By Stephen W. Earnhart, MS
CEO, Earnhart & Associates
Austin, TX
Patient errors in our industry are a major cause of U.S. deaths. More than 251,000 people each year come into healthcare for help, advice, and loving care, and we kill them! It is a significant challenge for staff and a facility to recover from a patient death caused by human error.
Patient safety is not cheap; in fact, it is massively expensive. It cannot be compromised. If it is — and clearly it is — then you enter into the horrible world of catastrophic events from which there is no escape.
As a Medicare inspector for the Centers for Medicare and Medicaid Services, I know the standards we all vow to live by are sound, but the breakdown often comes from failure to abide by those strict standards. I am going to give advice from my perspective. If possible, cut out the following and post it.
You must encourage patients to speak up and let someone know if something that is being done to them is not what they expected. Most of our patients just assume that we are doing the right thing for them, but more than 251,000 patients died last year because we didn’t.
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Empower your safety officer with indemnification from anything that doesn’t abide by the accreditation standards or dictates from the Association of periOperative Registered Nurses, government agency, and any other agency your facility is associated with, or is just plain common sense. Every facility is required to have a safety officer listed by name. Who is yours? Most do not even know.
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Post the following in your waiting room, change areas, and registration desks: “Please ask questions about every aspect of your care today. Please feel free to question anything and everything we do, and ask to speak with the administrator if something does not seem right!”
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Staff meetings. Talk about patient safety!
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Create a patient advocate who wears a nametag that says “Ask me about your safety today!” Rotate that advocate. Most of our patients do not know whom to ask when they have questions. They just assume we know what we are doing, and clearly we don’t always know. Leave your egos at home.
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Your safety officer should randomly ask members of your staff, including anesthetists and surgeons, questions about your policies on patient safety issues. If they cannot answer them, be a leader and report them in violation of your standards. After three such violations (I would suspend them after one and fire them after three) they should have to reread the policies and be quizzed before they can return to duty. It also should be noted in their personnel file, and it should impact any future pay increases or bonuses.
You don’t need to have friends in your workplace when it comes to patient safety and making sure staff members follow the rules. The world is going to judge the United States for this terrible stigma we have earned for many, many years. It will take time, effort, and money to correct this situation, but let it start with you.
CMS Releases ASC Quality Data
The Centers for Medicare and Medicaid Services (CMS) has released comprehensive ASC quality data reports from its Ambulatory Surgery Center Quality Reporting Program, according to the Ambulatory Surgery Center Association. The data, collected in 2013 and 2014, is available at http://1.usa.gov/27wF6ew. Data are available for ASC-1 through ASC-10.
The tables available online contain results by facility, state, and nation. Results for measures reported using G-codes are provided per 1,000 cases. For measures ASC-1 through ASC-4, lower numbers are better. For ASC-5, higher numbers are better.
