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Hospitals Say Medicare Law Won't Spur Changes
By Linda S. Mah, Kalamazoo Gazette
February
22, 2008
A new policy under which Medicare
will stop paying hospitals to treat certain preventable injuries that incurred
in the hospital will not cause any major changes at local hospitals, according
to hospital officials.
Borgess Medical Center and Bronson Methodist Hospital officials say their
institutions have long been active in addressing the eight preventable injuries
being targeted by Medicare.
"It's really not new to anything we do at Bronson," said Jane Janssen, director
of clinical operations improvement at Bronson. "These areas of care have been
focused on here for many years. We have ongoing initiatives that we continue to
put resources toward to make sure our patients are safe while they are here."
Likewise, Dr. Robert Brush, Borgess' chief quality officer, said hospitals have
known about the Medicare changes, which will be implemented in October, for more
than a year.
Most hospitals have been working on reducing hospital errors for several years,
he said. Ascension Health, Borgess' parent organization, has an internal effort
to reduce errors and infections in its hospitals. And many institutions work on
the issue with groups such as the Joint Commission, the major hospital
accreditation agency, and Leapfrog, a business group that advocates for patient
safety and other health concerns.
Already at Borgess, there is extremely low incidence of four of the targeted
problems, Brush said: objects left in patients during surgery, air bubbles in
blood vessels, giving patients the wrong type of blood and infection after heart
surgery.
And the hospital is working on the other areas of concern: falls, bedsores or
pressure ulcers, urinary tract infections related to catheters, and bloodstream
infections from using catheters.
Ellen Griffith, a public affairs specialist with Medicare, said the new policy
is not meant to signal major changes in hospital practices.
News reports have talked about new technologies such as sponges with alarms that
sound if they are left in the body, but those kinds of measures are unnecessary,
she said. Most institutions and their accreditation agencies have "accepted
protocols" to reduce these problems, she said.
"We are simply asking hospitals to do what is required," Griffith said. "Once a
patient comes into a hospital we want the hospitals to make an effort to ensure
they get the proper care."
Of the eight preventable injuries highlighted by Medicare, the one that may
require the most serious review of practices is urinary tract infections from
catheters.
Janssen and Brush said too often catheters are left in place as a matter of
convenience. The new Medicare policy requires that hospital staff evaluate
patients more rigorously to ensure the catheters are removed as quickly as
possible.
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Safety measures
Both Bronson Methodist Hospital and Borgess Medical Center offered several
examples of measures they employ to reduce hospital infections and errors:
- Bronson has a central line team. Having a set team to insert catheters means
protocols are more likely to be followed, reducing the chance of bloodstream
infections.
- Bronson also has an aggressive hand-washing policy. While the national average
for hand washing among hospital staff is 40 percent, Bronson is close to 90
percent.
- Borgess identifies patients at high risk of falling with specially colored
clothing, which allows staff to give them extra attention.
- Borgess also has begun using new mattresses, which reduce the chance of
patients getting pressure ulcers or bedsores.
- Both hospitals employ computerized physician order entry, or computer systems
that help reduce medication errors.
Helpful Web sites
• U.S. Department of Health & Human Services
• The Joint Commission, a hospital accreditation agency
• HealthGrades, a health-care ratings organization
• Leapfrog Group, a group of business leaders advocating for health-care issues
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