January 12, 2015

New rules adopted by the Obama administration will discourage nonprofit hospitals from over charging and using aggressive tactics to collect payments from low income patients

Nonprofit hospitals despicable practices of overcharging patients with no insurance and then using aggressive tactics to collect payments are being discouraged by new rules recently adopted by the Obama Administration. Under the new rules, patients with no insurance who are eligible for financial assistance can not be charged more than "the amounts generally billed" to people who have insurance through a government program or a private carrier. Additionally, hospitals must try to determine whether a patient is eligible for assistance before they start to use aggressive tactics to collect payment.

Read more in the New York Times

December 2, 2014

The ECRI Institute just released its 2015 top 10 medical technology hazards faced by hospital patients

Health%20tech.jpgDevice-related hazards can lead to medical malpractice. In its 2015 top 10 Health Technology hazards, ECRI Institute lists 10 safety topics deemed crucial for hospitals to address. Here is the list of the top 10 technology hazards;

1. Alarm hazard: inadequate alarm configuration policies and practice
2. Data integrity: incorrect or missing data in EHR's and other Health IT Systems
3. Mix-Up of IV lines leading to misadministration of drugs and and solutions
4. Inadequate reprocessing of endoscopes and surgical instruments
5. Ventilator disconnections not caught because of mis-set or missed alarms
6. Patient-handling device use errors and device failures
7. "Dose Creep": unnoticed variations in diagnostic radiation exposures
8. Robotic surgery: complications due to insufficient training
9. Cyber security: insufficient protections for medical devices and systems
10. Overwhelmed recall and safety-alert management program

In future blogs we will look at each of these medical technology hazards in detail.

The complete report can also be downloaded here

October 9, 2014

Are New York Hospitals ready for Ebola?

After a first US patient died from Ebola yesterday in a hospital that handled the case in a very negligent manner (see article in Reuters), New York hospitals and airports are gearing up for the worst. Starting this Saturday all passengers arriving from the West African countries of Guinea, Liberia and Sierra Leone will have their temperature taken. Passengers suspected to have contracted the virus will be sent to Bellevue Hospital Center in Manhattan. Bellevue can treat up to 4 patients in dedicated isolation rooms and 9 additional rooms may be similarly equipped if necessary. The staff has received training related to leave-no-skin-cell uncovered precautions and all necessary protective gear is available.

Read more in the New York Times

October 2, 2014

New York State Senator Adriano Espaillat says ER conditions at NY-Presbyterian/Columbia are like a "third-world country level of healthcare

espailat.jpgAfter visiting a friend at the Emergency Room of the New York Presbyterian/Columbia Medical Center Hospital in Washington Heights in Manhattan, Senator Adriano Espaillat University said he was outraged by the horrendous conditions patients and staff had to deal with. People are lying on stretchers in the hallways, there is no privacy, the staff is overwhelmed, patients are waiting 85 minutes to see a doctor on average and 717 minutes to get a room.

Senator Espaillat is planning to meet with hospital management this week to discuss the problems.

Read more in the New York Daily News

September 23, 2014

The average 125 minute emergency room wait at Brooklyn's Interfaith Hospital puts patients at risk of death from life-threatening illnesses such as stroke or heart attacks

A diagnosis delayed by a too long wait time in an emergency room can be medical malpractice and can be deadly. In Bedford-Stuyvesant, patients checking in at the ER of the Brooklyn Interfaith Hospital wait an average of 125 minutes before they can be seen by a doctor. The hospital recently added more staff but it has financial struggles. Most of its ER patients are uninsured.

The Brooklyn Hospital has the worst ER waiting time in New York State and 4 times the national average according to an article in the New York Daily News.

September 22, 2014

Unexpected out of network charges on hospital bills are driving up medical costs

Hospital%20Patient.jpgRecently more and more hospital patients have been receiving bills with hefty charges from unexpected out of network doctors or other medical service providers such as labs or Radiologists. Services that used to be included in the daily hospital rate now comes as additional costs because they are provided by out of network contractors. Many emergency rooms, for example, are now staffed by out-of-network doctors who bill separately.

Out-of-network doctor charges are not negotiable and can reach phenomenal amounts. For example a patient requiring a skin graft would pay $1,781 to an in-network doctor while an out-of-network doctor would potentially charge $150,500. In a recent article in the New York Times, Elisabeth Rosenthal exposes this practice.

September 16, 2014

Patients in small military hospitals are at high risk of medical malpractice because the small number of patients compromises doctors and nurses' skills in diagnosing and treating severe illnesses and performing surgery

US%20ARMY%20MEDICAL.jpgSharon LaFraniere and Andrew W. Lerhen from the New York Times continue to investigate Medical Malpractice in military hospitals. The two reporters who last June provided an in-depth analysis of the flaws of the military hospital system (see "In Military Care, a Pattern of Errors but Not Scrutiny" ) recently published a new article focusing on the high risk of medical malpractice in small military hospitals. Military hospitals with a turnover of 10 to 30 patients a day are often staffed with inexperienced doctors and nurses who are not busy enough to keep their skills sharp. Most of them are poorly managed and run by untrained and inexperienced physicians with a culture of complacency that threatens patients safety.
Most of these small military hospitals are being considered for closing or transforming into outpatient facilities by the Pentagon as part of its plan to scale back costs but political obstacles are preventing streamlining the system.

Read the complete article here

August 21, 2014

How can hospital and health care providers mitigate the increased risk of medical malpractice related to tubing misconnections during the transition to new ISO connecting standards?

tubing%20misconnections.jpgTubing misconnection error is medical malpractice mostly caused by nursing or hospital negligence that can result in severe personal injury or death of the patient. Misconnections errors have a high risk to happen not only because most patients checking into a hospital are likely to receive at least an IV but also because tubes with different functions can too easily be connected together. Gardiner Harris from the New York Times raised the alarm on this problem in 2010 in the article "U.S. Inaction Lets Look-Alike Tubes Kill Patients".

To address this issue and prevent these types of medical errors, tubing connector standards have recently been developed through a collaboration of the International Organization for Standardization (ISO), the Association for the Advancement of Medical Instrumentation (AAMI), clinicians, manufacturers and regulators, including the U.S. Food and Drug Administration (FDA).

New connectors are going to start to reach the market during the fourth quarter of 2014 and the transition phase is expected to continue through 2015.

To help health care organization prepare for changes in connectors and reduce the risk of tubing misconnections during the transition phase the Joint Commission recently released guidelines on how to manage risks during the transition to new ISO tubing connector standards.
The complete guidelines can be dowloaded here
Click on the infographic to view as pdf.

August 12, 2014

After more than 40 employees suffered from head, face and groin injuries, OSHA investigated and fined Brooklyn's Brookdale Hospital $78K for failing to protect the staff from violent patients and failing equipment

Brooksdale%20Hospital.jpgIn 2012 there were more than 100 open lawsuits against the hospital including a dozen alleging patients died due to medical malpractice or negligence. The hospital has financial problems and struggles to stay open. The latest report from the federal Labor Department indicates that some employees have been the victims of extremely violent attacks by patients. A 70 year old nurse required brain surgery after a patient repeatedly stomped on her head while beating her and a staffer was punched in the back by a patient. OSHA fined the hospital $78K and recommended the installation of panick buttons and alarm systems at workstations as well as video systems.
Read the complete OSHA News Relase
Read the article in the NY Daily News

June 18, 2014

To reduce intravenous medication errors and potential contamination a New York Hospital turns to advance robotic technology

RIVA%20system.jpgTo reduce IV medication errors and possible contamination, the Belmont's St. Barnabas Hospital in the Bronx, NYC, just acquired a high-tech medication machine that uses robots to fill syringes, sanitize intravenous medications and make sure that patients receive the proper medication.

When an error occurs with intravenous medication, harmful effects to the patient may happen faster and be more severe than errors with oral medications, due the direct administration into the bloodstream.

The RIVA system acquired by the hospital is a fully automated IV compounding system used by hospital pharmacies to prepare intravenous medication (syringes and IV bags) for general hospital needs, chemotherapy and pediatric needs.

Read more in the New York Daily News
Picture: courtesy of Intelligent Hospital Systems