Today's question
I hope this isn't too difficult a question to answer for anyone...
A response to Pauline Chen's article in the New Yorker Who pays for medical mistakes?
In August 2007, officials at the agency announced that Medicare and Medicaid would no longer pay for the treatment costs of “conditions that could reasonably have been prevented” (i.e. "Never events") in an effort to improve patient safety and rein in health care costs. Instead, hospitals and physicians would have to take responsibility for these errors and cover their own costs.
And the list of "never events" is getting longer.
Patients with malnutrition or kidney failure are more likely to develop severe wound infections after heart bypass operations.
JL has kidney failure. he needs a heart bypass. You are a cardiac surgeon in the USA.
You are aware that should he develop an infection, you will be out of pocket to cover expenses of his ongoing treatment.
Will you operate?
Here is the old list of Never Events. I think we'd all agree that at least these ones SHOULD be never events.
source: http://www.psnet.ahrq.gov/primer.aspx?primerID=3
Table. Never Events, 2006
The National Quality Forum’s Health Care "Never Events" (2006)
Surgical events
Surgery performed on the wrong body part
Surgery performed on the wrong patient
Wrong surgical procedure performed on a patient
Unintended retention of a foreign object in a patient after surgery or other procedure
Intraoperative or immediately postoperative death in an American Society of Anesthesiologists Class I patient
Artificial insemination with the wrong sperm or donor egg
Product or device events
Patient death or serious disability associated with the use of contaminated drugs, devices, or biologics provided by the health care facility
Patient death or serious disability associated with the use or function of a device in patient care, in which the device is used for functions other than as intended
Patient death or serious disability associated with intravascular air embolism that occurs while being cared for in a health care facility
Patient protection events
Infant discharged to the wrong person
Patient death or serious disability associated with patient elopement (disappearance)
Patient suicide, or attempted suicide resulting in serious disability, while being cared for in a health care facility
Care management events
Patient death or serious disability associated with a medication error (eg, errors involving the wrong drug, wrong dose, wrong patient, wrong time, wrong rate, wrong preparation, or wrong route of administration)
Patient death or serious disability associated with a hemolytic reaction due to the administration of ABO/HLA-incompatible blood or blood products
Maternal death or serious disability associated with labor or delivery in a low-risk pregnancy while being cared for in a health care facility
Patient death or serious disability associated with hypoglycemia, the onset of which occurs while the patient is being cared for in a health care facility
Death or serious disability (kernicterus) associated with failure to identify and treat hyperbilirubinemia in neonates
Stage 3 or 4 pressure ulcers acquired after admission to a health care facility
Patient death or serious disability due to spinal manipulative therapy
Environmental events
Patient death or serious disability associated with an electric shock or electrical cardioversion while being cared for in a health care facility
Any incident in which a line designated for oxygen or other gas to be delivered to a patient contains the wrong gas or is contaminated by toxic substances
Patient death or serious disability associated with a burn incurred from any source while being cared for in a health care facility
Patient death or serious disability associated with a fall while being cared for in a health care facility
Patient death or serious disability associated with the use of restraints or bedrails while being cared for in a health care facility
Criminal events
Any instance of care ordered by or provided by someone impersonating a physician, nurse, pharmacist, or other licensed health care provider
Abduction of a patient of any age
Sexual assault on a patient within or on the grounds of the health care facility
Death or significant injury of a patient or staff member resulting from a physical assault (ie, battery) that occurs within or on the grounds of the health care facility
A response to Pauline Chen's article in the New Yorker Who pays for medical mistakes?
In August 2007, officials at the agency announced that Medicare and Medicaid would no longer pay for the treatment costs of “conditions that could reasonably have been prevented” (i.e. "Never events") in an effort to improve patient safety and rein in health care costs. Instead, hospitals and physicians would have to take responsibility for these errors and cover their own costs.
And the list of "never events" is getting longer.
Patients with malnutrition or kidney failure are more likely to develop severe wound infections after heart bypass operations.
JL has kidney failure. he needs a heart bypass. You are a cardiac surgeon in the USA.
You are aware that should he develop an infection, you will be out of pocket to cover expenses of his ongoing treatment.
Will you operate?
Here is the old list of Never Events. I think we'd all agree that at least these ones SHOULD be never events.
source: http://www.psnet.ahrq.gov/primer.aspx?primerID=3
Table. Never Events, 2006
The National Quality Forum’s Health Care "Never Events" (2006)
Surgical events
Surgery performed on the wrong body part
Surgery performed on the wrong patient
Wrong surgical procedure performed on a patient
Unintended retention of a foreign object in a patient after surgery or other procedure
Intraoperative or immediately postoperative death in an American Society of Anesthesiologists Class I patient
Artificial insemination with the wrong sperm or donor egg
Product or device events
Patient death or serious disability associated with the use of contaminated drugs, devices, or biologics provided by the health care facility
Patient death or serious disability associated with the use or function of a device in patient care, in which the device is used for functions other than as intended
Patient death or serious disability associated with intravascular air embolism that occurs while being cared for in a health care facility
Patient protection events
Infant discharged to the wrong person
Patient death or serious disability associated with patient elopement (disappearance)
Patient suicide, or attempted suicide resulting in serious disability, while being cared for in a health care facility
Care management events
Patient death or serious disability associated with a medication error (eg, errors involving the wrong drug, wrong dose, wrong patient, wrong time, wrong rate, wrong preparation, or wrong route of administration)
Patient death or serious disability associated with a hemolytic reaction due to the administration of ABO/HLA-incompatible blood or blood products
Maternal death or serious disability associated with labor or delivery in a low-risk pregnancy while being cared for in a health care facility
Patient death or serious disability associated with hypoglycemia, the onset of which occurs while the patient is being cared for in a health care facility
Death or serious disability (kernicterus) associated with failure to identify and treat hyperbilirubinemia in neonates
Stage 3 or 4 pressure ulcers acquired after admission to a health care facility
Patient death or serious disability due to spinal manipulative therapy
Environmental events
Patient death or serious disability associated with an electric shock or electrical cardioversion while being cared for in a health care facility
Any incident in which a line designated for oxygen or other gas to be delivered to a patient contains the wrong gas or is contaminated by toxic substances
Patient death or serious disability associated with a burn incurred from any source while being cared for in a health care facility
Patient death or serious disability associated with a fall while being cared for in a health care facility
Patient death or serious disability associated with the use of restraints or bedrails while being cared for in a health care facility
Criminal events
Any instance of care ordered by or provided by someone impersonating a physician, nurse, pharmacist, or other licensed health care provider
Abduction of a patient of any age
Sexual assault on a patient within or on the grounds of the health care facility
Death or significant injury of a patient or staff member resulting from a physical assault (ie, battery) that occurs within or on the grounds of the health care facility