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Toolkit offers new ideas for preventing hospital falls

Integrating fall-prevention protocols into scheduled rounds, grouping cognitively impaired patients into so-called safety zones and doing post-fall assessments are some new strategies to reduce the number of falls for hospital patients. The ideas are part of a recently released Agency for Healthcare Research and Quality toolkit aimed at cutting the estimated 700,000 patient falls that happen in hospitals each year. Since 2008, the Centers for Medicare & Medicaid Services has denied hospitals payment for complications due to a fall or trauma in the hospital that results in fractures, burns or other serious injuries. Despite the financial incentive, progress in preventing falls has not been easy, experts say. Setting a goal of zero falls is probably unrealistic, they added, given that hospitalized patients often need treatments that may make them unstable on their feet, and yet they need to be mobile to prevent bed-rest complications such as de-conditioning, pressure ulcers, aspiratio ...

Ways EHRs can lead to unintended safety problems

In spring 2012, a surgeon tried to electronically access a patient’s radiology study in the operating room but the computer would show only a blue screen. The patient’s time under anesthesia was extended while OR staff struggled to get the display to function properly. That is just one example of 171 health information technology-related problems reported during a nine-week period to the ECRI Institute PSO, a patient safety organization in Plymouth Meeting, Pa., that works with health systems and hospital associations in Kentucky, Michigan, Ohio, Tennessee and elsewhere to analyze and prevent adverse events. Eight of the incidents reported involved patient harm, and three may have contributed to patient deaths, said the institute’s 48-page report, first made privately available to the PSO’s members and partners in December 2012. The report, shared with American Medical News in February, highlights how the health IT systems meant to make care safer and more efficient can s ...

State forgoes federal funds to go its own way on Medicaid expansion

Wisconsin’s Republican governor wants to expand Medicaid to some of the poorest adults in the state while placing others on the state’s health insurance exchange, but he’s not going to get enhanced federal matching dollars to do so. The Affordable Care Act gives states the option to expand their Medicaid programs to everyone up to 133% of poverty (an effective rate of 138% when certain income is discounted from consideration) starting in 2014. Although some Republican governors — such as Nevada’s Brian Sandoval and Arizona’s Jan Brewer — decided to take up this provision after initial resistance, GOP holdouts remain, including Wisconsin Gov. Scott Walker. Walker has rejected the idea of fully expanding Medicaid under the ACA. Instead, his upcoming budget proposal outlines a plan for Medicaid to cover non-disabled, non-elderly adults up to 100% of poverty. As part of the proposal, Walker would lift a 2009 enrollment cap on the BadgerCare Plus Core program, which cove ...