree with you and Kaila on is that there are a lot of stupid, drug addicted, and otherwise $ucked up idiots out there.
And as they all bought phones and cable TV...they will all need a doctor some day.
Spend some time in an Emergency Department and watch the Walking Dead Zombies stroll in and out. Our city is a medium sized urban nightmare. I cannot imagine what life in LA or NY are like.
One good virus will take those places down in a week.
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