Articles Posted in Quality of Care

According the Medline Plus, “A nursing home is a place for people who don’t need to be in a hospital but can’t be cared for at home. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day.” Skilled Nursing Facilities were instituted to administer adequate full time care to ailing seniors. Although expected by most families, adequate care is not always guaranteed. An essential component of a nursing home is the nurses who tend to the elderly residents. Although medical professions are a necessity, majority of the time registered nurses are not at the facilities 24/7. The Los Angeles Times states, “The 1987 law intended to reform the country’s nursing homes required a registered nurse on site only eight hours a day, regardless of the size of the facilities.” The implementation of this law was monumental at the time, but as America sees an influx in the geriatric community, the law needs to be revisited. Continue Reading

Medical Errors account for approximately 1,000 deaths daily.  These preventable errors are the third leading cause of death in 2013. Medical Errors are avertable actions that can include errors in medication administration and botched surgeries. With simple changes in attention and focus, coupled with assistance from the government health agencies, these unnecessary deaths have the potential to be eradicated completely.  On Thursday July 17th, multiple medical-quality experts confronted senate committee members and insisted that “government action is needed to lower the rate of hospital medical errors and infections.” With aid from the government, hospital related deaths can be better monitored and reprimanded. Continue Reading

As reported in the Los Angeles Times , a study shows that in 1999, more than 98,000 wrongful deaths occurred due to medical error, and the number has since fluctuated significantly. The majority of medical errors are caused by the negligence of healthcare professionals when distributing medications. Certain combinations of antibiotics can lead to medical complications and even fatalities.   Consequently, this negligence can generate potential medical malpractice lawsuits. Although medical mistakes are likely, healthcare professionals are not properly trained on discussing these medical errors with patients. Despite the staggering statistic that medical error is the fifth leading cause of death in the United States, little has been accomplished to better educate healthcare professionals on disclosing viable information to their patients.

Medical Error is defined as “a significant deviation from accepted standards of care.” Accepted standards of care comprise a fundamental right to which a patient is entitled. Further, should a health care professional cause that right to be forfeited, a patient is entitled to be notified and fully informed of the error made. The Los Angeles Times explains, “…research suggests, that most patients would like to know—and know early—if an error has occurred.”

Although a majority of fourth year medical students admit to being associated with a medical error, only a small percentage have received training when dealing with disclosure to their patients.   Although disclosure is appropriate, it is not always warranted. For example, a woman enters an emergency room with complaints of vomiting, high fever, aches on her left side, and burning pain when urinating.   These are “textbook symptoms” of a Urinary Tract Infection that has spread to the kidneys. The woman is transported to a hospital bed and is given a second dosage of common interventions: Intravenous fluids—an IV is inserted to infuse a large amount of liquid directly into the vein; and Tobramycin— a strong antibiotic with vigorous side effects. Due to the lack of communication amongst the hospital staff, the woman was given two dosages of an antibiotic that can increase the risk of harm to her kidneys. Though no kidney damage occurred, the woman expressed her dismay of being informed about the medical error as it increased her stress level in an already exceptionally aggravating situation; especially, when there was no severe outcome.

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Recent revisions to Medicare’s policy on physical therapy and other services are leading to more coverage for those requiring skilled care from outpatient therapy, home health, and skilled nursing facilities. Prior to this revision, many individuals were unable to obtain insurance coverage for treatments, including physical therapy and occupational therapy, if it was found that the beneficiary’s condition was not improving. However, the settlement of the lawsuit, Jimmo v. Seblius, prompted this revision.

This lawsuit was filed against the secretary of the Health and Human Services Department, which oversees Medicare. It was alleged that patients were inappropriately denied coverage for skilled care due to the “improvement standard“. This “improvement standard” was a rule-of-thumb under which a claim for treatment would be denied, due to the beneficiary’s lack of improvement in restoration potential, even though the beneficiary required the treatment in order to prevent or slow the deterioration of their condition. This standard proved problematic for many patients, particularly those with chronic or degenerative diseases, as their treatments and services would be denied because their condition would plateau, or fail to improve.

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