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Issues & Legislative Committee Report

November 9, 2006

JCAHO/Gainsharing Update

Gainsharing Agreements

The Leapfrog Group announced that they have launched the Leapfrog Hospital Rewards Program, https://leapfrog.medstat.com/hrp/index.asp. According to a letter written to the Department of HHS by Leapfrog’s CEO Suzanne Delbanco, this program allows implementers to examine both the quality and efficiency of care in hospitals as well as provide rewards in a sustainable way by funding them through actual savings that result from reductions in length of stay and readmissions. They are designing a “gainsharing” component for the Program to explore and resolve how to provide rewards for both hospitals and physicians. Leapfrog reports that this new aspect of the program fully aligns with the goals of the new CMS gainsharing demonstrations. 

Source: www.leapfroggroup.org/media/file/Secretary_Leavitt_letter_101206.doc

The Joint Commission (JCAHO)

The Joint Commission is asking for input on health care organization experiences with their standards and elements of performance. The information gathered will be considered in continuing efforts to improve the relevance, clarity, and achievability of the standards and related elements of performance. Through December 18, 2006, comments are being gathered on the following chapters: Provision of Care and Nursing (critical access hospital and hospital programs only).

Source: http://www.jointcommission.org

Disaster Preparedness Issue - Funding

Flu Pandemic Preparations Would Cost U.S. Hospitals $5B, AHA Official Says

The Center estimated the initial cost of preparing for pandemic will be about 5 billion dollars across the nation's 5000 general acute care hospitals. This statistic was quoted by AHA Spokeswomen Nancy Donegan in written testimony to the Senate Special Committee on Aging.

This estimate assumes initial spending of at least $1 million for average, 164-bed hospitals and includes spending in the following categories:

The five billion did not include spending on capital such as ventilators. She also added that it would take about $200k on an annual basis to keep a facility prepared. Health Officials agree that there needs to be a sustained and predictable stream of funding for effective response. The Bush flu preparation plan call for $7 billion over the next two to three year period, but none of the funding is allocated directly to hospitals.

Source: University of Pittsburgh Center for Biosecurit, May 2006.
https://www.upmc-biosecurity.org.

Quality, Medication Errors and Safety Issues

Quality

Wal-Mart and Target stores will begin, or have already begun, selling generic prescription drugs for $4.00 per prescription in several states. It is a wonderful benefit for the under insured and aged population if there are no quality issues, but there is the potential for sourcing quality issues  at sometime in the future.

Medication Errors

The J.A.M.A., Journal of the American Medical Association, study says that IV medications have been associated with 54% of potential adverse drug events, 56% of medication errors and almost 61% of the serious and life threatening errors nationwide. The use of wireless technology to help prevent IV drug errors is strongly recommended by Joint Commission ( JCAHO ) and patient advocacy groups; Discussion ensued about IV pumps which can or cannot be upgraded to wireless and the fact that wireless allows for real-time updates universally throughout the institution where wireless antennae are available.

Safety Issues

Drug eluting, drug coated, plain stents: stents vs. endarterectomies. Concerns are being raised that an increase in strokes or death may occur with the use of some stents. The validity of the methodologies used in the European study recently published raising this issue had been questioned by physicians who are using stents.

Hospitals for a Healthy Environment (H2E)

Arkansas has awarded Baptist Health the Environmentally Friendly award. This award is received by taking extraordinary steps to avoid air pollution, use of mercury and use of energy. Baptist Health was also given credit for moving away from wet film processing to the digital picture archive system. This has done away with more than 2,000 gallons of chemical waste each month.