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MANAGED CARE Magazine July 2007. ©MediMedia USA

CMS and states may stop paying for specific hospital-acquired conditions. Will health plans follow suit?

"We have very specific requests," says Delbanco. They include having the hospital:

• apologize to the patient and family affected by the never event,
• report the event to at least one reporting program,
• conduct a root-cause analysis, and
• waive all costs directly related to the never event and refrain from seeking payment from the patient or a third-party payer.
  
  

"There are no reporting requirements at this time for hospital-acquired conditions, including infections,**" says Griffith-Cohen. "A purpose of the proposed rule is to attempt to address that. The initiative was mandated by Congress in order to prevent Medicare from bearing the cost when a patient incurs a hospital-acquired condition that could have been prevented with proper care and evidence-based guidelines."

 

By Using PROACT Software You Can:

1. Understand how proactive activities such as RCA, FMEA and OA integrate into existing systems.
   
   
2. Differentiate between the values of chronic vs acute events, and problems vs opportunities.
   
   
3. Contrast FMEA’s vs Opportunity Analyses to learn how to mine hospital systems for opportunities.
   
   
4. Correlate proactive analyses to actual patient safety.
   
   
5. Understand the importance of collecting the 5P’s of data collection.
   
   
6. Organize the appropriate team members to increase chances of an unbiased analysis.
   
   
7. Use a logic tree to uncover the Physical, Human and Latent root causes associated with any undesirable outcome.
   
   
8. Ensure that evidence is used to support all hypotheses.
   
   
9. Understand the Top 10 Traps resulting in human error.
   
   
10. Learn why mix-ups occur.
    
    
11. Prepare