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Science Forum Index » Medicine - Nursing Forum » Medicare will not pay if hospital errs ...
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 Posted: Fri Feb 29, 2008 7:00 pm |
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if you use a fine tooth comb, you can pick more nits, but to do well
at nitpicking, you must be willing to spend a lot of time getting
nothing done.
...Guiding premise from the unwritten laws of THE Antisheep
For nearly 20 years I have worked as a staff nurse (RN), and a
consistent factor has always been there: too few nurses with too many
patients. There are three studies cited below that show that
understaffing has a negative effect on pt. outcomes (I could cite more
examples). Far too many hospitals cotinue to understaff /short staff
their units and with the advent of DRG's push for faster discharges
and sicker people being admitted to general floors; we are seeing
longer stays, which do generate higher revenues. We are seeing more
frequent readmissions for the same problem with different names, again
generating higher revenues.
A UTI from a catheter is a high probability outcome, but if you stop
combing out the nits for a moment to follow this line, you find that
elderly patients (hospitals have a lot of them as patients) with UTI's
tend to become very confused and disoriented (a significant indication
of a UTI) , quite a number of them fall, a number of those falls lead
to hip fractures and breaks that need repair (more revenue).
From my viewpoint this seems to me to be rewarding poorer quality of
care. I do not see hospitals as creating policies with this as a goal;
I see paying for bad outcomes as creating a negative incentive to
address the problem.
We should also keep in mind that Medicare is spending our/taxpayers
healthcare dollars, CMS has a fiduciary responsibility to try to be as
frugal as possible. This is a step in the right direction, not a cure.
In my present role I speak with many Medicare recipients nearly daily,
a near universal frustration is the necessary cutbacks made to cover
as many people as possible, and the futher out you spread the money,
the thinner it gets.
Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job
Dissatisfaction
Linda H. Aiken, PhD,RN; Sean P. Clarke, PhD,RN; Douglas M. Sloane,
PhD; Julie Sochalski, PhD,RN; Jeffrey H. Silber, MD,PhD
JAMA. 2002;288:1987-1993.
Medication errors involving patient-controlled analgesia
Hicks et al.
Am J Health Syst Pharm 2008;65:429-440.
Impact Of The Nurse Shortage On Hospital Patient Care: Comparative
Perspectives
Buerhaus et al.
Health Aff (Millwood) 2007;26:853-862. |
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