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Patient Safety at the Heart of the Joint Commission's New Hospital Accreditation Chapter

Tue, 2014-10-21 08:57
The Joint Commission announces publication of the new “Patient Safety Systems” chapter in the 2015 Comprehensive Accreditation Manual for Hospitals. The purpose of the chapter is to inform and educate hospital leaders about the importance and structure of an integrated patient-centered system that aims to improve quality of care and patient safety. There are no new requirements in the Patient Safety Systems chapter. Instead, the standards are culled from existing chapters including Leadership, Rights and Responsibilities of the Patient, Performance Improvement, Medication Management and Environment of Care. The standards will continue to be published in their respective chapters as well as in the Patient Safety Systems chapter. During on-site surveys, the standards will be scored in their originating chapter.
To underscore the importance of a patient-centered safety system, The Joint Commission will make this new chapter available online indefinitely for customers and non-customers alike.
“For the first time, The Joint Commission is providing a standards chapter on our website because this information is so important that we want everyone to have access to it. A solid foundation for patient safety is a safety culture. For leaders, our hope is they will study this chapter and use it as a tool to build or improve their safety culture program,” says Ana Pujols McKee, M.D., executive vice president and chief medical officer, The Joint Commission. “Developing a culture of safety starts at the top of the chain of command, and then works its way through the layers of management and employees to build trust which is an essential ingredient for improvement. In order for improvement to take root and spread, leaders need to be engaged and know the current state of the culture in their organization.”
The chapter is oriented to leadership because leader engagement is imperative to the trust-report-improve cycle of establishing a safety culture. The standards are intended to assist leaders in creating a culture of safety that equates to an environment where staff and leaders work together to eliminate complacency, promote collective mindfulness, treat one another with respect and learn from patient safety events.
The chapter has three guiding principles:
  • Aligning existing Joint Commission standards with daily work in order to engage patients and staff throughout the health care system, at all times, on reducing harm.
  • Assisting health care organizations with advancing knowledge, skills and competence of staff and patients by recommending methods that will improve quality and safety processes.
  • Encouraging and recommending proactive methods and models of quality and patient safety that will increase accountability, trust and knowledge while reducing the impact of fear and blame.
The chapter is included only in the hospital accreditation manual; however, other health care settings may benefit from applying the patient safety strategies discussed in the chapter. Read the new chapter
Elizabeth Eaken ZhaniMedia Relations Manager, The Joint Commission

"Medical Training Gets a Second Life"

Wed, 2014-10-15 09:56
A report by Health Leaders Media details how instructors at the University of Michigan School of Nursing are using an online virtual world called Second Life to help students develop communication and leadership skills. Students can log in from anywhere with an internet connection and train in scenarios they may otherwise never see in a traditional training setting. For more information, view the article HERE.

Social Media and Medicine: The New "Instagram for Doctors"

Tue, 2014-10-14 12:06
According to the BBC, a new social media app has been developed which allows doctors to share pictures of their patients for medical and educational purposes. The app, called Figure 1, is already available in North America, Ireland and the United Kingdom and joins services like UpToDate and DynaMed in the emerging market of social media for physicians and healthcare professionals. In the article from the BBC, Dr. Josh Landy, the founder of Figure 1, is quoted as responding to patient privacy concerns by stating, "We do not possess any personal medical data at all... We are not an organization that delivers healthcare." While anyone can download the app, only physicians and other healthcare practitioners whose credentials have been verified can post photos or provide commentary on other posted photos. For a full discussion of this new app, please read the BBC article HERE.

Hospital Leaders Brief Congress on Importance of CME

Fri, 2014-10-10 08:20
From AHA and AAMC:

"At an AHA- and Association of American Medical Colleges-sponsored briefing on Tuesday, October 7, on Capitol Hill, hospital leaders shared with congressional staff the important role that Medicare funding for graduate medical education plays in helping teaching hospitals train the next generation of health care providers. “We need to train a workforce today that will meet the needs of the population of our country,” said Thomas Burke, M.D., executive vice president for the MD Anderson Cancer Network®, which is part of The University of Texas MD Anderson Cancer Center. Burke also is a member of the AHA Board of Trustees. Hospital leaders from the University of Mississippi School of Medicine, Cleveland Clinic and Oregon Health & Science University also described how direct and indirect GME payments are critical to supporting their efforts to provide highly-specialized services to patients in rural and urban communities. For more on GME and teaching hospitals, including why the AHA supports the Resident Physician Shortage Reduction Act of 2013 (S. 577), read today’s AHAStat blog post."

California Ballot Measure Calls for Drug Testing for Doctors

Mon, 2014-10-06 10:43
A measure which will appear on California's ballot during this November's election - Proposition 46 - would require drug testing for doctors at random or "after a patient suffers an 'adverse event,' which encompasses a long list of complications including developing a more serious ulcer while in the hospital and death from a medication error." If passed, California would become the first state in the nation with such a drug testing policy for physicians. Read more HERE.

UPDATE: 15 States Considering Interstate Medical Licensure Compact

Mon, 2014-09-29 12:44
In response to the finalization of the Federation of State Medical Boards' (FSMB) Interstate Medical Licensure Compact, several states and large healthcare organizations, such as the American Medical Association (AMA), have expressed support and the possibility of endorsement. According to Humayan Chaudhry, DO, president and CEO of the FSMB, “many stakeholders across the spectrum [are] expressing support.” Read herefor a full account of the latest developments.

This post is a follow-up to previous posts on September 9 and August 7 regarding the FSMB's proposed interstate compact. Scroll down to learn more.

Hydrocodone Combo Products Moved from Schedule III to Schedule II: What It Means For You

Mon, 2014-09-29 12:32
Beginning on October 6, 2014, hydrocodone combination products (HCPs) will be moved from Schedule III to Schedule II substances at the recommendation of the Secretary of the Department of Health & Human Services. This change was included in the Federal Register as part of the Drug Enforcement Agency’s recent publication of its final rule on the matter.  Read herefor important need-to-know information on what this change means for family physicians and their patients.

Cautionary Advisory to International Medical Graduates Regarding Certification Requirements

Mon, 2014-09-29 12:25
According to the Educational Commission for Foreign Medical Graduates (ECFMG), some organizations, such as the American Medical Residency Board (AMRCB) may be misrepresenting the requirements for certification for international medical graduates seeking positions in graduate medical education within the US. See the link below for further important information:

http://www.ecfmg.org/annc/ECFMG-release-Sep-16-2014.pdf

UPDATE: FSMB Compact Proposal Released

Tue, 2014-09-09 09:48
According to an article by ModernHealthcare.com, the Federation of State Medical Boards (FSMB) has released its finalized planfor an interstate compact for physician licensure “under which physicians who are licensed in one state can use a streamlined process to be quickly licensed in another.” (Read the full article here)

This post is a follow-up to the August 7, 2014 post regarding FSMB’s initial proposal for this interstate compact. Scroll down to view the original post.

DEA to Increase Hydrocodone Combination Product Oversight

Thu, 2014-08-28 10:02
Yesterday, the Drug Enforcement Administration (DEA) announced that it will enforce stronger regulations for individuals who handle hydrocodone combination products (HCPs).  This rule will shift HCPs from Schedule III to Schedule II of the Controlled Substances Act -- the designation for products that are most subject to abuse and mishandling.  This rule will go into effect 45 days from DEA's official announcement.   

What Could Black Boxes in Operating Rooms Tell Us?

Wed, 2014-08-27 10:01
According to HealthData Management, some hospitals have begun to develop black box mechanisms for their operating rooms (OR) in an effort to reduce preventable errors and increase transparency.  The goal is to use black boxes to record OR procedures to help improve patient safety by identifying errors and facilitating teachable moments for all practitioners.  The black boxes models would record both video and voice, as well as other elements, such as room temperature and noise levels.

Read more about it at HealthData Management.com.


ABIM Pledges to Examine MOC Requirements

Mon, 2014-08-25 13:31
In response to physicians' collective opposition to revised Maintenance of Certification (MOC) requirements, the American Board of Internal Medicine (ABIM) recently announced that it would lessen the financial and course requirements associated with the MOC process, as well as ensure that MOC requirements are clear and consistent across specialty boards.  ABIM also pledged to work closely with the American Board of Medical Specialties and specialty societies to improve the MOC process for all parties. 

Read more about ABIM's MOC initiative.


TJC Amends Standards in Response to May 2014 CMS Rule

Thu, 2014-08-21 15:39
The Joint Commission (TJC) announced that it has revised its hospital and critical-access hospital standards to align with CMS's May 2014 conditions of participation rule.  According to its website, TJC standards "clarify the requirements of a practitioner not appointed to the medical staff who is ordering outpatient services, governing body consultation with the medical staff, and medical staff structure for multihospital systems."

Learn more about CMS's final rule and TJC's revised standards for hospitals and critical-access hospitals

Fast Track For Primary Care Docs At One Calif. University

Fri, 2014-08-08 15:22
From Kaiser Health News:

Some doctors in the state of California will soon be able to practice after three years of medical school instead of the traditional four. The American Medical Association is providing seed money for the effort in the form of a $1 million, five-year grant to the University of California at Davis.

Read more online: http://capsules.kaiserhealthnews.org/index.php/2014/08/fast-track-for-primary-care-docs-at-one-calif-university/

FSMB Compact Could Ease Multistate Licensing

Thu, 2014-08-07 11:25


FSMB Compact Could Ease Multistate Licensing Ken Terry
 
August 05, 2014 The Federation of State Medical Boards (FSMB) has unveiled a draft interstate compact for physician licensure that, it said, should make it easier to practice telemedicine across the country. The compact, which the FSMB expects to finalize in the next month or two, offers a "streamlined alternative pathway" for physicians who want to practice in multiple states, according to a federation news release.Under current state medical board policies, physicians must be licensed in the state where a patient is located to diagnose or treat that patient, a stance that the FSMB recently reaffirmed in its model policy for telemedicine. As a result, physicians who consult remotely with patients in other states must be licensed in those states. That can create barriers to telehealth consultations, especially for on-call physicians who are not licensed in every state where patients may contact them online.The FSMB's interstate compact would allow physicians to apply once and receive licensure in all states that are party to the compact.Once the compact is finalized, individual medical boards can decide whether to endorse it and submit it to their state legislatures for approval. Three state boards, including the Texas and Oklahoma medical boards and the Washington State osteopathic medical board, have already approved the compact in principle, said Humayan J. Chaudhry, DO, president and chief executive officer of the FSMB."Many other boards have it on their agenda and are waiting for the final language before they can present it to their legislatures," he told Medscape Medical News, adding that 15 states are expected to approve the compact in the near term.According to Chaudhry, a house of delegates representing the FSMB's 70 member boards asked the federation to study the concept of an interstate compact. What motivated the boards, he said, was the need to address the nation's growing physician shortage, to ease patient access issues related to the Affordable Care Act, and to facilitate telemedicine in both rural and more populated areas.In addition, he said, the interstate compact could help physicians get licenses in metropolitan regions that cross state boundaries. He cited the situation of Washington, DC, physicians, many of whom have had to obtain separate licenses in Maryland and Virginia to treat their patients.The draft interstate compact specifies that, to be eligible for multistate licensure, physicians must have passed the US Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination, must be board-certified, must have clean records, and must have been in practice for at least 3 years. Because they must also complete a residency program, the latter requirement might be dropped in the final version, Chaudhry said.A "Baby Step"Jonathan Linkous, president and chief executive officer of the American Telemedicine Association (ATA), told Medscape Medical News that the draft interstate compact falls far short of what is needed to promote telemedicine. "The federation is taking a step. But it's a baby step, and what we need is a giant leap."The key area where the interstate compact falls short, he said, is that it would create a "clearinghouse," rather than reciprocity among states. Physicians would be able to apply for licensure to multiple states through a single entity but would still have to pay license fees to each state and would have to "follow every state's unique and peculiar rules regarding how you practice medicine."There are some large differences in those rules, he noted. For example, 24 states allow physicians to prescribe medications in telehealth encounters with patients. The rest require prior patient visits, a presenter in the same room as the patient, or a live follow-up visit.State license fees are also substantial, Linkous pointed out. The ATA performed an analysis in 26 states and found that for the fifth of physicians who had licenses in multiple states, license-related fees cost them about $300 million a year. He granted, however, that those costs might be reduced if physicians filled out a single application and did not have to provide original documents to each medical board.The ATA does not favor national licensure of physicians. What it wants is reciprocity among all states, similar to the way they treat driver's licenses today. If a physician is licensed in one state, he or she should be able to practice in any state, Linkous said.
Medscape Medical News © 2014  WebMD, LL

Data Bank to Reduce Query Fees

Wed, 2014-08-06 09:28
From The Data Bank: Effective October 1, 2014, the new fee to query the National Practitioner Data Bank (NPDB) will be $3.00 for both Continuous and One-Time Queries and $5.00 for Self-Queries. All other aspects of querying will remain the same.

Read more online

From H&HN Daily: Concerns Raised Over IOM's Report on GME

Mon, 2014-08-04 11:01
Hospitals & Healthcare Networks Daily: An influential IOM panel recommended a monumental shift in how graduate medical education is governed and financed. Teaching hospital officials worry the proposed changes would negatively impact patient care and physician training.

Read the entire article here: http://www.hhnmag.com/display/HHN-news-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HHN/Daily/2014/Jul/073014-weinstock-IOM-recommends-changes-to-GME&utm_source=daily&utm_medium=email&utm_campaign=HHN

Weinstock, Matthew. "Concerns Raised Over IOM's Report on GME." H&HN Daily 30 July 2014: n. pag. Web.

The D.O. Is In Now: Osteopathic Schools Turn Out Nearly a Third of All Med School Grads

Tue, 2014-07-29 17:59
From the New York Times - July 29, 2014

Getting into osteopathic school is still excruciatingly tough. Last fall, more than 144,000 students applied for some 6,400 spots. Touro this year received 6,000 applications for 270 first-year seats for the Manhattan school and a new campus opening this summer in Middletown, N.Y. (The average M.C.A.T. score for students entering this fall was just a point below the M.D. average.)
The boom in osteopathy is striking. In 1980, there were just 14 schools across the country and 4,940 students. Now there are 30 schools, including state universities in New Jersey, Ohio, Oklahoma, Texas, West Virginia and Michigan, offering instruction at 40 different locations to more than 23,000 students. Today, osteopathic schools turn out 28 percent of the nation’s medical school graduates.
Read the full article at the New York Times website
Berger, Joseph. "The D.O. Is In Now: Osteopathic Schools Turn Out Nearly a Third of All Med School Grads." The New York Times 29 July 2014 Published: Web. 29 July 2014.

Interstate Medical Licensure: Major Reform of Licensing to Encourage Medical Practice in Multiple States

Tue, 2014-07-29 17:50
From the Journal of the American Medical Association - July 28, 2014

The Interstate Medical Licensure Compact is a streamlined process that would allow physicians to rapidly become licensed to practice medicine in multiple states. If the compact were to be approved by state legislators and incorporated into the laws of most, if not all, states, it could catalyze many substantial changes in medical practice. 

Read more at JAMA

Corresponding Author: Robert Steinbrook, MD, Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, I-456 SHM, PO Box 208008, New Haven, CT 06520 (robert.steinbrook@yale.edu).Published Online: July 28, 2014. doi:10.1001/jama.2014.9809.Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

AOA House of Delegates Approves Single GME

Tue, 2014-07-29 11:15
The American Osteopathic Association (AOA) House of Delegates recently voted to approve the AOA Board of Trustees' decision to implement a single accreditation system for graduate medical education.  This movement stems from an agreement that the Accreditation Council for Graduate Medical Education and the American Association of Colleges of Osteopathic Medicine reached earlier this year to collaborate to create a single GME accreditation program.  The new accreditation system will be fully implemented in July 2020. 

Read more about the new accreditation policy at osteopathic.org.