With obesity on the rise nationwide, some states, including Tennessee, are now looking at policies and initiatives aimed to reduce the number of those afflicted with preventable conditions caused by excess weight.
A substance brought into the emergency room at Children's Healthcare of Atlanta at Egleston Saturday night temporarily closed that area of the hospital, and sickened four workers. The DeKalb County Fire Department's HAZMAT team found the substance to be a small bag of pellets typically used in pool maintenance. It was apparently brought into the hospital with a patient and his mother, both of whom were also sickened.
Although Crocs are known by many as some of the most comfortable shoes around, the Morton Plant Mease Healthcare system in Florida is banning the shoes from use by hospital employees. Hospital leaders there cite safety concerns raised after a needle fell through one of the holes and inside the shoe of an employee at a hospital in Tampa.
Authorities say a program aimed at preventing falls among older Connecticut residents appears to be helping reduce injuries and lowering medical costs. A study found an 11% drop between 2001 and 2004 in the use of fall-related medical services in Hartford County.
The drop came during a campaign in which practitioners in home healthcare services, senior centers, and outpatient rehabilitation programs educated older residents about specific ways to help prevent falls. The reduction translates to about 1,800 fewer emergency department visits or hospital admissions in Hartford County and $21 million less in acute care costs, the study found.
There's been a lot of debate lately about whether the conditions on CMS' no-pay list are preventable in every case. Some wonder whether the agency is asking the impossible.
But the discussion shouldn't be about whether the agency is asking healthcare organizations to reinvent the wheel, says Gene Burke, vice president and executive medical director of clinical effectiveness at Sentara Healthcare in Virginia. It should be about the patients who will be better served with these regulations.
"If you look at the document that CMS released... they bring up the fact that people have said that they don't know they're all preventable. CMS acknowledges that, and says that in future rule making, it will work to identify procedures that can be considered reasonably preventable," Burke says.
In other words, CMS realizes that the three additions to the no-pay list—deep vein thrombosis, surgical site infections resulting from elective orthopedic or bariatric procedures, and complications from poor blood sugar control—will still occasionally occur, but it is using its influence to force hospitals to put procedures and processes in place that will do everything reasonable to prevent it.
"Will we be able to eliminate all infections? Not likely," Burke says. "Should we work to get as close to zero as we possibly can? Yes. We may not know exactly how much of a reduction we can achieve, but that doesn't mean that we shouldn't work at it."
Beyond the work that will go into "reasonably preventing" these conditions, Burke encourages his fellow quality and safety executives to see opportunity, as well. Monitoring the blood sugar levels of patients presents all organizations the opportunity to not only prevent complications, but also educate patients who are at risk for diabetes about proper nutrition and exercise.
"While we can't force people to do the right thing, we can make a greater effort to educate them," he says.
As diabetes reaches epidemic proportions in our country, Burke hopes that CMS' requirements will refocus healthcare's attention on a problem that carries very high risk for patients.
"Because diabetes is so frequent a problem, caregivers at every level have lost an appreciation for just how important hypoglycemic management is," he says. "Its frequency has dulled our appreciation of that."
And while extra efforts will have to be made in every hospital to ensure that hospitals are eligible to receive every penny of their Medicare reimbursement, Burke says doing everything reasonable to prevent the 11 no-pay conditions from occurring will more than make up for the time and money spent.
"Will it be a challenge? Absolutely. I for one am confident that the savings achieved by the avoidance of complications should more than offset the cost of the effort," he says.
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A recent outbreak of the C difficile bug has claimed the lives of eight more patients in Northern Ireland, bringing the total number of deaths to 60. According to healthcare leaders there, a side effect of various powerful antibiotics is an increased rate of C diff infection.