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It's nothing new. Compliance with verbal orders has been a struggle for hospitals for more than 25 years. Many experts Hospital Peer Review spoke with compare verbal-order compliance to hand-washing compliance. It's behavioral. It's something we know we have to do. And it's not a matter of ill-intentioned practitioners. It's a matter of time and logistics.
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The Centers for Medicare & Medicaid Services (CMS) in 2007 stipulated a five-year period in which verbal orders must be "dated, timed, and authenticated promptly by the prescribing practitioner or another practitioner responsible for the care of the patient, even if the order did not originate with him or her.
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She watched the young nurse getting chastised for making an error and could see the fear in her face as her manager's voice rose in anger. The young nurse was put on indefinite leave. That's what happens when you make mistakes, she thought to herself.
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Beth A. Duthie, RN, PhD, director of patient safety at NYU Langone Medical Center, wasn't surprised by findings in the study "New nurses' views of quality improvement education" published in the Jan. 10 issue of The Joint Commission Journal on Quality and Patient Safety.
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When The Joint Commission revised its medical staff standard in 2007, there was tumult in the field.
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With its last survey in December 2006, Faith Regional Health Services ended up in conditional status.
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Case managers are a hospital's first line of defense when it comes to smoothing transitions of care and preventing readmissions.
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Case managers typically have concentrated on what has to happen before the patient can be discharged from the hospital, but now, to reduce readmissions, hospitals also have to take into consideration what happens to patients after they leave the acute care setting, says Beverly Cunningham, RN, MS, vice president, clinical performance improvement, Medical City Dallas Hospital, and health care consultant and partner in Case Management Concepts LLC.
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As part of the ongoing education to prepare for Medicare's Recovery Audit Contractors (RAC) program, Cynthia Lawson, RN-BC, MBA, CPHQ, director of case management at North Hills (TX) Hospital is teaching her case management staff to think innovatively when reviewing charts.
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If you haven't started analyzing your hospital's readmission rates and the role case managers can play in reducing readmissions, it's time to start so your hospital can avoid penalties from the Centers for Medicare & Medicaid Services (CMS).
