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Bridges to Excellence (BTE) CEO Francois de Brantes doesn't mince words when asked if he thinks there is an ethical conflict between the payment model of pay-for-performance essentially giving physicians additional payments for good performance based on certain quality measures and ethical decision-making by physicians.
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More and more questionable ties between physicians and drug companies are being uncovered in an investigation into such financial relationships conducted by Sen. Charles Grassley (R-IA).
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In addition to physician ethics, the pay-for-performance concept also has been instituted by the Centers for Medicare & Medicaid (CMS) related to its statement that its policy will be to no longer pay for any on a list of so-called "never" events that occur at hospitals. The policy became effective Oct. 1.
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Just as in certain consumer-driven businesses, the mantra was always "the customer is always right," in health care, the mantra at least the one attributed to physician attitudes and principles historically has been "the patients' needs come first."
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A story that ran in the Sept. 12 issue of the Philadelphia Inquirer "Hospitals' mistakes are going unreported" might have shocked readers with its description of unreported errors in New Jersey and Pennsylvania despite the states' mandatory reporting requirements.
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In September, the American Hospital Association issued a quality advisory on implementing standardized colors for patient alert wristbands, citing a near miss when a nurse mistakenly placed a wrong-colored bracelet on a patient, confusing the color codes of the two hospitals for which she worked.
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While The Joint Commission is asking health care facilities to use computerized physician order entry and bar coding technology as an adjunct to arm themselves in managing high-risk medications including anticoagulants, a recent study highlights the errors implicit in this kind of information technology support.
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Four recognized categories of hospital-acquired conditions, "never events" that have received more attention in recent years, make up 12.2% of total medical professional liability costs, according to the 2008 Hospital Professional Liability and Physician Liability Benchmark Analysis released recently by risk management services provider Aon Corp. and the American Society for Healthcare Risk Management (ASHRM), both in Chicago.
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Any risk manager with hopes of reducing birth trauma rates should look to The Seton Family of Hospitals, based in Austin, TX, for lessons in what can yield dramatic results.
