To minimize damage from RAC audits, risk managers should make sure their facilities have highly competent case managers available seven days per week, advises Bill Hammock, RN, BSN, CMC, ACM, vice president and senior consultant in the Global Clinical Health Care Consulting Practice of Marsh in Nashville, TN.
The philosophy behind the RAC program at Palomar Pomerado Health (PPH), based in Escondido, CA, is that it is better to find problems yourself before an auditor finds them for you.
Good intentions can backfire when it comes to preparing for RAC audits, cautions Rebekah Plowman, JD, an attorney specializing in health care litigation with the law firm of Epstein Becker in Atlanta.
Tube-feeding misconnections fall into the category of medical errors that are so obviously wrong that clinicians think they could never make such a mistake. But feeding tube errors do happen, and they sometimes bring grave consequences.
What happens when a hospital patient's physician goes off duty and another physician assumes responsibility for the patient? Or when care is transferred to the next nursing shift? How about when a patient is transferred from intensive care to another unit?
A woman underwent an excisional biopsy on her left breast. The physician who performed the surgery diagnosed cancer and began chemotherapy. Later, other physicians evaluated the woman and recommended a mastectomy and removal of lymph nodes in the woman's breast. After the mastectomy, no evidence of cancer was found.
A 30-year-old man presented to an ED with complaints of fever, joint pain, a severe headache, and shaking chills. The ED physician further determined that the man was suffering from a rapid heart rate and some paresthesia. The man did not undergo any further testing and was sent home with instructions to take acetaminophen and drink fluids.
