Fragmented Health Care

In the United States alone there are 98,000 deaths per year caused by low quality health care (Ignatavicius & Workman, 2013, pg. 2). This statistic is disturbing because the errors that resulted in death were errors that were preventable. The intent of this chapter is to bring awareness to health care providers that are able to make a change in the quality of health care. In current practice patients are subjected to medication errors, preventable hospitalizations, premature death, and poor care provided due to racial, ethical, or low-income factors.

One of the most critical factors which contribute to the number of preventable cases of healthcare harm is the culture of silence surrounding these cases. The fear of medical providers to report incidences is related to the possibility of punishment and liability due to a medical error (Discovery, 2010). The criminalization of some acts of medical error has resulted in job dismissal, criminal charges and jail time for some healthcare workers. This is despite the fact that the system they are working in helped to create the situation which led to the error in the first place. Human error, due to fatigue and system errors can result in deadly consequences, but by criminalizing the error it effectively shuts down the ability to correct the root problem. Healthcare workers, working at all levels within the medical system, can provide valuable input on how to improve the processes and prevent harm from occurring (Discovery, 2010).

By 2001 it was brutally apparent that the U.S. Health Care system was in dire need of a reform in regards to quality and patient safety. Following two separate reports issued by The Institute of Medicine (IOM), To Err is Human (1999) and Crossing the Quality Chasm: A New Health Care System for the 21st Century(2001) the U.S. Congress requested the IOM review quality processes across multiple government funded health care programs. And understandably, “these reports described America’s healthcare system as a tangled, highly fragmented web that often wastes resources by duplicating efforts, leaving unaccountable gaps in coverage, and failing to build on the strengths of all health professionals” (Brown J., p. I – 15, 2013). Thus, the Committee on the Quality of Health Care in America released 6 aims to address key dimensions that require improvement in our health care system. These aims propose that our system needs to strive to be more Safe, Effective, Patient-Centered, Timely, Efficient, and Equitable (STEEEP). All of which were created to help overhaul our current health care system and, more importantly, narrow the quality chasm.

As a nurse it has happened to be an essential need to be conscious of the legal aspects associated with caring and serving people in the health industry today. Unfortunately, only fewer people want to get into the health care field fearing the legal aspects and the predictable law suits. The Tort Law is one of the legal aspects of the law that most nurses is more familiar with. This is the law that involved misconduct and negligence cases, which many nurses take the time to study in depth. This is one of the most universal and well-known laws, something that nurses and doctors must be familiar with, to maintain their care resourcefully.

The main objective of healthcare professionals is to provide the best quality of patient care and the highest level of patient safety. To achieve that objective, there are many organizations that help improve the quality of care. One of the best examples is the Joint Commission. Unfortunately, the healthcare system is not free from total risks. In healthcare activities, there are possible errors, mistakes, near miss and adverse events. All of those negative events are preventable. But, it is clear that errors caused in healthcare result in thousands of deaths in the United States.

It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).

This documentary video is very informative and very useful as eye-opener to all that works in the healthcare industry. John Hopkins patient safety expert have calculated that more than 250,000 deaths per year are due to medical error in the U.S. This large number, victims of medical error, leads to a stigma that people became questioning and doubting the capabilities of healthcare providers resulting on losing trust. This video “Chasing Zero” is a reminder that all nurses, doctors and all the people that works in healthcare industries should be very cautious on the care they provide to patients. A single error can hurt and worst, it can kill someone. This video made me realize as a nurse, that anyone can make a big mistake regardless of years

Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency

November, 1999 brought about a release of a report prepared by the prestigious National Academy of Science’s Institute of Medicine (IOM) making medical mistakes and their magnitude of the risks to patients receiving hospital care to common public knowledge. The IOM concluded that between 44,000-98,000 deaths occur annually because of medical errors. Among a general agreement was that system deficiencies were the most important factor in the problem and not incompetent or negligent physicians and other caregivers (Sultz & Young, 2010). An excellent example of a system deficiency that leads to a crisis and sentinel event was the highly publicized overdose of Heparin to Dennis Quaid’s newborn twins in 2007.

The current paper examines the Disproportionate Share Hospital Payment Reduction CMS 2367F rule which was effective on November 18, 2013. The Disproportionate Share Hospital Payment Reduction CMS 2367F is Federal Legislation that was implemented due to the Affordable Care Act. The rule was initially proposed by the Centers for Medicare & Medicaid Services (CMS), HHS on May 13, 2013. The proposed rule was to implement the provision of the Affordable Care Act that reduces Medicaid Disproportionate Share Hospital (DSH) allotments.

When it comes to health care in the United States, the initial thought many people have are the many growing controversies concerning Obamacare, vaccinations, and making sure all Americans have access to affordable and quality health care. However, what many people fail to realize is a certain aspect in the medical community that, since the early 80’s with the infamous study by Berkman and Frankel, is increasing at such a tremendous rate that the Columbia Medical Review has referred to it as an “epidemic in the medical community.” The statistics regarding the number of individuals who die each year due to medical errors is rising; slowly becoming a major concern in the field. Doctors are busy individuals and at the end of the day still

Each year medical errors cause more than 400,000 American deaths and at least 10-20 times that number experience serious harm. Researchers say that is equivalent to “three 747 airplanes crashing each day.” Medical errors rank as the third-leading cause of death in America. Therefore, patient safety is a national concern.

Tort reform has intense arguments to both sides and creates a myriad of concerns. On one side of the tort reform movement, defendants such as corporations and medical professionals want limits on the damages awarded to the plaintiff. The benefit of tort reform for defendant is the financial savings. However, a cap placed on medical malpractice cases and other cases that are of negligence would standardize the monetary compensation regardless of the damage. In my opinion, Medical malpractice tort reform is a gray area, for each breach of the standard of care involves a different story and person, therefore the damages vary and should be evaluated fairly. In this essay, both sides of the argument are discussed, with a focus on medical malpractice tort reform.

This article was selected as it explained and discussed the probable standardized procedure that health care organizations may have to follow for improvements in patient safety. This article explains how the inter-personal and professional relationship of different health care providers need to be maintained for better health care as explained in one of the chapters of health care management.

Medicare is administrated by the Centers for Medicare and Medicaid Services (CMS). It is divided by subdivisions which is the Center for Medicare Management who overseas development of payment policy and management of fee-for-service contractors. The Center for Beneficiary provides beneficences with information on Medicare programs, and research grievance and appeal functions. The Center for Medicaid and State Operations focuses on federal and state programs like Children’s Health Insurance Program and the Clinical Laboratory Improvement and CMS who enforces insurance portability and transaction and code set requirements of HIPAA.