Note from Health Lover, Ilena Rosenthal:
http://ilenarose.blogspot.com
A seemingly good idea with some very serious downsides!

Patients could be left ill or injured and not cared for ...

Caution!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Medicare will not pay if hospital errs

February 19, 2008



WASHINGTON - It's a new way to push for patient safety: Don't pay
hospitals for their errors.

Beginning Oct. 1, Medicare no longer will cover extra-care costs for
eight preventable hospital errors. Nor can hospitals bill the injured
patient for those extra costs.

"Money talks," says Dr. Steven Gordon, infectious disease chief at the
Cleveland Clinic Foundation. "Every hospital CFO, this gets their
attention."

- - -

Medicare's targets

*Urinary tract infections from catheters

"Ilena Rose" <BIA@mundo.com> wrote in message
news:e02mr31mvnkggh68o0rjdra44sde0phlnm@4ax.com...
Note from Health Lover, Ilena Rosenthal:
http://ilenarose.blogspot.com
A seemingly good idea with some very serious downsides!

Patients could be left ill or injured and not cared for ...

Caution!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Medicare will not pay if hospital errs

February 19, 2008



WASHINGTON - It's a new way to push for patient safety: Don't pay
hospitals for their errors.

Beginning Oct. 1, Medicare no longer will cover extra-care costs for
eight preventable hospital errors. Nor can hospitals bill the injured
patient for those extra costs.

"Money talks," says Dr. Steven Gordon, infectious disease chief at the
Cleveland Clinic Foundation. "Every hospital CFO, this gets their
attention."

- - -

Medicare's targets

*Urinary tract infections from catheters

This is old news. This is also one of the biggest reasons we should be
very
fearful of a government run healthcare system. UTI's are an absolutely
unavoidable outcome in a percentage of patients with catheters in place.
The people that come up with this insanity simply don't have a clue.


The concept that people will get infections and nothing can be done

"Ilena Rose" <BIA@mundo.com> wrote in message
news:e02mr31mvnkggh68o0rjdra44sde0phlnm@4ax.com...

WASHINGTON - It's a new way to push for patient safety: Don't pay
hospitals for their errors.

Beginning Oct. 1, Medicare no longer will cover extra-care costs for
eight preventable hospital errors. Nor can hospitals bill the injured
patient for those extra costs.

"Money talks," says Dr. Steven Gordon, infectious disease chief at the
Cleveland Clinic Foundation. "Every hospital CFO, this gets their
attention."

- - -

Medicare's targets

*Urinary tract infections from catheters

This is old news. This is also one of the biggest reasons we should be very
fearful of a government run healthcare system. UTI's are an absolutely
unavoidable outcome in a percentage of patients with catheters in place.
The people that come up with this insanity simply don't have a clue.

In misc.health.alternative D. C. Sessions <dcs@lumbercartel.com> wrote:

: Unlike many who prefer to demonize the medical professions, I
: consider the generally excellent care that patients receive to
: be a testament to the ethics and professionalism of the care
: givers *despite* a system that leans in the opposite direction.

Recommended viewing (nearly 40 years old, but still not out of date):
_The Hospital_ starring George C. Scott and Diana Rigg.

: However, wouldn't it be better to not "place a stumbling block
: before the blind?" Let's remove the perverse incentive structures.

Do you really think that Jan Drew is going to realize that you just
quoted -- gasp -- the Torah?

"George Conklin" <n...@earthlink.net> wrote in message

news:13roasrsl69hr12@corp.supernews.com...


Cutting something in half is not the same as eliminating it.  Catheters are
plastic tubes that extend from inside the bladder, through the penis, and
out onto the skin/bed/etc.  The external part of the catheter will, by
definition, be contaminated.  There is no way around that fact.  Within a
week, the overwhelming majority of patients will have bacteria present in
their urine.  Technically, they would thus have a urinary tract infection.
There is no way around that.  It is unavoidable.- Hide quoted text -

- Show quoted text -

"Skeptic" <bcs002b@yahoo.com> wrote in message
news:xMMuj.41516$yE1.27616@attbi_s21...

"Ilena Rose" <BIA@mundo.com> wrote in message
news:e02mr31mvnkggh68o0rjdra44sde0phlnm@4ax.com...
Note from Health Lover, Ilena Rosenthal:
http://ilenarose.blogspot.com
A seemingly good idea with some very serious downsides!

Patients could be left ill or injured and not cared for ...

Caution!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Medicare will not pay if hospital errs

February 19, 2008



WASHINGTON - It's a new way to push for patient safety: Don't pay
hospitals for their errors.

Beginning Oct. 1, Medicare no longer will cover extra-care costs for
eight preventable hospital errors. Nor can hospitals bill the injured
patient for those extra costs.

"Money talks," says Dr. Steven Gordon, infectious disease chief at the
Cleveland Clinic Foundation. "Every hospital CFO, this gets their
attention."

- - -

Medicare's targets

*Urinary tract infections from catheters

This is old news. This is also one of the biggest reasons we should be
very
fearful of a government run healthcare system. UTI's are an absolutely
unavoidable outcome in a percentage of patients with catheters in place.
The people that come up with this insanity simply don't have a clue.


The concept that people will get infections and nothing can be done
about it has been disproven by many hospitals which have cut infection
rates
in half by making staff and doctors do things like wash their hands,
something Skeptic obviously does not believe in.

In message <xMMuj.41516$yE1.27616@attbi_s21>, Skeptic wrote:
"Ilena Rose" <BIA@mundo.com> wrote in message
news:e02mr31mvnkggh68o0rjdra44sde0phlnm@4ax.com...

WASHINGTON - It's a new way to push for patient safety: Don't pay
hospitals for their errors.

Beginning Oct. 1, Medicare no longer will cover extra-care costs for
eight preventable hospital errors. Nor can hospitals bill the injured
patient for those extra costs.

"Money talks," says Dr. Steven Gordon, infectious disease chief at the
Cleveland Clinic Foundation. "Every hospital CFO, this gets their
attention."

- - -

Medicare's targets

*Urinary tract infections from catheters

This is old news. This is also one of the biggest reasons we should be
very
fearful of a government run healthcare system. UTI's are an absolutely
unavoidable outcome in a percentage of patients with catheters in place.
The people that come up with this insanity simply don't have a clue.

Is it possible to prevent every last single catheter infection?
(Aside from never using catheters, anyway) No, of course not.
Is the alternative to give care providers carte blanche to be
paid for bad patient outcomes regardless of substandard care?
One would hope not. Is the alternative to require the equivalent
of a Board of Inquiry on every nosocomial infection? Not cost-
effective.

If we take all of this out of the "blame" space and put it in
a "quality improvement" space, though, you get a different
perspective. The current incentive structure, frankly, is a
"cost plus" system where providers have a financial incentive
to provide substandard care which, when it causes adverse
patient outcomes, *increases* their revenues.

Unlike many who prefer to demonize the medical professions, I
consider the generally excellent care that patients receive to
be a testament to the ethics and professionalism of the care
givers *despite* a system that leans in the opposite direction.
However, wouldn't it be better to not "place a stumbling block
before the blind?" Let's remove the perverse incentive structures.

We don't need to get into finger-pointing on each and every
adverse outcome to recognize that AT AN AGGREGATE LEVEL:
* Hospitals are large enough that nosocomial infection rates average out,
* Policies, procedures, and supervision affect those rates,
* Pushing the cost of adverse outcomes to the hospital incents
reduction of those rates overall,
* Pushing the cost of adverse outcomes to patients at best removes
an incentive to improve care and at worst incents poor care.

Example: despite Semelweiss being in his grave lo these many years,
the largest single factor in nosocomial infections is *still*
that caregivers don't take simple hand-disinfection precautions
between patients. THAT is correctable -- but not when the
"cost of nonquality" is being externalized. Make the hospital
pay for those infections and I guarantee you it won't be long
before there is a glove dispenser and recepticle at the entrance
to every patient room and an incident report for every time a
caregiver is either (a) wearing gloves outside of rooms or
(b) _not_ wearing them in rooms.

In an industrial environment, we don't consider every defective
product a source for personal blame (in some fields, like mine,
it's actually possible to calculate the unavoidable loss of yield
due to the laws of physics.) On the other hand, we don't push the
risk for those defects down to our customers, either. We, in effect,
perform the "insurance" risk-pooling for them by factoring yield
loss into our cost structure.

THAT incents us to reduce the cost of nonquality rather than incenting
us to reduce costs irrespective of quality issues and (first order)
increasing our revenues by shipping junk that has to be replaced.
This is a pretty basic matter of economics: reducing the externalization
of negatives.

So -- once you take the blame aspect out of the matter, what you're
looking at here is the application of a quality improvement process
to the practice of medicine.

It's either that, or postulate the the economics of health care
somehow violates some of the most basic principles of economics
and of statistics (upon which quality control depends.) If that's
your thesis, I anxiously await your detailed analysis.

"George Conklin" <n...@earthlink.net> wrote in message

news:13roasrsl69hr12@corp.supernews.com...


Cutting something in half is not the same as eliminating it. Catheters are
plastic tubes that extend from inside the bladder, through the penis, and
out onto the skin/bed/etc. The external part of the catheter will, by
definition, be contaminated. There is no way around that fact. Within a
week, the overwhelming majority of patients will have bacteria present in
their urine. Technically, they would thus have a urinary tract infection.
There is no way around that. It is unavoidable.- Hide quoted text -

- Show quoted text -

"George Conklin" <nil@earthlink.net> wrote in message
news:13roasrsl69hr12@corp.supernews.com...

The concept that people will get infections and nothing can be done
about it has been disproven by many hospitals which have cut infection
rates
in half by making staff and doctors do things like wash their hands,
something Skeptic obviously does not believe in.

Cutting something in half is not the same as eliminating it. Catheters are
plastic tubes that extend from inside the bladder, through the penis, and
out onto the skin/bed/etc. The external part of the catheter will, by
definition, be contaminated. There is no way around that fact. Within a
week, the overwhelming majority of patients will have bacteria present in
their urine. Technically, they would thus have a urinary tract infection.
There is no way around that. It is unavoidable.

Easter Bunny.

D. C. Sessions <dcs@lumbercartel.com> wrote:

Jan Drew

-----
Richard Schultz

"D. C. Sessions" <dcs@lumbercartel.com> wrote in message
news:jkpt85-1oi.ln1@news.lumbercartel.com...
In message <xMMuj.41516$yE1.27616@attbi_s21>, Skeptic wrote:
"Ilena Rose" <BIA@mundo.com> wrote in message
news:e02mr31mvnkggh68o0rjdra44sde0phlnm@4ax.com...

WASHINGTON - It's a new way to push for patient safety: Don't pay
hospitals for their errors.

Beginning Oct. 1, Medicare no longer will cover extra-care costs for
eight preventable hospital errors. Nor can hospitals bill the injured
patient for those extra costs.

"Money talks," says Dr. Steven Gordon, infectious disease chief at the
Cleveland Clinic Foundation. "Every hospital CFO, this gets their
attention."

- - -

Medicare's targets

*Urinary tract infections from catheters

This is old news. This is also one of the biggest reasons we should be
very
fearful of a government run healthcare system. UTI's are an absolutely
unavoidable outcome in a percentage of patients with catheters in place.
The people that come up with this insanity simply don't have a clue.

Is it possible to prevent every last single catheter infection?
(Aside from never using catheters, anyway) No, of course not.
Is the alternative to give care providers carte blanche to be
paid for bad patient outcomes regardless of substandard care?
One would hope not. Is the alternative to require the equivalent
of a Board of Inquiry on every nosocomial infection? Not cost-
effective.

If we take all of this out of the "blame" space and put it in
a "quality improvement" space, though, you get a different
perspective. The current incentive structure, frankly, is a
"cost plus" system where providers have a financial incentive
to provide substandard care which, when it causes adverse
patient outcomes, *increases* their revenues.

I don't see that. Substandard care can result in medical complications.
Medical complications are costly to fix and can be devastating to a
physician's credibiltiy. A commonly used example is the gastroenterologist
perforating a colon and making money on the surgical repair. People that
make those sorts of claims simply do not understand that the doctor
repairing the colon will be a busy general surgeon who was not involved in
the case and now has to cancel his clinic or come in in the middle of the
night for an urgent surgery. The GI doc who perforated gets nothing except
scrutiny.

Unlike many who prefer to demonize the medical professions, I
consider the generally excellent care that patients receive to
be a testament to the ethics and professionalism of the care
givers *despite* a system that leans in the opposite direction.
However, wouldn't it be better to not "place a stumbling block
before the blind?" Let's remove the perverse incentive structures.

We don't need to get into finger-pointing on each and every
adverse outcome to recognize that AT AN AGGREGATE LEVEL:
* Hospitals are large enough that nosocomial infection rates average out,
* Policies, procedures, and supervision affect those rates,
* Pushing the cost of adverse outcomes to the hospital incents
reduction of those rates overall,
* Pushing the cost of adverse outcomes to patients at best removes
an incentive to improve care and at worst incents poor care.

Example: despite Semelweiss being in his grave lo these many years,
the largest single factor in nosocomial infections is *still*
that caregivers don't take simple hand-disinfection precautions
between patients. THAT is correctable -- but not when the
"cost of nonquality" is being externalized. Make the hospital
pay for those infections and I guarantee you it won't be long
before there is a glove dispenser and recepticle at the entrance
to every patient room and an incident report for every time a
caregiver is either (a) wearing gloves outside of rooms or
(b) _not_ wearing them in rooms.

I agree washing hands is an area that can be (and has been) greatly
improved. I do not agree that a hospital simply eat the bill for every
nosocomial infection. Again, they can be reduced but not eliminated.
Things can be clean, not sterile. Infections can even occur in a sterile
operating room environment where everyone involved wears clean scrubs,
washes their hands, gowns and gloves, wears hats and masks.... yet
infections still occur. So in regular patient beds, infections will occur.

In an industrial environment, we don't consider every defective
product a source for personal blame (in some fields, like mine,
it's actually possible to calculate the unavoidable loss of yield
due to the laws of physics.) On the other hand, we don't push the
risk for those defects down to our customers, either. We, in effect,
perform the "insurance" risk-pooling for them by factoring yield
loss into our cost structure.

THAT incents us to reduce the cost of nonquality rather than incenting
us to reduce costs irrespective of quality issues and (first order)
increasing our revenues by shipping junk that has to be replaced.
This is a pretty basic matter of economics: reducing the externalization
of negatives.

So -- once you take the blame aspect out of the matter, what you're
looking at here is the application of a quality improvement process
to the practice of medicine.

It's either that, or postulate the the economics of health care
somehow violates some of the most basic principles of economics
and of statistics (upon which quality control depends.) If that's
your thesis, I anxiously await your detailed analysis.

I don't have a thesis... just practical knowledge and first hand experience.

Note from Health Lover, Ilena Rosenthal:http://ilenarose.blogspot.com
A seemingly good idea with some very serious downsides!

Patients could be left ill or injured and not cared for ...

Caution!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Medicare will not pay if hospital errs

    February 19, 2008

WASHINGTON - It's a new way to push for patient safety: Don't pay
hospitals for their errors.

Beginning Oct. 1, Medicare no longer will cover extra-care costs for
eight preventable hospital errors. Nor can hospitals bill the injured
patient for those extra costs.

"Money talks," says Dr. Steven Gordon, infectious disease chief at the
Cleveland Clinic Foundation. "Every hospital CFO, this gets their
attention."

- - -

Medicare's targets

*Urinary tract infections from catheters

*Bloodstream infections from using catheters

*Falls

*Bed sores, or pressure ulcers

*Objects left in a patient during surgery

*Blood incompatibility, giving a dangerously wrong blood type

*An infection after heart surgery called mediastinitis

*Air embolism, an air bubble in a blood vessel

----------

Page compiled from Tribune reporter Jon Hilkevitch and Tribune news
services