Standard of Care--Hospitals

October 14, 2016

Cuddle your newborn? That’ll be $39.35, please

“Skin to skin” therapy? That was the line item charge that appeared on the hospital bill for a young couple, and the dad decided to check it out. What he found has blown up across the Internet.

It turns out that the Utah parents were charged $ 39.35 by their hospital just so the new mom and dad, just after the C-section delivery of their son, could have their baby placed between her neck and chest. There, proud pops took the requisite newborn pictures.

Only later, as part of $13,280.49 tab for their son’s delivery, did the couple see the skin to skin charge. They posted the bill on a popular online site, where it drew more than 11,000 comments.

October 12, 2016

S. Dakota high court asked to pry open hospitals’ secret approval of brutal MD

by Patrick A. Malone

South Dakota’s highest court has been asked to reject hospitals’ attempts to keep secret why a doctor, who also is a convicted burglar with a checkered medical past that could have easily been uncovered, passed a peer review that permitted him to perform brutal, excruciating, and unnecessary spinal surgeries on dozens of patients.

A lower court rejected the sweeping claims by the hospitals that the reviews can never be disclosed. The judge said that indications of crimes or fraud, as raised by evidence-based malpractice lawsuits, are sufficient reason to breach confidentiality protections shielding vital insights into how hospitals judge physician performance and permit doctors to practice in their institutions.

More than 30 patients have sued surgeon Allen Sossan. He is a convicted felon, who had changed his name, and who apparently has fled to Iran. Patients assert he caused them great pain and maimed them with unnecessary, complex back procedures. Further, patients have sued more than a dozen doctors who reviewed his credentials and granted him privileges at Avera Sacred Heart and Lewis & Clark Specialty Hospital, both in Yankton, S.D.

September 27, 2016

Surgeon confesses to court lie, says MDs too willing to fib in malpractice suits

by Patrick A. Malone

A conscience-stricken surgeon in South Dakota has publicly confirmed one of the great frustrations for patients pursuing medical malpractice claims after they have been harmed: He says doctors are too willing to lie in court to protect themselves and colleagues, as he did two decades ago in a case involving a partner in his practice.

Dr. Lars Aanning says he no longer could live with his lie. Because he is 77, retired, and cannot be subject to colleagues’ retribution, he decided to ‘fess up, and to help attorneys who represent injured patients. Aanning says he does not know whether his false testimony was decisive in his partner’s lawsuit. But he confesses that he knew his colleague’s patient had suffered because of the treatment this stroke victim received. He also had had doubts before about his partner’s work.

He tells a reporter for Pro Publica, the Pulitzer Prize-winning online investigative site, that he knew at the moment he uttered his untruths that his lying flew in the face of everything he thought he stood for. But he says, “I did it as a matter of course. And I did it because there was a cultural attitude I was immersed in: You viewed all attorneys as a threat and anything that you did was OK to thwart their efforts to sue your colleagues. I just accepted that as normal. It wasn’t like, ‘I’m going to lie. It was, ‘I’m going to support my colleague.’ ”

September 15, 2016

Can hospitals cure life-saving intensive care units of their risky high-tech chaos?

by Patrick A. Malone

The spots in hospitals where patients in the direst shape receive specialized treatment are themselves in need of urgent care, experts say, explaining that antiquated intensive care units (ICUs)

contribute to needless harm. But how exactly to yank them and the therapies they provide into the 21^st century?

Usha Lee McFarling, a Pulitzer Prize winner, examines ICU reforms for the online health news site Stat, finding that these crucial and “heroic” hospital facilities fundamentally have changed little in a half century, although they now are jammed with new technology and devices. They serve almost 6 million Americans in grave condition, but in them, she says, “studies show serious and sometimes fatal medical errors are routine. And a recent review published in the journal Critical Care found no major advances in ICU care since the field’s inception in the 1960s.”

September 13, 2016

3 hospitals strive for a caregiving rarity: allowing patients a good night’s sleep

by Patrick A. Malone

It long has been a nightmare for patients. It also likely affects patients’ health, and how happy the public is with hospital care. So why do hospitals make it so difficult for the already sick to get a good night’s rest? Some hospitals in Connecticut, however, are blazing a trail for quiet, lights out, coordinated night care, and other measures to boost the prospect that their charges get healing sleep.

The reasons to act are many, as Karen Weintraub writes for the nonprofit Connecticut Health-I-Team:

There’s no question that sleep matters for recovery and health. Patients who don’t get enough sleep heal more slowly, have decreased immunity and pain tolerance, higher rates of anxiety, and are more likely to suffer from confusion and delirium. Hospitals nationally are also waking up to the need to prioritize patient sleep as part of the broader shift toward patient-centered care, and also because of a federal program that penalizes hospitals for substandard performance scores in patient surveys.

April 25, 2016

A U.S. privacy crackdown: Hospital fined $2.2 million in filming of dying patient

by Patrick A. Malone

Hospital patients who are dying or in extreme duress should not have their privacy exploited by reality television camera shows, federal health care regulators now have made clear. They have just settled with a noted New York hospital on $2.2 million in penalties and fines for its role in cooperating with a celebrity doctor whose crews recorded for broadcast the last throes of a an elderly Manhattan resident fatally injured when hit by a garbage truck.

The dead patient’s family complained that neither he nor they gave the hospital permission to film during his unsuccessful emergency treatment. Further, they said repeated broadcasts of the reality TV show “New York Med,” headlined by Mehmet Oz (the heart surgeon-cum-TV show celebrity known as “Dr. Oz”), caused them great pain and distress, as well as invading their and their loved one’s privacy.

Federal authorities, who oversee patient privacy matters under the Health Insurance Portability and Accountability Act (HIPAA), finally agreed with the family years after they filed complaints, posting online this stance about patients’ protected health information (PHI):

February 7, 2016

Good ideas abound for curbing patient harms; they just need to be shared

by Patrick A. Malone

What does it take to make hospitals safer so patients aren’t harmed? Big stuff and small, some of it surprising─and all of it mattering a lot. For instance:

Getting caregivers to wash their hands. It’s the top cause of debilitating and sometimes deadly hospital-acquired infections. Some institutions empower nurses to police and remind dirty doctors; some install video cameras to catch scofflaws; others run frequent and largely successful ─for awhile─ publicity campaigns.
Paying extra attention to hygiene with procedures, often considered routine, that break the skin, even a little bit. This has paid off in big reductions in some hospitals in infections linked to catheters put in veins and arteries, especially the central line (for IVs).

December 6, 2015

Hospitals make progress in curbing harms to patients, but a lot more is needed

by Patrick A. Malone

It’s hard not to look at the latest federal data on how hospitals have improved their efforts to avoid harming patients and think, “Pretty good job, folks. But can’t you do more?”

Yes, it does sound impressive that a big push under the Affordable Care Act, also known as Obamacare, has resulted in an estimated 87,000 fewer patients dying due to hospital-acquired conditions and that averting these harms saved $19.8 billion in costs in the period between 2010 and 2014.

But it’s also true, as Kaiser Health News points out, that the measured successes also have hit a plateau after three years of declines in harms. As the KHN report notes, “Hospitals have averted many types of injuries where clear preventive steps have been identified, but they still struggle to avert complications with broader causes and less clear-cut solutions.”

October 23, 2015

Hospital Satisfaction Is Tied to Readiness for Discharge

by Patrick A. Malone

Too often a hospital is more like a battleground than a place to heal. Insurance companies want to hold the line on expenses, hospitals want to maximize use of their services and providers of care want their piece of the action. An interesting new study showed that one factor in how happy patients were with the whole experience was how ready they felt to go when they were discharged.

A recent story on Reuters.com reviewed a study in the Journal of the American College of Surgeons that found that hospitalized patients who felt ready to go home when they were discharged were more satisfied with both the hospital and their caregivers than those who felt rushed out the door.

It was a small study, but it might be useful for medical community members who depend on patient satisfaction for at least some of their remuneration (per Medicare’s patient survey initiative), not to mention anybody who really cares about the quality of the patient experience.

August 13, 2015

Hospitals Still Lag in Meeting Medicare’s Bounceback Standards

by Patrick A. Malone

Bouncebacks are patients who get readmitted to the hospital less than a month after they’ve been sent home. You want to keep the rate low, because too many bounceback admissions means the hospital is discharging patients too soon.

One element of the Affordable Care Act (ACA, or “Obamacare”) now in its fourth year is a review of hospital readmissions, and the imposition of penalties if facilities don’t meet the standards Medicare has established. As reported by KaiserHealthNews.org (KHN), the latest review shows that most U.S. hospitals aren’t measuring up.

A readmission is when a former hospital inpatient must return for care within a month of his or her discharge. Readmissions are one way to measure hospital quality, and this year, 2,592 hospitals will receive less money from Medicare reimbursements as a penalty for a readmission rate that’s too high. The total loss: $420 million government dollars.