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CMS's Proposed Hospital Staffing Revisions Get Cool Reception

Margaret Dick Tocknell, for HealthLeaders Media, January 3, 2012

The Tennessee Medical Association notes that "the stake in quality for those of the staff and thus responsible for quality would be much different from the class beholden to the business side of hospital administration."

"The hospital medical staff is best suited and most qualified to determine provider privileges at their respective facilities," says Steve Campbell, who is identified only as being from South Carolina. "Allowing some providers to circumvent medical staff oversight will detrimentally impact patient safety and quality of care afforded to Medicare beneficiaries and all patients. In my 20 years of working in a hospital setting, I have seen cases where physicians were denied hospital staff privileges because their practices were unrelated to the mission of the hospital or their practice patterns did not meet the medical community standards. To legitimize these practices by giving them hospital status would be a disservice to the community."

The American Nurses Association would like to CMS to add language to ensure that all medical practitioners are granted clinical and medical staff privileges, including voting rights and full due process. The ANA would like advanced practice registered nurses to have admitting and discharge privileges, as well as the ability to serve on hospital committees. It supports efforts to allow hospitals to develop either a stand-alone nursing care plan or an overall interdisciplinary care plan as long as "it is recognized that nurses alone are responsible for development of the nursing care plan."

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2 comments on "CMS's Proposed Hospital Staffing Revisions Get Cool Reception"


S Bork (1/9/2012 at 7:23 PM)
Amazing in one article it's all about value based purchasing and quality initiatives, then the next article with the real bottom line[INVALID]it's all about expecting better outcomes, but doing with less. Wanting higher quality but then maybe we can pull this off with untrained staff, or u-do-it medicine... Do you really think that eliminating an infection control log already in place is really in the patient's best interest? Or do you think maybe the hospitals "own tracking system" might just turn up different outcomes? Allowing hospitals to develop a "stand alone" nursing care plan is nice that way everyone can have the very same one. Saves money for sure as we won't really have to individualize the care. Why appoint medical staff to the the hospital when we can just throw open the doors and just let everybody operate when they get here? Same with credentialing[INVALID]toss it. You have a license right? Finally I must admit this one tops it all. One million lives lost, the previous focus on medication errors, thousands of articles, regulations, and rules and now just let the patients manage their own medications. I can just wait as they manage the pain medications. Do patients on the vent have to have a family member adjust the settings? Wow, what an amazing bunch of "proposals".

Jenise McGovern-Lowe (1/6/2012 at 10:35 AM)
I am an RN and a risk manager of an acute care hospital. I am opposed to allowing the patient or support person to administer medications. It would be a dangerous practice. A patients stay in the hospital is based off of an illness or event that requires medical intervention. A treatment plan for his illness is individually developed and based off of current illness/injury and concurrent medical history. Alot of information is collected and reported between medical disciplines licensed to make assessmnets. The assessmnet includes the pts. current condition and his reponse to the treatment provided. This requires a controlled environment that includes all of the consistent routines and any variables. Medication administration has to be a consistent routine and the patients response has a large role in the resolution of the illness, the discharge plan and hospital length of stay. There is a safety risk to the patient and the nurse if she/he were asked to make these medical assessments based off of only half of what she/he is sure of.