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CMS to Cover Smoking Cessation Survey: Hospital Executives Reluctant to Endorse
Public Error Reporting CMS Announces First Medicare Ombudsman Health
Affairs: More Specialists Doesn’t
Mean Lower Mortality JCAHO Announces Plans to Establish Worldwide
Patient Safety Center OIG Report Looks at Care Trends in Nursing Homes NQF
Outlines Hospital Board Quality Duties The Centers
for Medicare and Medicaid Services ( CMS ) announced that it is adding
coverage for smoking and tobacco use cessation counseling for certain
beneficiaries. The coverage involves only Medicare beneficiaries who
have an illness caused or complicated by tobacco use, including heart
disease, cerebrovascular disease, lung disease, weak bones, blood clots,
and cataracts – the diseases that account for the bulk of Medicare
spending today. It also applies to beneficiaries who take any of
the many medications whose effectiveness is complicated by tobacco use – including
insulins and medicines for high blood pressure, blood clots and depression. Smoking
cessation in older adults leads to significant risk reduction and other
health benefits, even in those who have smoked for years. Researchers
estimate that smoking accounts for approximately 10% of the total costs
of the Medicare program or about $20.5 billion in 1997. On
average, nonsmokers survived 1.6-3.9 years longer than those who have
never smoked. The final Medicare coverage decision is available on the CMS Website
at https://www.cms.gov/coverage/. In a survey published in the March 16 edition of the Journal of
the American Medical Association, researchers found that most
hospital executives have serious reservations about implementing mandatory
public error reporting systems. The survey focused on mandatory state reporting systems and closely
related issues of patient safety. Responses were received from 63% of
320 chief executive and chief operating officers randomly selected from
hospitals in two states with mandatory reporting and public disclosure,
two states with mandatory reporting without public disclosure, and two
states without mandatory systems in 2002-2003. More than two-thirds of the respondents thought that a state-mandated
public reporting system would discourage error reporting and would not
improve patient safety. In contrast, the hospital executives thought
that confidential reporting would foster the desire to focus on identified
problems rather than lay blame and would lead to safer, higher quality
care. Nearly 80% thought the name of the hospital and the practitioner should
be confidential and said public reporting would increase lawsuits, although
hospital executives in states where the information already is made public
were more willing to name the hospitals. However, patient-safety experts
and the Institute of Medicine stress that public reporting would enable
hospitals to share data, spot trends, and develop systems to prevent
errors. More than
20 states have a mandatory reporting system. Some states mandate reports
just for serious injuries, some require only aggregate data and others
don’t
release the reports to the public. The Centers
for Medicare & Medicaid Services has announced that
Daniel Schreiner will serve as Medicare’s first ombudsman. The ombudsman, a role created by the Medicare Modernization Act of
2003, is to be the single point of contact with CMS to oversee all beneficiary
concerns. He will focus on appeals, complaints, grievances and requests
for assistance. Schreiner, currently an independent health care policy consultant,
has a broad health care background that includes service to federal and
state health agencies. In a CMS
news release announcing the appointment, CMS administrator Ma rk McClellan
said, “ Ma
ny components in Medicare already have ways to handle direct communications
with beneficiaries, but the ombudsman would serve as a single beneficiary
contact for the entire agency.” In a March
15 research article published on the Health Affairs website, public
health investigators report that increasing the ratio of medical specialists
in the population does not improve mortality rates. By analyzing federal data on physician supply in more than 3,000 US
counties, the researchers found that having a higher ratio of primary
care physicians in an area results in lower mortality rates overall including
heart disease and cancer. The findings also confirm previous research
that shows no improvement in population health when the ratio of medical
specialists is increased. For more information, visit: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.97 The Joint
Commission on Accreditation of Healthcare Organizations (JCAHO) and
its companion organization, the Joint Commission Resources (JCR), plan
to establish an international patient-safety center designed to focus
on identifying, analyzing, and disseminating patient-safety advances
in the United States and abroad. The center, known as Joint Commission
International Center for Patient Safety will also address organizational “cultures
of safety.” Peter Angood, MD, a professor at the University of Massachusetts Medical
School, will serve as chief patient-safety officer and co-leader of the
center. Other principal members of the center include Richard Croteau,
JCAHO's executive director for strategic initiatives, and Laura Botwinick,
currently a George W. Merck Fellow at the Institute for Healthcare Improvement.
Croteau and Botwinick will work with critical resource groups across
JCAHO and JCR to integrate existing patient safety initiatives and products,
and begin to develop a database of patient safety solutions. For more
information, visit: http://www.jcaho.org/news+room/news+release+archives/jci.htm Janet Corrigan,
Ph.D., who currently serves as Senior Board Director at the Institute
of Medicine will join the National Committee for Quality Health Care
(NCQHC) as President and CEO on June 1, 2005. Corrigan will replace
NCQHC’s current CEO, Catherine McDermott, who plans to
retire. At the
IOM , Corrigan provided strategic direction and oversight of the Institute
of Medicine's Quality Chasm Series, sponsoring two national summits
and a series of ten reports on safety and quality. She was instrumental
in production of the landmark reports, "To Err is Human" and "Crossing
the Quality Chasm." Corrigan’s priorities at the NCQHC will include upgrading existing
education and outreach initiatives, forging more collaborative relationships
with other quality organizations, and amplifying the organization’s
health care quality and safety efforts. The National Committee for Quality Health Care (NCQHC) is a national,
independent, membership organization that promotes improving quality
throughout the health care continuum by providing a non-partisan forum
for discussion, research and education. The Office
of Inspector General recently issued a report on “emerging
practices” in nursing homes such as mentoring programs, making
decisions for resident care based on collected data, and maintenance
of a home-like environment for residents. Agency
representatives visited 16 nursing homes and conducted telephone interviews
with more than a 1,000 to glean information on initiatives related
to improved staffing, quality of care, and enhancement of resident’s
quality of life. Read the full report: http://www.oig.hhs.gov/oei/reports/oei-01-04-00070.pdf Under the
title “Call to Responsibility,” the
National Quality Forum (NQF) has outlined guidelines that define quality
improvement roles for hospital board of trustee members. Calling
for active board engagement in quality improvement issues, NQF says
governing boards should be responsible for ensuring the quality of
health care delivered in their institution; enable effective evaluation
of their own role in enhancing quality; develop “quality literacy” regarding
patient safety, clinical care, and health care outcomes; and oversee
and be accountable for their institution’s participation and performance
in national quality measurement efforts and improvement activities. The document also classifies other hospital stakeholders into 3 categories:
policy-making organizations, consumers, and payers. Specific principles
are defined for each stakeholder group. Read the guidelines: http://www.qualityforum.org/txcalltoresponsibilityFINAL-WEB02-15-05.pdf  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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