Hospital Acquired Conditions

Clarifying “Never-Events” Terminology

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

dr-david-marcinko1Did you know that “never-events” are also being called “hospital acquired conditions”; in some cases? 

Of Terms and Definitions 

Below is the list of conditions that the Centers for Medicare and Medicaid Services (CMS) selected in its FY 2008 final rule: 

  • Serious Preventable Event — Object Left in Surgery
  • Serious Preventable Event — Air Embolism
  • Serious Preventable Event — Blood Incompatibility
  • Catherther-associated Urinary Tract Infections
  • Pressure Ulcers (Decubitus Ulcers)
  • Vascular Catheter-Associated Infection
  • Surgical Site Infection — Mediastinitis After Coronary Artery Bypass Graft (CABG) Surgery
  • Hospital-Acquired Injuries — Fractures, Dislocations, Intracranial Injury, Crushing Injury, Burn and Other Unspecified Effects of External Causes

Assessment 

IOW: You might say “nosocomial”; but I may say “hospital-acquired” when it comes to infections? 

And so, is this a linguistic technique to take some of the legal-liability and “sting” out of “never-events” terminology?

Does a term-of-art really matter to the affected patient? Suppose you were the patient? 

Conclusion 

Please comment and opine? 

Speaker: If you need a moderator or a speaker for an upcoming event, Dr. David Edward Marcinko; MBA – Editor and Publisher-in-Chief – is available for speaking engagements. Contact him at: MarcinkoAdvisors@msn.com 

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9 Responses

  1. PEs and NEs – The List Grows

    According to the Associated Press, the government estimates that its’ proposed Never-Events rule changes will save Medicare $50 million annually during each of the next three years.

    Perhaps that is why Federal health officials just proposed adding dangerous blood clots in the leg and eight other conditions to the list of complications that Medicare would not pay to treat if they were acquired at the hospital?

    The Centers for Medicare and Medicaid [CMS] set a new precedent last year by saying it would no longer pay hospitals for treating eight “never events” – conditions that occur as a result of hospital error, such as giving a patient the wrong blood type.

    Now, the newly-proposed rules add nine conditions, including: deep-vein thrombosis, ventilator-associated pneumonia, bloodstream infections with the staphylococcus aureus bacteria, and Legionnaire’s disease.

    Suggestions for the next set of NE are appreciated; as “the list goes on.”
    -Jane

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  2. Cigna the Next N-E No Payer

    Did you know that the Cigna Corporation will soon stop reimbursing hospitals for major medical errors, including operating on the wrong organ, the wrong side, the wrong body part or the wrong person; etc?

    Yes, it’s finally true. The policy also will deny payment for avoidable hospital conditions such as objects left inside a patient during surgery; use of the wrong blood type during transfusions; infections from urinary catheters; and bedsores, according to the Philadelphia Inquirer.

    Cigna is just the next payer to join a national movement to attack medical errors by not paying for them, or for the care necessary to fix errors after they have occurred.
    Aetna Inc. announced a similar measure in January; while Pennsylvania, Minnesota and Massachusetts have set up no-pay policies through their Medicaid programs.

    And so, what are the chances that medical errors overall will indeed decrease, going forward, once these non-payment polices are fully implemented? Your thoughts are appreciated

    -Hope

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  3. Clostridium Difficile Infections

    Did you know that last month, Medicare proposed adding the spore producer C. diff to the growing list of preventable problems after the agency recorded 96,000 cases of the infection in 2007 at an average cost of $59,000 apiece?

    Read more: http://www.msnbc.msn.com/id/24407803
    Any comments on this ever growing list of Never-Events?

    -Staff Reporters

    Like

  4. NEs

    A new report from the Agency for Healthcare Research and Quality concludes that stays for skin and subcutaneous tissue infections went up 90 percent for men and 75 percent for women. The rate of another dangerous infection, septicemia, shot up by 63 percent–77 percent among men and 53 percent among women.

    http://www.hcup-us.ahrq.gov/reports/factsandfigures/2007/highlightsV2.jsp

    Now, we know why some infections are NEs.
    Too costly or, pity the patient?

    Glenda

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  5. Hi Glen,

    This report noted that several California hospitals have been fined for preventable mistakes. Any thoughts?

    http://www.healthjournalism.org/blog/2009/09/11-calif-hospitals-fined-for-preventable-mistakes/

    Mandy

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  6. Glenda and Mandy,

    Did you know that CMS is now considering the addition of clostridium difficile infections in the hospital setting, as a “never-event” – or condition for which CMS payments will be lowered or cut?

    Richard

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  7. Cut hospitalizations to reduce hospital related medical errors

    http://content.healthaffairs.org/content/30/4/581.abstract

    Hope R. Hetico RN MHA

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  8. The ultimate [well almost] never-event?

    In two medical malpractice lawsuits just filed in Alleghney County PA, a couple alleges negligence on the part of UPMC Presbyterian Hospital, University of Pittsburgh Physicians, four doctors, a nurse and the entire staff of the hospital’s kidney transplant center.

    Learn why? http://www.msnbc.msn.com/id/44599555/ns/health-infectious_diseases/

    Naomi

    Like

  9. Hospitals report only 1% of patient harm events

    Although about 60 percent of patient harm events occurred at hospitals in states with reporting systems, only 12 percent of the events met state requirements for reporting, according to new report from the Office of the Inspector General released today that looked at Medicare beneficiaries discharged in October 2008.

    http://oig.hhs.gov/oei/reports/oei-06-09-00092.asp

    Mitzi

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