Essay on Patient Falls and Medication Errors

The Improving Medicare Post-Acute Care Transformation Act (IMPACT) standardizes data collection and data sharing among post-acute providers. The IMPACT Act is part of the Centers for Medicare and Medicaid services (CMS) effort on basing reimbursement on quality as it moves from voluntary reporting of quality measures to mandatory reporting, basing reimbursement on the data reported. Presently, post-acute providers are paid on a fee-for-service basis but with the IMPACT act, bundle payment will replace the fee-for-service. The bundle or value based payment pays for outcomes and not for the volume of services. The Act gives post-acute providers an incentive to work on

Falls are one of the major patient safety problems that every facility encounter on a day to day basis. An aging patient population, combined with multiple diagnosis and medications are prime contributing factors for patient fall. Other contributing factors are shortage of nursing and auxiliary staff, ineffective work environment and shortage of appropriate equipment. According to the Joint Commission around 30-50 percent of the falls happening in the hospitals have resulted in injury to the patients. Since Joint Commission started keeping records of fall from 1995 to 2012, it has been reported that there were 659 fall related death or permanent disability, which were voluntarily reported as a

Problem: Patient falls have long been a common and serious problem in hospitals across the nation, causing

Many of these inpatient falls can be prevented when following the proper fall prevention measures. Not only does patient safety make preventing falls a priority but the financial impact these falls have on an institution make it a priority as well.

“Starting in 2009, Medicare, the US government 's health insurance program for elderly and disabled Americans, will not cover the costs of "preventable" conditions, mistakes and infections resulting from a hospital stay. So for instance, if you are on Medicare and you pick up a hospital acquired infection while you are being treated for something that is covered by Medicare, the extra cost of treating the hospital acquired infection will no longer be paid for by Medicare. Instead, the bill will be picked up by the hospital itself since the rules don 't allow the hospital to charge it to you” (Paddock, 2007).

The reimbursement method used at St. Anthony’s hospital is quite distinct depending on the party doing the payments. Payments are received from Medicare, Medicaid, private insurers and also directly from patients. The party responsible for Medicare payment is the Federal government and it offers payment mainly for the elderly. With the Medicare payment, hospitals receive a flat fee depending on the case. According to Gee (2006), most hospital revenue has declined because of the revised payment set by the Diagnosis-Related Groupings. The fee for most cases varies according to the Diagnosis-Related Group (DRG) it can be classified under. For example, Medicare pays only a fixed amount for an elderly patient suffering from pneumonia regardless

As the United States population is advancing in age, the amount of patient falls and medical costs are estimated to increase. Approximately 700,000 patients fall per year in the hospital, which one-third of those falls could have been prevented (AHRQ, 2012). Prolonged hospital stays related to fall injuries is very costly. In 2013, a total of $34 billion dollars was paid due to falls by patients and insurance companies (CDC, 2015). Examples of injuries that can occur as a result of falls are fractures, lacerations, or internal bleeding (AHRQ, 2012). Studies also show

In the past several years, there have been several changes in economic policy at federal and state levels. The two economic policies that present to be the most precedent for healthcare leaders with concern to facility reimbursement are the Affordable Care Act (ACA) and the switch from volume to value reimbursement. First, there is the ACA policy, which have affected healthcare facilities and their reimbursement methods. In fact, ever since this policy was implemented, provider reimbursement has started to decrease in terms of fee-for-service payments (The Common-Wealth Fund, 2015). In other words, the intention of this policy was to provide budget relief to the government payers as well as giving providers an incentive to provider patients with great quality of care.

Medicare is trying to create incentives for hospitals to keep from making patients sicker, instead of healthier, during their inpatient stay. Hospital-acquired conditions (HACs) can lead to poor patient results

In October 1, 2008, the CMS adopted a non-reimbursement policy for certain "never events, which are defined as non-reimbursable serious hospital-acquired conditions (Sollecito & Johnson, 2013, p. 25). Examples of “never events” include surgery on the wrong body part; foreign body left in a patient after surgery; mismatched blood transfusion; major medication error; severe “pressure ulcer” acquired in the hospital; and preventable post-operative deaths (Center for Medicare & Medicaid Services, 2008)

According to the reports published by the Centers for Disease Control and Prevention Injury Centre (2007), falls are the third most common cause of unintentional injury death across all age groups and the first leading cause among people 65 years and older. A hospital can be a dangerous and erratic place for inpatients because of its unfamiliar

Trends indicate the administrative complexity in the U.S. health care system requires that American hospitals employ far larger staffs to handle billing requirements (Anderson & Squires, p. 1-2). Furthermore, despite enormous innovation and investments in technology, the U.S. is failing to achieve improvements in life expectancy. The return on investment has been low; therefore, examination into other methods to increase quality of care, and decrease costs has become compelling. The U.S. has known for quite some time that health care costs, and therefore spending have gotten out of control. There have been several Presidents who have unsuccessfully attempted to help alleviate the nation of this issue. However, with the implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, we have begun to notice a positive trend, in the said decline in spending. There have been methods implemented to begin helping providers and organizations monitor their progress, reward them for proper adherence, and now there are

Patient safety is one of the nation's most imperative health care issues. A 1999 article by the Institute of Medicine estimates that 44,000 to 98,000 people die in U.S. hospitals each year as the result of lack of in patient safety regulations. Inhibiting falls among patients and residents in acute and long term care healthcare settings requires a multifaceted method, and the recognition, evaluation and prevention of patient or resident falls are significant challenges for all who seek to provide a safe environment in any healthcare setting. Yearly, about 30% of the persons of 65 years and older falls at least once and 15% fall at least twice. Patient falls are some of the most common occurrences reported in hospitals and are a leading

Tzeng and Yin (2008) state that nurses assume the responsibility and are liable when a patient falls in their care. Nurses spend the most time with patients at their bedside; however, nurses don’t have any

In 2008, the Centers for Medicare and Medicaid Services changed its payment regulations to eliminate payment for hospital-acquired complications.