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Would you give your physicians a $19 million bonus? What if you knew doing so would save you $113 million, cut your length of stay and improve quality? Thats what a group of New Jersey hospitals did as part of a pilot program for the Centers for Medicare & Medicaid Services. It was so successful that the group applied for, and was granted, permission to continue the project on a larger scale.
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Last year, a 1.25% reduction in hospital costs by the Centers for Medicare & Medicaid Services (CMS) fed the quality bonuses at hospitals more than 600 received something for their efforts, while more than 700 lost something for their perceived lack of it. This year, the bonus pool is being funded by a 1.5% decrease in costs, estimated to be some $1.4 billion up for grabs.
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There are a lot of things counted in hospitals, a lot of data collected. Thats why it might seem surprising that until very recently, there was no measure of sepsis as a proportion of hospital mortality.
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There have been several efforts by various groups to curb overuse of healthcare treatments in different settings use of antibiotics for uncomplicated ear infections in children, for example, and the use of surgery to correct back problems that might be resolved without it.
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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.
