Presented by Copyright 2013, all rights reserved
|
|
- Austen McDonald
- 5 years ago
- Views:
Transcription
1 Presented by Copyright 2013, all rights reserved
2 1
3 2
4 3
5 4
6 5
7 6
8 As senior manager of your long term care facility, have you faced any of these situations? Can you imagine how you or your staff would react? How can high risk incidents devastate your long term care facility? The high risk incidents described here involve situations of elopement, falls, pressure ulcers, and medication errors. This risk management program will explain how these incidents can lead to devastating results for the long term care setting. These four types of high risk incidents will be discussed in greater detail throughout this educational presentation. 7
9 Did you take a few minutes to think about how you really would have reacted to the incidents on the previous slide? Is your first response panic? Wondering what to do? Your reaction to these incidents can put your residents and the future of your facility at risk due to litigation. Do you know what the standards of care are for high-risk occurrences? Have you held mock emergency practice sessions for your employees? How well do you supervise your staff to ensure that your residents receive quality care? If your staff reacts to those scenarios without knowing what to do, the results can lead to injury or death of the resident. In addition, the facility and you as an individual can be charged with a criminal act and suffer fines or imprisonment! The long-term care facility can also receive sanctions, making it financially harder to continue to provide care for residents. Weinberg and Levine describe specific interventions to help reduce liability risk in long-term care settings. These key points include: 1) family education; 2) good communication skills; 3) good risk management strategies; and 4) monitoring the care being delivered to residents. As a senior manager, you should be monitoring these interventions. 8
10 In the past 20 years, nursing homes have seen a large increase in the amount of malpractice litigation! This calls for a need to improve education to decrease the risk of lawsuits. As per Weinberg and Levine, the increase in nursing home litigation has led to higher medical malpractice insurance premiums for physicians practicing in these facilities. As a result, some physicians refuse to see residents in nursing homes due to increasing costs of coverage. Some long-term care Medical Directors are unable to get any medical malpractice coverage for their administrative duties. This makes them vulnerable to litigation. What can your facility do to help manage risk? You can start by instituting prevention strategies and education by working closely with the facility s legal team to develop an overall risk management plan. In addition, you may want to name one employee as risk manager for the facility. 9
11 Throughout this educational program, you will learn about the high-risk occurrences of wandering/elopement, falls, pressure ulcers, and medication errors. As a senior manager, you must keep in mind that whenever a resident is at risk for elopement, the resident is also at risk for falls! This occurs because the resident may use back exits and staircases to escape from the facility. By the end of the program, you will understand why these incidents have high morbidity and mortality rates for residents of nursing home facilities. You will also understand how your employees can greatly impact the rates at which these mishaps occur and the severity of the outcomes that can result. 10
12 Why is elopement a high-risk occurrence? Residents who elope can get lost, become injured, or die! Since the resident who eloped was in the care of the long-term care facility, the responsibility for the resident lies upon the facility and its staff members. Litigation can lead to insurance companies paying large settlement claims, which makes it hard for the facility to obtain future insurance coverage at reasonable rates. Patients with psychiatric conditions, including wandering, have a need for constant observation. To help allay this cost, Rausch and Bjorklund recommend using Bachelor s prepared psychiatric liaison nurses to provide constant observation for residents. These psychiatric liaison nurses can provide the resident with the appropriate observation needed to keep them safe. This permits the skilled nurses and nursing assistants to provide higher quality care since they will have more time to care for other residents. 11
13 The greatest risk for elopement by a nursing home resident is within the first 72 hours after admission! All staff should be aware of the nursing home s policies on, and prevention strategies to reduce, wandering and elopement. Senior management personnel need to engage the staff in regular practice and policy reviews on emergency procedures when a resident elopes. Resident risk factors for elopement include: 1) history of attempts for elopement (has the resident previously tried to escape from this facility or a different facility before?); 2) desire to escape (does the resident talk to staff or residents about wanting to escape the facility?); and 3) loitering around a locked door (is the resident hanging around a locked door that leads out of the facility, awaiting a chance to escape when someone walks through it?). It is important that nursing staff develop a care plan for residents who are identified as being at high risk for elopement. Rausch and Bjorklund s psychiatric liaison nurse pilot project, performed in 2008, resulted in a decrease in elopements and their consequences, thereby decreasing the facility s costs. The out-of-pocket costs for a facility using constant observation is lower than the costs of penalties, sanctions, and/or claim settlements that may occur when a resident is injured or dies after wandering or elopement. As a senior manager, you should balance the cost of appropriate care for high-risk residents with the cost of the liability of insufficient surveillance for these residents. 12
14 In the December 2010 issue of Healthcare Risk Management s Legal Review and Commentary, the authors described an elopement case that occurred in a hospital setting. An 88-year-old woman was hospitalized after wandering to her son s house, apparently confused. She was fitted with a vest-restraint type of system to keep her from wandering in the hospital. A plan of care was developed to address her wandering and confusion issues. Her confusion appeared to be intermittent and she continually complained about her lack of tolerance of the restraints. Three days after being admitted, there were orders to discontinue the restraints. However, the plan of care for the woman had not changed. A physical therapist noted in the medical chart the next day that the woman had a tendency to wander but didn t tolerate the restraints. An occupational therapist went to see her for a therapy session. Later, her son visited with her. The son told the nurses that his mother was able to recognize him and have a conversation. After he left her room that day, no one saw the woman for the next 14 to 16 hours. It was then she was found on the roof of the hospital. She had died from hypothermia. The hospital denied any wrongdoing. A lawsuit ensued, and the family received a settlement of $900,
15 According to CDC data from 2010, one in three adults over age 65 falls each year. In 20% to 30% of these falls, a moderate to severe injury occurs. More than 660,000 elderly patients who were evaluated in Emergency Departments had to be hospitalized due to nonfatal fall injuries in Costs of fall injuries appear to be growing each year. In 2000, the cost of elderly adult falls was $19 billion. The costs rose to $30 billion in By 2020, it is predicted that falls for elderly adults will rise to $55 billion. 14
16 For residents who are identified as a moderate fall risk, an appropriate plan of care and interventions should be documented. Johnson and colleagues identified interventions to help prevent falls for residents in this category. This includes: use of a yellow flagging system, alert bands, wall charts, and signs. By decreasing the incidence of falls, the facility saves money. 15
17 Falls cause injury, death, and lawsuits against your facility. This is why it is necessary for your facility to find a prevention program that can be implemented to reduce this risk. One way your staff can remember how to prevent falls is the mnemonic FALLS, utilized by the state of Maryland s fall prevention program. 16
18 Fall prevention programs have been developed and initiated in Maryland and Minnesota. In 2009, Maryland began their Keeping Residents Safe from Falls initiative. This was developed as a patient care bundle. In Minnesota, the Minnesota Hospital Association began a statewide campaign for prevention of falls, which included participation by 100 hospitals. 17
19 The Final Recommendations on Financial Support for the Maryland Patient Safety Center report explains that by utilizing this preventative strategy, Maryland health care facilities were able to reduce the number of falls in acute care and long-term care facilities by preventing both frequency and severity of falls. This allowed a cost containment of $1.3 million for acute care hospitals and $2.4 million for long-term care facilities in It was found that the fall prevention program eliminated 623 falls in long-term care facilities. This report speculates that the use of the fall prevention program saved long-term care facilities more than $10 million per year. For more specific information about the financial aspects of Maryland s fall prevention plan, the Website References Section at end of this educational program provides a link for the report. You will also find a link to The Joint Commission Center for Transforming Health Care Preventing Falls with Injury. The Minnesota Hospital Association initiated a statewide campaign to decrease falls. More than 100 hospitals participated in this prevention program. It recommended that residents be made aware of their risk for falls and given information on their individual plan of care to help prevent them from falling. By using this type of communication with the residents of your facility, it can help promote greater program participation. 18
20 Take a minute and think about this question: If you walked into your long-term care work environment right now, what percentage of the residents presently have a pressure ulcer? Are you surprised to learn that approximately 43% of nursing home residents have pressure ulcers? Pressure ulcer incidence has increased over the years and is now at epidemic proportions in bed-bound residents. This results in high care costs. In fact, it is estimated that $11 billion are spent each year on treatment and resulting morbidity from pressure ulcers. Brem and colleagues conducted a research study to investigate the cost of pressure ulcers. They found that $129,248 were spent on hospital-acquired stage IV pressure ulcers during one hospital stay. The treatment cost for community-acquired stage IV pressure ulcers was found to be $124,
21 The Center for Medicaid and Medicare Services has decided that any stage III and IV pressure ulcers that develop in a hospital will be considered a never event. Therefore, CMS will not reimburse facilities for treatment or morbidity related to hospital-acquired pressure ulcers. Using cost-effective pressure ulcer treatments is necessary. Prevention of pressure ulcers is the key to improving the financial success of the long-term care facility. 20
22 Accreditation and licensing sanctions can occur when residents develop pressure ulcers in nursing homes. As a result, lawsuits and criminal proceedings can occur from residents developing pressure ulcers while being cared for in their facility. It is important that staff caring for residents follow standards of care and document this care on a daily basis. Staff should be educated on facility and national guidelines for pressure ulcer prevention and treatment. 21
23 The Omnibus Budget Reconciliation Act (OBRA) of 1987 set standards for Medicarecertified skilled nursing facilities that linked assessments directly to plans of care that are individualized for each patient. In order to utilize this law, the Department of Health and Human Services developed the Resident Assessment Instrument (RAI) which includes three components: the Minimum Data Set (MDS); Resident Assessment Protocols; and Care Plan. The MDS is used to collect data on residents for determining reimbursement. MDS 2.0 was released in Due to many criticisms of MDS 2.0, MDS 3.0 was created and later implemented on October 1, Since this date, there have been numerous updates. Section M of MDS 3.0 specifically addresses coding of skin conditions. At the end of this program, you will find website information to assist you with finding more specific information about MDS
24 Middle managers of long-term care facilities should develop policies and documentation requirements as recommended by Raso and Gulinello. These recommendations include: 1) comprehensive skin assessments for every resident upon admission, 2) periodic reassessments, and 3) thorough skin assessments prior to transferring a resident. Next, pressure ulcer risk assessments should be performed. The nursing home managers should determine a policy for frequency of these assessments. Turning and positioning residents to prevent pressure ulcers should be determined based on each individual s needs. The nurse manager can determine the facility s policy for repositioning based on national guidelines. Monthly prevalence rounds should be performed to share and benchmark overall facility goals for pressure ulcer reduction. Progress toward the goals should be shared with the staff. To help nurses and nursing assistants on an everyday basis, managers may consider appointing unit champions as a staff resource to provide daily coaching. Another option is to incorporate certified wound care nurse specialists into the facility s pressure ulcer care both to help with individual residents and to educate staff. 23
25 A report released by the Institute of Medicine showed that the cost of medicationrelated illness and deaths in long-term care facilities has a cost of $7.6 billion per year. The residents, mostly frail and elderly, are usually taking multiple medications at the time of admission. Many of the indications for these drugs have been resolved, but the health care provider never discontinued the medication. In addition, medication dosages for this population can be different than the usual dosing recommendations. 24
26 Certain medications cause more of a risk to the elderly due to a high risk for adverse reactions, such as delirium. These drugs include meperidine, diphenhydramine, and amitriptyline. By reducing the use of these three medications, it is believed that delirium will decrease. This will help reduce length of hospital stays and costs. 25
27 Why do medication errors keep occurring? This is a very good question that led The Joint Commission to include medication errors as one of its top 10 Sentinel Events. One of the most frequent causes of medication errors includes nurses being interrupted while preparing to administer a medication, which leads to more than 10% in procedural failures and clinical errors. Another frequent cause is clinicians drawing up medications in syringes and not labeling them. This leads to errors because the nurse administering the drugs can get distracted and then forget which medication is in which syringe. 26
28 According to the Joanna Briggs Institute, a study conducted in the United States showed that the most common error occurred due to nurses not having enough information about the medication prior to administration. The second most common error that occurred is not having enough information about the patient prior to medication administration. The lack of knowledge about the medical history of the patient can lead to administering drugs that are not appropriate. Solutions to help with prevention of medication errors include having nurses double-check the orders and then prepare the medication dosage prior to administration to the resident. It is also helpful to identify a dedicated medication administration nurse on each unit to assist in reducing medical errors that occur from distractions. 27
29 Computer prescriber order entry is one method that can help nursing homes in preventing medication errors. However, some problems can arise within this system. In one facility, physicians were ordering medications for the wrong patients because patients within the facility had similar names. This happened several times per month. In addition, physicians did not close one medical record in the computer before ordering medications for another patient. To help eliminate these computer prescriber order entry situations, the facility should limit computer access for each physician to include his or her patients only. This way physicians cannot access a chart for someone who is not under their care. To prevent future medication errors, facilities need to create committees to develop quality improvement and risk management programs. In order for these committees to identify the causes of errors and actively work to find solutions, there needs to be an accepting environment for staff members to report errors. Many facilities currently have cultures that punish nurses for reporting medication errors. It is important to encourage reporting errors so that more data can be collected for committees to analyze. This culture change will lead to greater success in problem-solving. 28
30 Polypharmacy is a large problem for elderly nursing home residents. Many enter with multiple medications, some of which may no longer be needed. Many drug-to-drug interactions can cause morbidity and mortality. Upon admission to a long-term care facility, staff should review of all medications and supplements to ensure that each one is still needed by the resident. If a medication is no longer needed, it should be discontinued from their regimen. 29
31 To help reduce liability of medication errors, here are three solutions that can help your facility. 1) Check timing of IV push or IV bolus medication prior to administration. Nurses need to be vigilant about verifying the length of time to push the IV medication because it can cause severe reactions in the resident if not done properly. The nurse can verify this information with the ordering physician, pharmacist, and/or medication reference material available on the unit. 2) Educate nursing staff about repercussions of falsifying a medical document to cover up a mistake. Falsification of medical records is a criminal act that that can result in fines and imprisonment! 3) Train your facility s staff members and attending physicians regarding policies and procedures for telephone orders. It is imperative that all staff within the facility is aware that only registered nurses can take a telephone order! Medication errors have occurred because a registered nurse was not present when a physician wanted to give a telephone order. Adequate staffing of registered nurses in the long-term care facility is vital, especially in evening and night hours. 30
32 According to Patricia Iyer, the majority of suits involve institutionalized elderly patients of hospitals or nursing homes. Elderly women are more likely to be the recipients of deficient care because women constitute approximately 85% of the nursing home population. In addition, elderly women have higher incidences of morbidity. Liability to nursing homes results from residents having issues with the care delivered to them. Usually the resident s family members file suit against the nursing home. The Omnibus Reconciliation Act is legislation that brought attention to the quality of care, staffing patterns, and accidents that occur in long-term care facilities. As a senior manager in a long-term care facility, it is important that you keep abreast of legislation, regulations, and reimbursement changes that occur. By knowing the laws and requirements for reimbursement, standards of care, and prevention strategies, you will be able to guide your facility to financial stability with fewer liability issues. 31
33 If you implement the information that you have learned in this program, your facility should be able to reduce liability and enhance quality care for your residents. This can be achieved if you practice risk management strategies and educate staff about reduction of liability issues. You can start with strategies such as initiating prevention programs, incorporating national standards of care into facility policies, and scheduling adequate unit staffing. This will help avoid lawsuits, sanctions, fines, and imprisonment! 32
34 The next few slides provide website resources to help you reduce your facility s liability risk. By changing your facility s environment to increase quality care and diminish liability risk, you can help the facility avoid devastation and become a quality leader in the nursing home community. 33
35 This website link will provide you with more detailed financial information regarding the Maryland fall prevention program that was discussed earlier in this educational program. Reviewing the funding specifics can help you to choose the appropriate fall prevention program for your facility. 34
36 These two website links will provide you with pressure ulcer resources for staging and standards of care. 35
37 36
38 37
39 38
40 39
41 40
Presented by. Copyright 2013, all rights reserved
Presented by Copyright 2013, all rights reserved 1 2 3 4 5 6 Here are some situations that could possibly arise in a nursing home setting. How would you react? How can high-risk incidents devastate your
More informationPresented by. Copyright 2013, all rights reserved
Presented by Copyright 2013, all rights reserved 1 2 3 4 5 6 Why is it important for indirect care providers to know about malpractice claims against nursing homes in the United States? It s because your
More informationHealthStream Ambulatory Regulatory Course Descriptions
This course covers three related aspects of medical care. All three are critical for the safety of patients. Avoiding Errors: Communication, Identification, and Verification These three critical issues
More informationPatient Safety Course Descriptions
Adverse Events Antibiotic Resistance This course will teach you how to deal with adverse events at your facility. You will learn: What incidents are, and how to respond to them. What sentinel events are,
More informationWe Get Letters May 2004 Number 11
We Get Letters May 2004 Number 11 Sharing office space Psychiatric medication management EMTALA changes To reach MIEC This newsletter is written in response to numerous questions the Loss Prevention Department
More informationMedication Reconciliation with Pharmacy Technicians
Technician Education Day March 29, 2014 Jacksonville, FL Outline with Pharmacy Technicians Roma Merrick RPhT., CPhT. Pharmacy Technician Coordinator St. Vincent s Medical Center Southside Jacksonville,
More informationETHICAL CONSIDERATIONS THAT ARISE IN LONG TERM CARE PART 2 REPORTING OBLIGATIONS
ETHICAL CONSIDERATIONS THAT PART 2 REPORTING OBLIGATIONS Brian D. Pagano, Esq Burns White LLC bdpagano@burnswhite.com Event: Different Types of Events A discrete, auditable, and clearly defined occurrence.
More informationDelirium management initiative: Guarding the minds of our patients
Delirium management initiative: Guarding the minds of our patients Introduction This past January (2014), in response to requests from a number of our physicians, a new effort began at Baptist Health,
More informationTest An Overview of-risk Management in Long-Term Care: Middle Management
Test An Overview of-risk Management in Long-Term Care: Middle Management General Purpose: To provide middle management personnel with knowledge of common malpractice issues and risk management strategies
More informationUnderstanding the Legal System and Infusion Nurse Liability
Understanding the Legal System and Infusion Nurse Liability Infusion Nurse Society Annual Conference May 18, 2013 Presented by Jan Haedt, RN, BS, CPHRM Sr. Risk Management Consultant University of Wisconsin
More informationPatient Safety: Fall Prevention. Unlicensed Assistive Personnel
Patient Safety: Fall Prevention Unlicensed Assistive Personnel Purpose and Objectives Purpose: Review the UCH Fall Prevention Program Objectives: 1. Present evidence about patient safety and falls. 2.
More informationAPPLICATION for: LONG TERM CARE Claims Made Basis. Underwritten by Underwriters at Lloyd s, London
APPLICATION for: LONG TERM CARE Claims Made Basis. Underwritten by Underwriters at Lloyd s, London THIS APPLICATION MUST BE COMPLETED, SIGNED AND DATED BY THE CEO, CFO, ADMINISTRATOR, DIRECTOR OF NURSING
More informationQAA/QAPI Meeting Agenda Guide
QAA/QAPI Meeting Agenda Guide Date of Meeting The facility is required to have a QAA committee (do not need to use this name) that meets at least quarterly and as needed to coordinate and evaluate activities
More informationSNAPSHOT Nursing Homes: A System in Crisis
SNAPSHOT 2004 A Crisis in Care The number of Californians age 65 and over is projected to double in the next decade. Many of the facilities slated to provide long-term care for these individuals already
More informationMedication Administration & Preventing Errors M E A G A N R A Y, R N A M G S P E C I A L T Y H O S P I T A L
Medication Administration & Preventing Errors M E A G A N R A Y, R N A M G S P E C I A L T Y H O S P I T A L Principles of Medication Administration Talk with the patient and explain what you are doing
More informationPreventing Medical Errors
Presents Preventing Medical Errors Contact Hours: 2 First Published: March 31, 2017 This Course Expires on: March 31, 2019 Course Objectives Upon completion of this course, the nurse will be able to: 1.
More informationSafe Transitions Best Practice Measures for
Safe Transitions Best Practice Measures for Nursing Homes Setting-specific process measures focused on cross-setting communication and patient activation, supporting safe patient care across the continuum
More informationEvidence-Based Falls Prevention
A Study Guide for Nurses Second Edition Carole Eldridge, DNP, RN, CNAA-BC Patient falls remain the largest single category of reported incidents in hospitals, making falls prevention a vital National Patient
More informationFall Liability in Long Term Care Facilities by Roger S. Weinberg, May
Fall Liability in Long Term Care Facilities by Roger S. Weinberg, May 2007 http://www.weinberglaw.com Falls are extremely common among older persons. It is estimated that 30% of non-institutionalized persons
More informationLesson 9: Medication Errors
Lesson 9: Medication Errors Transcript Title Slide (no narration) Welcome Hello. My name is Jill Morrow, Medical Director for the Office of Developmental Programs. I will be your narrator for this webcast.
More informationCaring for Patients with Advanced and Serious Illnesses: Changing Medical Practice and Patient Expectations. Aetna s Compassionate Care SM Program
Caring for Patients with Advanced and Serious Illnesses: Changing Medical Practice and Patient Expectations Aetna s Compassionate Care SM Program Our chief want in life is somebody who shall make us do
More information#104 - Prevention of Medical Errors [1]
Published on Excellence In Learning (https://excellenceinlearning.net) Home > #104 - Prevention of Medical Errors #104 - Prevention of Medical Errors [1] Please login [2] or register [3] to take this course.
More informationCMS RULES FOR PARTICIPATION/LTC REGULATIONS: WHAT YOU NEED TO KNOW
CMS RULES FOR PARTICIPATION/LTC REGULATIONS: WHAT YOU NEED TO KNOW SATURDAY/3:15-4:15PM ACPE UAN: 0107-9999-17-242-L04-P 0.1 CEU/1.0 hr Activity Type: Knowledge-Based Learning Objectives for Pharmacists:
More informationProposed Standards Revisions Related to Pain Assessment and Management
Leadership (LD) Chapter LD.0001 Proposed Standards Revisions Related to Pain Assessment and Management 1 2 Leaders establish priorities for performance improvement. (Refer to the "Performance Improvement"
More informationFundamentals of Medication Therapy Management (MTM) Services By Bruce R. Siecker, Ph.D., R.Ph.
Fundamentals of Medication Therapy Management (MTM) Services By Bruce R. Siecker, Ph.D., R.Ph. Bruce Siecker is president of Paradigm Research & Advisory Services, Inc. based in Stone Ridge, Virginia.
More informationA Review of Current EMTALA and Florida Law
A Review of Current EMTALA and Florida Law South Carolina Hospital Fined $1.28 Million for EMTALA violations Doctor fined $40,000 for not showing up at Emergency Room Chicago Hospital and Docs settle EMTALA
More informationData Stewardship: Essential Skills for Long Term Care Facility Managers
Data Stewardship: Essential Skills for Long Term Care Facility Managers PRESENTED BY LEAH KLUSCH EXECUTIVE DIRECTOR THE ALLIANCE TRAINING CENTER ALLIANCE, OHIO 330-821-7616 leahklusch@sbcglobal.net Data
More informationLong Term Care Application
Long Term Care Application This is an application for a claims-made policy. Instructions: 1. Answer all questions (if not applicable, show N/A), and attach all additional information/explanations as required
More informationThanks to Anne C. Byrne, RN, Medical Monitor at Northwest Georgia Regional Hospital. This presentation was developed from one she designed for that
Thanks to Anne C. Byrne, RN, Medical Monitor at Northwest Georgia Regional Hospital. This presentation was developed from one she designed for that hospital. 1 2 3 Note that an actual variance occurs when
More informationMarch 5, March 6, 2014
William Lamb, President Richard Gelula, Executive Director March 5, 2012 Ph: 202.332.2275 Fax: 866.230.9789 www.theconsumervoice.org March 6, 2014 Marilyn B. Tavenner Administrator Centers for Medicare
More information5/1/2017 THE BEST DEFENSE IS A GOOD OFFENSE OBJECTIVES. Preparing for a Home Health Medicare Recertification Survey
THE BEST DEFENSE IS A GOOD OFFENSE Preparing for a Home Health Medicare Recertification Survey OBJECTIVES To gain an understanding how the Medicare Conditions of Participation (CoPs), the individual G-tags,
More information(1) Provides a brief overview of CMS Medicare payment policy for selected HACs;
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 Center for Medicaid and State Operations SMDL #08-004
More informationJoint Medicaid Oversight Committee Medicaid Behavioral Health Re-Design Panel Testimony
Joint Medicaid Oversight Committee Medicaid Behavioral Health Re-Design Panel Testimony Jennifer Riha, BAS, MAC, Vice President of Operations A Renewed Mind Behavioral Health September 22, 2016 Senator
More informationWe are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.
Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. The Old Vicarage Bullock Lane, Ironville, Nottingham, NG16 5NP
More informationRecommendations for Adoption
North Carolina Hospital Association Recommendations for Adoption ALLERGY FALL RISK 7 Recommendations for Adoption August 2009 Do Not Resuscitate Recommendation: It is recommended that hospitals adopt the
More informationQAPI Making An Improvement
Preparing for the Future QAPI Making An Improvement Charlene Ross, MSN, MBA, RN Objectives Describe how to use lessons learned from implementing the comfortable dying measure to improve your care Use the
More informationRISK MANAGEMENT AND PATIENT SAFETY
RISK MANAGEMENT AND PATIENT SAFETY Risk Management uses processes, methods, and tools to assess what can occur within the healthcare setting and to guide proactive decisions for implementing strategies
More informationCommunication and Teamwork for Patient Safety 1.0 Contact Hour Presented by: CEU Professor
Communication and Teamwork for Patient Safety 1.0 Contact Hour Presented by: CEU Professor 7 www.ceuprofessoronline.com Copyright 8 2008 The Magellan Group, LLC All Rights Reserved. Reproduction and distribution
More informationChapter 02 Hospital Based Care
Chapter 02 Hospital Based Care MULTICHOICE 1. The physician sends the patient to the hospital for a radiological examination. The patient returns to the physician's office for follow-up of test results.
More informationPrepublication Requirements
Issued Prepublication Requirements The Joint Commission has approved the following revisions for prepublication. While revised requirements are published in the semiannual updates to the print manuals
More informationRequired Organizational Practices Resources for 2016
Required Organizational Practices Resources for 2016 ROPs Tests for Compliance Things to Consider Available Resources CLIENT IDENTIFICATION Working in partnership with clients and families, at least two
More informationObjective Competency Competency Measure To Do List
2016 University of Washington School of Pharmacy Institutional IPPE Checklist Institutional IPPE Team Contact Info: Kelsey Brantner e-mail: ippe@uw.edu phone: 206-543-9427; Jennifer Danielson, PharmD e-mail:
More informationTransitions of Care: From Hospital to Home
Transitions of Care: From Hospital to Home Danielle Hansen, DO, MS (Med Ed) Associate Director, LECOM VP Acute Care Services & Quality/Performance Improvement, Millcreek Community Hospital Objectives Discuss
More informationTexas Administrative Code
RULE 19.1501 Pharmacy Services A licensed-only facility must assist the resident in obtaining routine drugs and biologicals and make emergency drugs readily available, or obtain them under an agreement
More informationMedicine Management Policy
INDEX Prescribing Page 2 Dispensing Page 3 Safe Administration Page 4 Problems & Errors Page 5 Self Administration Page 7 Safe Storage Page 8 Controlled Drugs Best Practice Procedure Page 9 Controlled
More informationAdult Family Homes. Susan L. Lakey, PharmD Pharmacy 492 January 24, 2005
Adult Family Homes Susan L. Lakey, PharmD Pharmacy 492 January 24, 2005 Background 1995 HB 1908 Required a reduction in NH medicaid beds by 1600 over 2 years The number of older adults in nursing homes
More informationIs It Time for In-Home Care?
STEP-BY-STEP GUIDE Is It Time for In-Home Care? Helping Your Loved Ones Maintain Their Independence and Quality of Life 2015 CK Franchising, Inc. Welcome to the Comfort Keepers Guide to In-Home Care Introduction
More information7/1/2011 EVERYTHING YOU NEED TO KNOW TO SUCCEED WITH THIS NEW PROCESS ABOUT LEAH I FOCUS ON LEARNING, NOT TEACHING
BIP-PITY BOB-PITY BOO!!!!!! MAKE THE MDS 3.0 WORK FOR YOU IT IS NOT MAGIC!!!!!! Leah Klusch, RN, BSN, FACHCA EVERYTHING YOU NEED TO KNOW TO SUCCEED WITH THIS NEW PROCESS ABOUT LEAH I FOCUS ON LEARNING,
More informationEliminating Avoidable Pressure Ulcers. Professor Gerard Stansby
Eliminating Avoidable Pressure Ulcers Professor Gerard Stansby gerard.stansby@nuth.nhs.uk Why is this important? Important patient safety issue Pressure ulcers can be prevented (?All) Pressure ulcers are
More informationDrug Events. Adverse R EDUCING MEDICATION ERRORS. Survey Adapted from Information Developed by HealthInsight, 2000.
Survey Adapted from Information Developed by HealthInsight, 2000. Adverse Drug Events R EDUCING MEDICATION ERRORS The Adverse Drug Events Survey will assist healthcare organizations evaluate the number
More informationApplicable State Licensing Requirements for Combined Federal and Comprehensive HHA Survey
Applicable State Licensing Requirements for Combined Federal and Comprehensive HHA Survey Statute 144A.44 HOME CARE BILL OF RIGHTS Subdivision 1. Statement of rights. A person who receives home care services
More informationMadison County Board of MR/DD. Areas of Excellence Application. Quality Framework Domain V. Promoting Physical Health and Prevention
Madison County Board of MR/DD Areas of Excellence Application Quality Framework Domain V Promoting Physical Health and Prevention ODMRDD Expected Outcome: People are healthy and safe in their communities.
More informationPatient Safety. If you have any questions, contact: Sheila Henssler Performance Improvement/Patient Safety Coordinator Updated:
Patient Safety If you have any questions, contact: Sheila Henssler Performance Improvement/Patient Safety Coordinator 615-7018 Updated: 2013-05-03 Learning Objectives In this presentation, you will learn:
More informationWe are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.
Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Queen Elizabeth Medical Centre Edgbaston, Birmingham, B15 2TH
More informationAccreditation Program: Long Term Care
ccreditation Program: Long Term are National Patient Safety Goals indicates scoring category ; indicates scoring category ; indicates situational decision rules apply; indicates 2009 The Joint ommission
More informationTrainingABC Patient Rights Made Simple Support Materials
TrainingABC 2017 Patient Rights Made Simple Support Materials Video Transcript The Patient Bill of Rights is a list of rights first developed in 1973 and then revised in 1992, by the American Hospital
More informationAHLA. GG. Physician Orders. Timothy P. Blanchard Blanchard Manning LLP Orcas, WA
AHLA GG. Physician Orders Timothy P. Blanchard Blanchard Manning LLP Orcas, WA Institute on Medicare and Medicaid Payment Issues March 26-28, 2014 Physician Orders Timothy P. Blanchard, MHA, JD Medicare
More informationMEDICATION THERAPY MANAGEMENT. MemberChoice FORMULARY MANAGEMENT MEDICATION THERAPY MANAGEMENT (MTM) SPECIALTY DRUG MANAGEMENT
MemberChoice FORMULARY MANAGEMENT MEDICATION THERAPY MANAGEMENT (MTM) SPECIALTY DRUG MANAGEMENT MEDICATION THERAPY MANAGEMENT Medication Therapy Management 1 $ 290 Billion Wasted in avoidable costs due
More informationNavigating the Hospital Readmission Reduction Program
Navigating the Hospital Readmission Reduction Program Since the Affordable Care Act passed in 200, a hospital s 30-day readmission rate has become synonymous with quality of care. Beginning in 202, the
More informationUnited Methodist Association National Conference Integrating Risk Management and Quality Assurance and Performance Improvement (QAPI)
United Methodist Association National Conference Integrating Risk Management and Quality Assurance and Performance Improvement (QAPI) March 11, 2015 Laura Lally, Caring Communities Victor Lane Rose, ECRI
More informationMedicare Home Health Prospective Payment System
Medicare Home Health Prospective Payment System Payment Rule Brief Final Rule Program Year: CY 2013 Overview On November 8, 2012, the Centers for Medicare and Medicaid Services (CMS) officially released
More informationConsumers Union/Safe Patient Project Page 1 of 7
Improving Hospital and Patient Safety: An overview of recently passed legislation and requirements towards improving the safety of California s hospital patients June 2009 Background Since 2006 several
More informationThe Multidisciplinary aspects of JCI accreditation
The Multidisciplinary aspects of JCI accreditation Saleem Kiblawi MD, FCCP, Physician consultant, Joint Commission International Oakbrook, Illinois USA Lebanese American University April 15, 2016 Beirut,
More informationNational Survey on Consumers Experiences With Patient Safety and Quality Information
Summary and Chartpack The Kaiser Family Foundation/Agency for Healthcare Research and Quality/Harvard School of Public Health National Survey on Consumers Experiences With Patient Safety and Quality Information
More informationStorage, Labeling, Controlled Medications Instructor s Guide CFR (b)(2)(3)(d)(e) F431
Centers for Medicare & Medicaid Services (CMS) Storage, Labeling, Controlled Medications Instructor s Guide CFR 483.60(b)(2)(3)(d)(e) F431 2006 Prepared by: American Institutes for Research 1000 Thomas
More informationFinancial Disclosure. Learning Objectives: Preventing and Responding to Sentinel Events in Surgery 10/13/2015
Preventing and Responding to Sentinel Events in Surgery Beverly Kirchner, BSN, RN, CNOR, CASC April 2014 Financial Disclosure I DO NOT have an actual, potential or perceived conflict of interest to disclose
More informationOctober 2011 Quarterly CMS OCCB Q&As
October 2011 Quarterly CMS OCCB Q&As Category 2; Category 3; M0100 Question 1: A patient is seen monthly. On a monthly visit, which falls within the last five days of the certification period, the assessing
More informationRULES OF THE TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
RULES OF THE TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES CHAPTER 0940-5-41 MINIMUM PROGRAM REQUIREMENTS FOR ALCOHOL AND DRUG HALFWAY HOUSE TREATMENT FACILITIES TABLE OF CONTENTS
More informationINTERACT 4 Patty Abele, FNP BC
INTERACT 4 Patty Abele, FNP BC (No relevant financial relationships to disclose) TODAY WE WILL Identify the risks and disadvantages associated with avoidable hospitalizations Identify the goals of the
More information4/28/2017. Medication Management for Improved Compliance & Home Care Satisfaction PREPARED FOR NEHCC Presenter. Overview
Medication Management for Improved Compliance & Home Care Satisfaction PREPARED FOR NEHCC 2017 Presenter Debra Demar, MS is the Community Liaison for White Cross Pharmacy, serving RI, MA and CT. She has
More informationManagement of Reported Medication Errors Policy
Management of Reported Medication Errors Policy Approved By: Policy & Guideline Committee Date of Original 6 October 2008 Approval: Trust Reference: B45/2008 Version: 4 Supersedes: 3 February 2015 Trust
More informationNational Health Regulatory Authority Kingdom of Bahrain
National Health Regulatory Authority Kingdom of Bahrain THE NHRA GUIDANCE ON SERIOUS ADVERSE EVENT MANAGEMENT AND REPORTING THE PURPOSE OF THIS DOCUMENT IS TO OUTLINE SERIOUS ADVERSE EVENTS THAT SHOULD
More informationManaging medicines in care homes
Managing medicines in care homes http://www.nice.org.uk/guidance/sc/sc1.jsp Published: 14 March 2014 Contents What is this guideline about and who is it for?... 5 Purpose of this guideline... 5 Audience
More information(10+ years since IOM)
Medication Errors We're Looking Down the Tunnel and Seeing Light (10+ years since IOM) Michael R. Cohen, RPh, MS, ScD Institute for Safe Medication Practices mcohen@ismp.org 1 Disclosure Information Michael
More informationMedications: Defining the Role and Responsibility of Physical Therapy Practice
This article is based on a presentation by Matt Janes, PT, DPT, MHS, OCS, CSCS, Division AVP, Therapy Practice and Quality, Kindred at Home, and Diana Kornetti, PT, MA, HCS-D, President, Home Health Section
More information5. returning the medication container to proper secured storage; and
111-8-63-.20 Medications. (1) Self-Administration of Medications. Residents who have the cognitive and functional capacities to engage in the self-administration of medications safely and independently
More informationPharmaceutical Services Instructor s Guide CFR , (a)(b)(1) F425
Centers for Medicare & Medicaid Services (CMS) Pharmaceutical Services Instructor s Guide CFR 483.60, 483.60(a)(b)(1) F425 2006 Prepared by: American Institutes for Research 1000 Thomas Jefferson St, NW
More informationNURSING FACILITY ASSESSMENTS
Department of Health and Human Services OFFICE OF INSPECTOR GENERAL NURSING FACILITY ASSESSMENTS AND CARE PLANS FOR RESIDENTS RECEIVING ATYPICAL ANTIPSYCHOTIC DRUGS Daniel R. Levinson Inspector General
More informationMedication Reconciliation
Medication Reconciliation The Care Transitions Network National Council for Behavioral Health Montefiore Medical Center Northwell Health New York State Office of Mental Health Netsmart Technologies Today
More informationADMINISTRATION OF MEDICATION PROCEDURE
1302.47 Safety practices. ADMINISTRATION OF MEDICATION PROCEDURE b) A program must develop and implement a system of management, including ongoing training, oversight, correction and continuous improvement
More informationDOCUMENTATION BASIC PRINCIPLES FOR LONG TERM CARE
DOCUMENTATION BASIC PRINCIPLES FOR LONG TERM CARE Speakers for this conference have disclosed that they do not have significant relationships or affiliations with any commercial organization that could
More informationThe Purpose and Goals of Risk Management in the Sleep Center. Melinda Trimble, RPSGT, RST, LRCP
The Purpose and Goals of Risk Management in the Sleep Center Melinda Trimble, RPSGT, RST, LRCP Objectives Overview of Risk Management as a concept What is the purpose of Risk Management and what are its
More informationDeborah Perian, RN MHA CPHQ. Reduce Unplanned Hospital Admissions: Focus on Patient Safety
Deborah Perian, RN MHA CPHQ Reduce Unplanned Hospital Admissions: Focus on Patient Safety Objectives At the end of this lesson, the learner will be able to: Identify key clinical and policy issues associated
More informationThe Criminalization of Adverse Events. Joy Schank, MSN Caroline E. Fife, MD,
The Criminalization of Adverse Events Joy Schank, MSN Caroline E. Fife, MD, Patient wanted to die at home and niece agreed to care for her Advanced Alzheimer s Called 911 Cause of death: Sepsis due to
More informationEnhanced Clinical Workflow Adherence Through Real-Time Alerts and Escalations for P4P
Enhanced Clinical Workflow Adherence Through Real-Time Alerts and Escalations for P4P Real-time alerts and escalations in hospitals can lead to forecasting, detecting and correcting adverse developments
More informationHomecare Q&A No-nonsense solutions that clear the Medicare fog
Homecare & No-nonsense solutions that clear the Medicare fog Service of the Beacon Institute Medicare clinician arrives at the home, where skilled services are provided. Based on the assessment/observation
More informationUsing People, Process and Technology to Enhance Outcomes for Patients and Their Caregivers
Using People, Process and Technology to Enhance Outcomes for Patients and Their Caregivers Melissa A. Fitzpatrick, RN, MSN, FAAN VP & Chief Clinical Officer, Hill-Rom Trends Driving Our Industry Aging
More informationMedicaid Prescribed Drug Program. Spending Control Initiatives
Medicaid Prescribed Drug Program Spending Control Initiatives For Quarters Ended September 30, 2010 and December 31, 2010 Table of Contents Purpose of Report... 1 Executive Summary... 2 Pharmacy Appropriations
More informationGeneral Information. Overview. Purpose. Table of Contents
Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.engage Inovalonto conduct outreach efforts for ouraca individual and small group on and off exchange
More informationDEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Discharge Planning
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services ICN 908184 October 2014 This booklet was current at the time it was published or uploaded onto the web. Medicare policy
More informationSerious Reportable Events (SREs) Transparency & Accountability are Critical to Reducing Medical Errors
Serious Reportable Events (SREs) Transparency & Accountability are Critical to Reducing Medical Errors Tens of thousands of lives are forever changed each year as a result of healthcare errors. There is
More informationImproving Hospital Performance Through Clinical Integration
white paper Improving Hospital Performance Through Clinical Integration Rohit Uppal, MD President of Acute Hospital Medicine, TeamHealth In the typical hospital, most clinical service lines operate as
More informationStep-Edit Training Program
Step-Edit Training Program What are step-edit programs? Why are they important? How can you address them? Step-edit programs affect your bottom line Step-edit programs create hassles for pharmacists, nursing
More informationHALF YEAR REPORT ON SENTINEL EVENTS
HALF YEAR REPORT ON SENTINEL EVENTS 1 October 2008-31 March 2009 Jul 2009-0 - TABLE OF CONTENTS Chapter Page 1. Executive Summary...... 2 2. Introduction 5 3. Sentinel Events Reported... 6 From 1 October
More informationDefending the Long Term Care and Nursing Home Elopement Case
Defending the Long Term Care and Nursing Home Elopement Case Frank Alvarez Quintairos, Prieto, Wood & Boyer, P.A. 1700 Pacific Avenue, Suite 4545 Dallas, TX 75201 (214) 754-8755 frank.alvarez@qpwblaw.com
More informationCATEGORY 4 - OASIS DATA SET: FORMS and ITEMS. Category 4A - General OASIS forms questions.
Q1. [Q&A RETIRED 09/09; Outdated] CATEGORY 4 - OASIS DATA SET: FORMS and ITEMS Category 4A - General OASIS forms questions. Q2. When integrating the OASIS data items into an HHA's assessment system, can
More informationGeneral Inpatient Level of Care: Managing Risks
General Inpatient Level of Care: Managing Risks THE CAROLINAS CENTER, 2015 1 Presenter Annette Kiser, MSN, RN, NE-BC Director of Quality & Compliance The Carolinas Center akiser@cchospice.org THE CAROLINAS
More informationMaryland Patient Safety Center s Annual MEDSAFE Conference: Taking Charge of Your Medication Safety Challenges November 3, 2011 The Conference Center
Maryland Patient Safety Center s Annual MEDSAFE Conference: Taking Charge of Your Medication Safety Challenges November 3, 2011 The Conference Center at the Maritime Institute Reducing Hospital Readmissions
More informationEMERGENCY DEPARTMENT DIVERSIONS, WAIT TIMES: UNDERSTANDING THE CAUSES
EMERGENCY DEPARTMENT DIVERSIONS, WAIT TIMES: UNDERSTANDING THE CAUSES Introduction In 2016, the Maryland Hospital Association began to examine a recent upward trend in the number of emergency department
More informationStrengthen Patient Care by Reducing Hospital Acquired Pressure Ulcers (HAPU)
Strengthen Patient Care by Reducing Hospital Acquired Pressure Ulcers (HAPU) Nihar Bhatia Head Quality Assurance & Fortis Operating System and Prateem Tamboli, Facility Director, Fortis Escorts Hospital
More information