Secret Hospital Inspections May Become Public - FINALLY

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Riddick
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Secret Hospital Inspections May Become Public - FINALLY

Post by Riddick » 04-23-2017 12:42 AM

Medical errors are a leading cause of death and injuries in U.S. hospitals. A 1999 report by the Institute of Medicine estimated that up to 98,000 people a year die because of mistakes in hospitals; subsequent reports have said the number is much higher.

The federal government took steps several years ago to post government inspection reports online for nursing homes and some hospitals. Those government inspection reports do not identify patients or medical staff, but they do offer a description—often detailed—of what went wrong.

Nearly nine in 10 hospitals are directly overseen by private health care accreditors, not the government. Private accrediting organizations, the largest of which is The Joint Commission, have created a patchwork of disclosure in which some inspections are public and others are not.

There’s increasing concern among regulators that private accreditors aren’t picking up on serious problems at health facilities. Right now, the reports accreditors release on problems they find during hospital inspections are secret.

The public could soon get a look at those confidential reports under a groundbreaking proposal from federal health officials. The Centers for Medicare and Medicaid Services wants to require private health care accreditors publicly detail errors, mishaps and mix-ups they find during inspections.

Or, to quote patient safety expert Rosemary Gibson:

“Right now the public has very little information about the places where they’re putting their life on the line, and that’s just not acceptable. If you’re a good place, what are they afraid of?”

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Re: Secret Hospital Inspections May Become Public - FINALLY

Post by kbot » 04-24-2017 05:59 AM

Since 1999 a lot has changed - now medical staff (physicians, nurses, techs and support staff) spend much more of their time inputting data, rather than engaging in direct patient care. :roll:

What has also changed is the rate of patients infected with MRSA, detected on admission. One result of the dangers lurking in healthcare settings is the up-front testing, on admission, for various microorganisms that patients come into the hospital with, spreading infections among the res of the patent and staff. By testing on admission, hospitals are able to identify these cases first and treat them up front, rather than after the fact.

What is truly scary is that we have a whole population out there blissfully ignorant hat with every hug, squeeze and kiss they give their relatives, they're passing along some nasty bugs. It's only when they are admitted and testing is done that they scream blue bloody murder. We started documenting infections over ten years ago when we were inserting PICC lines. The rationale for inserting the PICC Line was that the patient was going to be having long-term antibiotics for treatment of infections. The insurers said that we (the hospital) was the cause of the infection, and they consistently fought the reimbursement for the PICC lines. We were able to demonstrate that the reason the patient was admitted in the first place was that they had raging infections to begin with.....
There you go man, keep as cool as you can. Face piles and piles of trials with smiles. It riles them to believe that you perceive the web they weave. And keep on thinking free. (Moody Blues)

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Re: Secret Hospital Inspections May Become Public - FINALLY

Post by Riddick » 04-25-2017 01:28 AM

kbot wrote:Since 1999 a lot has changed - now medical staff (physicians, nurses, techs and support staff) spend much more of their time inputting data, rather than engaging in direct patient care. :roll:

What has also changed is the rate of patients infected with MRSA, detected on admission. One result of the dangers lurking in healthcare settings is the up-front testing, on admission, for various microorganisms that patients come into the hospital with, spreading infections among the res of the patent and staff. By testing on admission, hospitals are able to identify these cases first and treat them up front, rather than after the fact.

What is truly scary is that we have a whole population out there blissfully ignorant hat with every hug, squeeze and kiss they give their relatives, they're passing along some nasty bugs. It's only when they are admitted and testing is done that they scream blue bloody murder. We started documenting infections over ten years ago when we were inserting PICC lines. The rationale for inserting the PICC Line was that the patient was going to be having long-term antibiotics for treatment of infections. The insurers said that we (the hospital) was the cause of the infection, and they consistently fought the reimbursement for the PICC lines. We were able to demonstrate that the reason the patient was admitted in the first place was that they had raging infections to begin with.....
Following your gist, my thought is that all around on admission more and better infection inspections would be a good thing. Would you say that's something you see happening anytime soon?
A mind should not be so open that the brains fall out; however, it should not be so closed that whatever gray matter which does reside may not be reached. ART BELL

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Re: Secret Hospital Inspections May Become Public - FINALLY

Post by kbot » 04-25-2017 05:56 AM

Riddick wrote:Following your gist, my thought is that all around on admission more and better infection inspections would be a good thing. Would you say that's something you see happening anytime soon?
Difficult to tell. Patients can still opt-out, depending on the situation. For example, one of the everyday hazards of working in healthcare is needle sticks. Staff can accidentally stick themselves with needles or other sharps, such as scalpels while performing or assisting in performing a procedure. Let's say that an interventional radiologist is performing a CT-guided liver biopsy on a patient with Hepatitis-C and while reaching for a needle on the table which has already been used for a pass of liver tissue, accidentally stabs himself and draws blood.

Per policy, the radiologist should, at the end of the procedure, report to infection control, have Lab tests and be treated.

But, let's say that an employee has a needle stick after working with a patient where there is a suspicion of HIV/ AIDS. The employee would report to employee health/ infection control, but in order to determine the course of treatment the facility needs the patients permission to test his/ her blood samples and sometimes the patient refuses.

Then there are patients who come in to the ER (we had one recently) where the chest x-ray has the radiographic appearance of tuberculosis. The patient has been in the ER waiting room coughing while waiting to be registered, then gets to the registration desk, coughing on staff, then works his way through the ER exam room and their staff, radiology and the Lab with their staff, and finally gets admitted. Hopefully the patient is admitted into a negative pressure room...... A few days go by while the Lab culture that proves active tuberculosis is the reality, and by then, this one patient has potentially infected over a dozen people across the hospital. This is not all that uncommon BTW.......

Because of computerized medical records, we can identify the hospital staff fairly quickly and start prophylactic medications, but what about the public that has been infected in the days before the patient got "sick enough" to come-in and be seen?

Last night I started reading an old Bureau of Labor Statistic report that was published in 1919 and I started reading it because if deals with the health of the cotton mill workers in my hometown in the early 20th century. I find this stuff fascinating because my family worked in textile mills for a long time and quite a few of the old granite mills still dominate the city's architecture.

Anyway the report was written as a study of the varied causes of death in the city among textile mill operatives, ranging from accidents to issues raging at the time from exacerbation of asthma from the cotton dust flying around in the mill air, to accidents, to typhoid fever and influenza and tuberculosis. Naturally, in some of these instances, there was a huge dose of stigma attached to dying from certain causes, and because many of these individuals were first or second generation immigrants, they were afraid of reporting the true cause of death, and so when the physician wrote out the death certificate, the information may be incorrect.

That was an eye-opener to me as I love working on my family history and to see a contemporary government report state that in a large percentage of cases, the cause of death listed on the certificate may be wrong was something I didn't expect to find.

What little I read also said that sometimes people moved just prior to dying - they were ill, and sometimes would move back home. So, for this study, some people that may have moved here from the farms of Quebec or the depressed townlands in Ireland or the global textile mill competition in England, the person may have moved back home in the hope that with the different climate and being around family and old friends that their health would improve. The death statistics here would be incorrect in that the death did not occur here, but the situation "back home" may have been altered depending on the cause of death - and depending on the stigma attached, the true cause may not be known definitively. And, this reasoning can probably apply across the country

Looks like much hasn't changed in the past century.......
There you go man, keep as cool as you can. Face piles and piles of trials with smiles. It riles them to believe that you perceive the web they weave. And keep on thinking free. (Moody Blues)

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