The number of New York City residents 50 and older who have undergone a colonoscopy has risen by about 50 percent in five years, according to a survey conducted by the city from 2003 through 2007. The gains were credited to the work of a group of physicians, insurers, union workers, hospital administrators and city health officials called the New York Citywide Colon Cancer Control Coalition. The coalition emphasizes that a colonoscopy should be performed once every 10 years for anyone 50 or older without a family history or other heightened risk factor for colon cancer, and more often for those who have those risk factors.
In his first campaign swing as the likely Democratic presidential nominee, Barack Obama visited Virginia to mock Republican foe John McCain's healthcare proposals. Obama said special interests represented by the influence of lobbyists had blocked progress on issues like healthcare for too long. Obama critcized McCain's healthcare plan for weakening the employer-based insurance coverage system. McCain's plan would use tax credits to help shift to a more open-market approach where people could choose from competing policies.
Leaders in Prince George's County, MD, have chosen a lawyer and two financial gurus to represent the county on an authority designed to seek new owners for the county's hospital system. The group will be joined by three members selected by Gov. Martin O'Malley and a member chosen jointly by the Senate president and speaker of the House of Delegates. The hospital system is owned by the county and managed by the nonprofit Dimensions Healthcare. The authority will solicit bids from healthcare companies interested in taking over the struggling system.
Butler Health System has broken ground for an acute care tower at Butler (PA) Memorial Hospital. The seven-story, $128 million tower is a centerpiece in the health system's $167 million upgrade. The tower will include eight operating rooms, 24 intensive-care beds and 52 private medical-surgical beds, and its glass vestibule will serve as the new main entrance to the hospital. The new structure is scheduled to open in December 2009.
Texas-based JPS Health Network got hit with two surprise inspections recently—one by state investigators and one by the Joint Commission. As a result of the Joint Commission inspection, JPS has already been told of a number of deficiencies that must be addressed by certain deadlines, according to interim Chief Executive Robert Earley. Earley added, however, that The Joint Commission inspectors did not indicate that there would be a suspension of accreditation due to the investigation. The state inspection is ongoing, and if it uncovers violations it could also force changes in the way the hospital and its clinics operate, said JPS representatives.
Residents pushing for a new hospital in the unincorporated Florida community of Poinciana will be at the mercy of a state health agency for the third time in two years after a neighboring hospital challenged the facility's approval. During the hearings, supporters plan to tell state officials of the need for an acute-care facility in the community, which sprawls with more than 70,000 residents between parts of Osceola and Polk counties. The hearings will last about three weeks, and a decision from the state is expected by the end of the year.
Believe it or not, the first week of June is almost over, and time is running out to give your comments to CMS on its proposed 2009 Inpatient Prospective Payment System rule. The federal agency is accepting comments about its nine new proposed "never events" and 43 new reporting requirements until June 13.
Since the proposed rule was released in April, there has been chatter in the medical community about the possible effects the rule as it is written could have on the industry. Some have questioned how reasonable the new "never events" are, namely delirium and Legionnaire's Disease, says Nancy Foster, vice president for quality at the American Hospital Association. The AHA plans to file a response to CMS before the June 13 deadline based on the feedback it is getting from members and those who work in the field.
"Most of the feedback we are hearing is concern that CMS has stretched beyond the bounds of what we would think would be included in something that is reasonably preventable with known evidence-based practices," Foster says. "Certainly, delirium has raised a number of questions, and Legionnaire's disease—when it appears in any institution—is usually a function of not what clinicians are doing, but the hospital's cleaning and air conditioning systems."
The bottom line, Foster says, is that even when clinicians do everything possible to prevent the infections and conditions on CMS' list, they may still occur. That's why, leading up to the end of the comment period, the AHA has been working with infectious disease experts, surgeons, and intensivists to understand how each of the conditions on the CMS list can be prevented and the circumstances in which a hospital may not be able to prevent a condition from occurring.
The AHA will also express its concern with the section of the rule that would require hospitals to report another 43 quality measures. Foster says for hospitals to not only collect the data, but have staff members learn what it all means, will take time away from patient care.
"We're not sure that's the right way to deliver care to patients in our hospitals," she says.
The American Medical Association says it will also provide comments to CMS before the deadline, and Foster says she's heard that many state hospital associations have drafted opinions, too. Will CMS listen? That's yet to be seen, but Foster says the federal agency has a history of listening to constructive criticism from those in the field.
"CMS will receive a wide variety of comments from those of us in the healthcare provider role as well as other individuals—payers, policy makers, and the like," she says. "How they mash all that together to come up with a final rule is best known inside CMS, but they've shown in the past that they do take into account comments, especially when there is logic and reason."
What worries me most about the 2009 IPPS proposal is that no one yet knows how hospitals will be affected by the 2008 rule. As you recall, CMS won't stop reimbursement for the first eight "never events" until October 1. So it feels like CMS is jumping the gun just a bit. While I applaud its efforts to continue improving the care offered in hospitals, it may be better to delay another list of never events until we can get a handle on the effect of the first round.
Foster agrees.
"I do think it would be more prudent after the first round," she says. "Understanding the intended effects and the unintended consequences is important, as these are a large and very diverse set of additional issues."
Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at mlarkin@healthleadersmedia.com.
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Tampa (FL) General Hospital is conducting an internal investigation after staff members mistakenly started performing a cardiac catheterization on the wrong patient. The man was not harmed, but staff members failed to follow proper hospital policies to identify the patient before the procedure, said hospital representatives. Those who made the mistake "will be subject to the appropriate disciplinary actions," the hospital said in a statement. In announcing the error, Tampa General joined an increasing number of hospitals who choose to apologize for mistakes rather than deny them.
A Fayette County woman has filed a suit against Charleston Area Medical Center, claiming she was fired because she raised concerns over patient safety issues. Zeda Fox, who was employed by CAMC for about a year before being fired in February, claims she was fired because she had repeatedly raised patient safety concerns, particularly those related to understaffing of nurses. According to the lawsuit, the firing constitutes "unlawful retaliatory discharge."
The Federal Trade Commission is not happy with pending legislation that could place limits on Illinois' growing retail clinic industry. The FTC found that the bill could "excessively restrict retail clinics to the detriment of Illinois healthcare consumers." An analysis found a number of problems with the bill, including a definition it said could be interpreted to exempt retail clinics owned by hospitals or physicians from the rules.
