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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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Small IRBs often have a resource dilemma: How do you help the IRB improve consistency and quality of reviews when staffing is limited?
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The 21st century IRB office is run by professional-level staff more than in previous years. While 30 years ago an IRB could rely on a long-time employee who had experience without credentials, this model is becoming rare.
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Research institutions sometimes struggle with retaining experienced IRB members as the workload can be significant and there are so many competing duties and projects for these scientists, professors, bioethicists, and other professionals.
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The 2011 changes to the National Institutes of Health (NIH) Public Health Service (PHS) regulations for reporting investigator conflicts of interest may still be causing confusion for researchers and IRBs.
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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.
