The End

The first post on this blog was added on November 12, 2004 – it’s hard to believe I’ve been writing online about various aspects of healthcare for almost ten years.

When I started this site, originally named MSSPNexus, (Medical Staff Service Professionals) the focus of my writing was current news and standards pertaining to hospital medical staff administration.  Later, as my career took a different path, I added risk management and over the past few years patient blood management into the mix.

In 2004 being a healthcare blogger was a heady experience; there weren’t that many of us and we formed a sort of online friendship, especially through Nick Gene’s Medical Grand Rounds.  We were sometimes interviewed, either by one another or by traditional news media.  KevinMD came along in 2005, and his blog remains one of the best and most active medical sites on the web.  Nurse Kim’s Emergiblog was always a fascinating read.  Of note, she recently posted that she is shutting down her blog.  Dr. Mike Sevilla soon found that it is difficult to remain anonymous on the web, and he continues to write under his real name.  There were a host of others, many of whom contributed to the first grand rounds hosted on this site.

sunset_valleyOver the past couple of years Supporting Safer Healthcare has been sadly neglected.  There are many concerns about protected health information and social media, some justified, and some over-the-top paranoid.   We who write weigh every word and image carefully before posting.  There are also security issues, this blog was hacked by spammers a couple of years ago and had to be rebuilt from the ground up.

My current hospital position in bloodless medicine/patient blood management is fascinating and contributes to patient safety and good quality healthcare, although from a different perspective than medical staff administration and risk management.  I have learned more about the clinical aspects of healthcare, and my interactions with patients are often the most rewarding part of the job.  The down side is that the time and focus it requires can be a bit daunting.  I’ve been left with little creative energy for writing.

If I may offer one parting word of advice to everyone, find out of you are anemic and if you are, get treatment.  It’s often as simple as building up your body’s iron stores through changes in nutrition or iron supplements.  In many cases not being anemic (in other words, having a good blood hemoglobin count) is the single biggest protection against needing a blood transfusion during a hospital stay.  Research continues to mount showing that patients who do not need transfusions recover more quickly and with fewer complications.

Progressive hospitals everywhere are developing patient blood management programs that are designed to conserve a patient’s own blood supply and avoid the need for transfusion whenever possible.  In the hospital where I work the program is growing out of the body of knowledge acquired over the past 15 years of being a center of excellence for bloodless medicine patients, i.e., those who decline blood under all circumstances. Historically, that has been primarily Jehovah’s Witnesses, but others are now requesting our services in increasing numbers. If your hospital doesn’t have such a program encourage leadership to contact one that does.  There is also a professional society devoted to PBM, the Society for the Advancement of Blood Management, which offers professional education and resources.

It’s time to close this chapter of my professional career.  For those of you who have been readers of this blog for all or part of the past ten years, thank you. The older posts will remain online for now.  It has been my pleasure to be of some small service in sharing news and insights that affect both the delivery and safety of healthcare.  Many of you are gatekeepers for patient safety – a worthwhile role to be sure.  Keep up your good work. Patients, and at some point isn’t that all of us, need you.

Rita Schwab
MSSPNexus / Supporting Safer Healthcare


 

Living Forever Online May Not Be a Good Thing

Guest Post.  In these days of social media and automatic bill pay, Hillel L. Presser, Esq. offers some worthwhile tips for all of us.

Asset Protection Lawyer Offers 3 Steps to Take Now

Now, you really can live forever, but that’s not necessarily a good thing.

Many of your online accounts – from automatic bill payments to eBay – may remain active after you pass away, unless you take steps to ensure they don’t, says attorney Hillel Presser, author of “Financial Self-Defense (Revised Edition), ”www.assetprotectionattorneys.com.

Automatic bill pay, for example, can theoretically keep tapping your bank account long after you’re gone or, at least, until your money is.

“It’s important to make sure your online bank and shopping accounts, even your social media, can be closed out, or that your loved ones are authorized to access them,” Presser says. “You may ask, ‘Why would I care if I’m gone?’ I can tell you from experience: because it can create real headaches, and more heartache, for your family.”

Bank and shopping accounts will be vulnerable to identity theft, which would affect your estate if someone opens credit cards in your name. You might have valuable intellectual property, like domain names. They may need access to your health records, particularly if you died under questionable circumstances, he says.

There’s the sentimental stuff – photos and emails — that your family may want as a remembrance of you, and the libraries of music and ebooks, which may represent a considerable investment on your part.

“The problem is, even if you provide a family member with all of your accounts, log-ins and passwords, they may not be legally allowed to access them,” Presser says. “In many cases, they may be violating the accounts’ terms of service or violatingfederal privacy and computer fraud laws. Some states have laws governing online materials, but they’re different and which of your accounts are covered depends on where the provider is located.”

What can you do to ensure your family isn’t left with a virtual nightmare after your passing? Presser offers these tips:

• Create a list of all of your accounts, including log-innames, passwords, and answers to any security questions. Obviously, your list will need to be securely stored. Since you’ll need to update it regularly as you add accounts or change passwords,  it will be easiest if you keep the list on your computer in a password-protected folder. Some versions of Windows allow you to create protected folders, but you may need to get third-party software to do this, such as freeAxCrypt. Remember to create a backup of your list, whether it’s on a jump drive or printed out on paper. Store the backup in a secure place such as a safe deposit box. Do not put password information in your will, which is a public document.

• If you have a Google account, set up the new inactive account manager. In May 2013, Google became the first site to give users an option for choosing what becomes of their content if they should become debilitated or die. Under the profile button, click “Account,” scroll down to “Account Management,” and you’ll find instructions for “Control what happens to your account when you stop using Google.” You can select how long the account should be inactive before your plans are set into motion; choose to whom you want to offer content, such as YouTube videos, Gmail, Google+ posts, Blogger and Picasa web albums, or whether it should simply be deleted.

• Appoint a digital executor. Perhaps the simplest way to ensure your online life is taken care of is to appoint a digital executor – a tech-savvy person who will be willing and able to carry out your wishes. Authorize the person to access your inventory of log-in information and spell out what you want done with each account, whether it’s providing access to loved ones or business partners, or deleting it.

The digital world has grown and transformed so rapidly, the law hasn’t kept up, which makes managing your digital afterlife challenging, Presser says.

“Until there are more consistent laws and procedures governing this area, it’s best to plan ahead, leave clear instructions and be sure you have a list of accounts where your estate lawyer or a loved one can find it and access it,” he says. “It will make a world of difference to your survivors.”

About Hillel L. Presser, Esq., MBA

Hillel L. Presser’s firm, The Presser Law Firm, P.A., represents individuals and businesses in establishing comprehensive asset protection plans. He is a graduate of Syracuse University’s School of Management and Nova Southeastern University’s law school, and serves on Nova’s President’s Advisory Council. He is a former adjunct faculty member for law at Lynn University. Complimentary copies of “Financial Self-Defense” are available through www.assetprotectionattorneys.com.

Reporter Finally Gets to Wear Shirt & Tie Louwana Berry Gave Him

Since I worked nearby at the Cleveland Clinic during the time these young girls went missing, this is a story that touches my heart.
safos_berry

19 Action News Reporter Bill Safos has covered Amanda Berry’s disappearance since the beginning. He grew very close with the Berry family, and Amanda’s mother, Louwana. In fact, Bill’s shirt and tie were a gift from Louwana. Before she passed away, she bought the clothes for Bill and made him promise that he wear them on “the day Mandy comes home.”

It was a promise Bill was more than honored to keep today.

Hospital Inspections Site Launched

Healthcare transparency took a step forward this week.  The Association of Health Care Journalists (AHCJ) and the Centers for Medicare and Medicaid Services (CMS) have collaborated to bring HospitalInspections.org  online.

The searchable database contains information about serious federal safety rule violations in U.S. hospitals since January, 2011.  It does not contain hospital responses to deficiencies cited during inspections. Those can be obtained by filing a request with a hospital or the U.S. Centers for Medicare and Medicaid Services (CMS).

Searching is free.

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Example:  Greivance

One example documents a lengthy trail of CMS interviews with hospital personnel related to a patient’s complaint regarding a grievance letter to which she had received no response..

“An interview was conducted with S2 Divisional Director, Regulatory Management on 9/19/12 at 9:05 a.m. She reported the hospital was unable to locate what happened to the grievance letter after it was signed for on the loading dock.  Also the hospital has been unable to locate the letter sent by regular mail by the mother of Patient #7.

Review of the policy titled Patient Rights, Complaint, and Grievance Process, policy reference # OrgClin/020, revealed in part,  ” …All expressed concerns regarding care or treatment are entered into the approved complaint tracking software program …”

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Example:  Environment of Care / Fire Safety

“The inspector observed, while accompanied by the Plant Manager during the hours of the inspection from 8:00 am to 9:45 am on 7/24/2012 that the fire doors going into the generator room had the closers removed and the doors were propped open. The doors must be self-closing. If the facility requires the doors to be open, they must be placed on hold opens that will release with activation of the fire alarm.”

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The site also has a list of states that post their hospital inspections online.

Angry Physicians Impact Care

Kaiser Health Plan reports on a long-festering problem that many hospitals have been reluctant to address: disruptive and often angry behavior by doctors. Experts estimate that 3 to 5 percent of physicians engage in such behavior, berating nurses who call them in the middle of the night about a patient, flinging scalpels at trainees who aren’t moving fast enough, demeaning co-workers they consider incompetent or cutting off patients who ask a lot of questions.

Experts say that doctors’ bad behavior is not merely unpleasant; it also has a corrosive effect on morale and poses a significant threat to patient safety.

To be fair to physicians, bad behavior is not limited to them.  Administrators, nurses, and others can also subject co-workers and subordinates to what could only be termed as work-place bullying.  Physicians, however, impact patient care in ways that others do not.  When those caring for a patient hesitate to call a physician about care concerns for fear of being subjected to a wrathful outburst, hospital and medical staff leadership must act.

Read:  Hospitals Crack Down on Tirades by Angry Doctors

 

CMS Proposes Healthcare Rule Changes

The Centers for Medicare and Medicaid Services (CMS) issued a proposal to reduce redundancy and increase healthcare efficiency in the February 7, 2013 Federal Register. 

The proposed rule opens with this statement:  “This proposed rule would reform Medicare regulations that CMS has identified as unnecessary, obsolete, or excessively burdensome on health care providers and suppliers, as well as certain regulations under the Clinical Laboratory Improvement Amendments of 1988 (CLIA).”

The comment period is open until April 8, 2013.

The National Association Medical Staff Services Blog offers comments regarding proposed changes to medical staff rules.

 

DHHS Levies First Fine for Small Data Breach

MedLaw.com reports on the first payout for a HIPAA violation involving a small data breach:

“The Hospice of North Idaho (HONI) has agreed to pay the U.S. Department of Health and Human Services’ (HHS) $50,000 to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule.  This is the first settlement involving a breach of unprotected electronic protected health information (ePHI) affecting fewer than 500 individuals.”

The breach stemmed from a stolen laptop.

Read the rest:  http://www.medlaw.com/ocr-issues-first-fine-for-small-data-breach/

 

An Apple a Day Keeps the Doctor Away?

It’s great to have a skilled physician and a good hospital available when you need them; it’s even better to enjoy overall good health and need them less often.

The web site Nutrition and You offers some easy-to-digest information on the benefits of various fruits.  For example, did you know…

Apples

Apples are low in calories; 100 g of fresh fruit slices provide only 50 calories. They, however, contain no saturated fats or cholesterol, and are rich in dietary fiber which helps prevent absorption of dietary-LDL or bad cholesterol in the gut.

Grapefruit

Red varieties of grapefruits are especially rich in the most powerful flavonoid antioxidant, lycopene. Studies have shown that lycopene protects skin damage from UV rays, and offers protection against prostate cancer.

Kiwi

Research studies have shown that certain substances in kiwi-fruit functions as blood thinner function similar to aspirin; thus, it helps prevent clot formation inside the blood vessels and protect from stroke and heart-attack risk.

Raspberries

Raspberries contain a good amount of minerals like potassium, manganese, copper, iron and magnesium. Potassium is an important component of cell and body fluids that helps controlling heart rate and blood pressure.

Strawberries

Fresh berries are an excellent source of vitamin-C (100 g provide 58.8 mg or about 98% of RDI), which is also a powerful natural antioxidant. Consumption of fruits rich in vitamin C helps the body develop resistance against infectious agents, counter inflammation and scavenge harmful free radicals.

So snack on some delicious, guilt-free fresh fruit!

Read more:  http://www.nutrition-and-you.com/fruit-nutrition.html

 

Quiet Hospitals – Revisited

I work in a hospital and spend a fair amount of time on patient units, which tend to be astonishingly noisy.  The environment is often loud, even late in the evening or early in the morning when people who aren’t feeling their best would probably like to be sleeping.

Occasional noisey moments are to be expected, but maintaining a calm atmosphere in patient care areas seems to be an afterthought in most hospitals.

So, just as a reminder to us all, I am re-featuring this earlier post:

Shhh – Silent Hospitals Help Healing

When you have overnight guests in your home, chances are you do all you can to make their stay as comfortable as possible. In a sense, patients are guests in our “house,” but often they find their overnight accommodations anything but comfortable and restful. Hospitalized patients often complain “How am I supposed to sleep when…”

Read the rest