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| Insurer Halting Payments for Endoscopy Propofol |
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MEDICARE'S PROPOSED ASC PAYMENT SYSTEM REVISION will be summarized and discussed during a CMS conference call on Thursday, Sept. 7, from 2 p.m. to 3:30 p.m. Eastern time. The conference call is an opportunity for healthcare professionals to ask questions and voice initial reactions to the proposed payment system outlined in the Federal Register. To participate in the conference call, dial (800) 837-1935 and enter conference ID 5300639. CMS is accepting written comments on the proposed update of the ASC procedure list until Oct. 10. Written comments about the 2008 revised payment system are due November 6.
A FEDERAL JURY FOUND JOHNSON & JOHNSON, the New Brunswick, N.J.-based medical manufacturer, not guilty of antitrust practices following a lawsuit filed by rival Applied Medical Resources Corp. of Rancho Santa Margarita, Calif. Applied Medical, which sought $54 million in damages, alleged that Johnson & Johnson's Ethicon division illegally restrained competition in the trocar market by offering discounted suture for customers who bought the instruments. Johnson & Johnson countered that such bundling contracts did not block competitors and were sought out for their cost savings.
NUMBING A CHILD'S SKIN BEFORE PLACING AN IV can make the task easier for both sides. While two topical anesthetics are frequently and effectively used for numbing — amethocaine (Ametop) gel and EMLA cream (a combination of lidocaine and prilocaine) — a recent study suggests that amethocaine does the job faster. For the study, published in the Cochrane Collaboration's Cochrane Library, researchers reviewed six clinical studies comparing the use of the two anesthetics on 534 children between the ages of three months and 15 years, assessing their pain and numbness through patients' reports and clinicians' observations. While EMLA took up to 90 minutes to completely numb the IV site, amethocaine numbed the site in 30 to 60 minutes. |
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| Distressed Physicians More Likely to Err
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Physicians who feel they've committed major medical errors suffer symptoms of burnout and depression, which may lead to increased odds of future self-perceived errors, say researchers at the Mayo Clinic in Rochester, Minn. The researchers surveyed 219 internal medicine residents between 2003 and 2005, examining the relationship between physician distress and the future likelihood of an error, according to the study published in the September issue of the Journal of the American Medical Association.
Residents completed surveys at three-month intervals; the surveys covered their self-assessment of medical errors and quality of life as well as measurement of burnout symptoms such as depersonalization, emotional exhaustion and reduced personal accomplishment. Residents were also screened for depression every six months.
An average of 14.7 percent of residents reported making an error in the previous three months on each quarterly survey, results show. Residents reporting an error experienced higher levels of burnout and were more likely to indicate for possible depression, say researchers. The results further suggest that physicians scoring high on burnout measures were twice as likely to report an error in the next three months as those with low burnout.
Recognizing physicians who experience symptoms of burnout is not easy, according to Tait Shanafelt, MD, Mayo Clinic physician and the study's lead author. "We do see that burned-out physicians are less empathetic and compassionate," he says, adding that further research is needed to identify effective approaches to assist physicians who have made medical errors.
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| Panel Reaches PONV Treatment Consensus
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The American Society of PeriAnesthesia Nurses has done what no group of nurses, physicians and pharmacists has yet been able to: reach consensus on an evidence-based, multidisciplinary, multimodal approach to preventing and treating post-operative nausea and vomiting, the most commonly occurring post-op complication. A 21-page PDF file of the group's clinical guideline has been posted on the group's Web site.
To develop the guideline, ASPAN organized a panel consisting of 18 multidisciplinary, multispecialty experts to review and analyze published evidence related to PONV prevention and management. The panel used consensus-based decision-making techniques to establish recommendations regarding risk factor identification and stratification, traditional treatment modalities such as pharmacology, hydration and NPO status, and complementary treatment modalities such as acustimulation and aromatherapy. The panel also identified and prioritized areas of needed research.
"Translation of these guidelines into practice should improve health outcomes in adult surgical patients," says the panel.
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| News and Notes |
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CENTERS FOR MEDICARE AND MEDICAID SERVICES ADMINISTRATOR Mark McClellan, MD, PhD, will resign the position he's held since 2004 in October, the agency says. According to published reports, Dr. McClellan says he is leaving to spend more time with his family. He says he will likely join a think tank or accept an academic position. No replacement has yet been named, but The Washington Post reports that potential candidates include CMS Deputy Administrator Leslie Norwalk; CMS Director of the Center for Medicare Management Herb Kuhn; and Julie Goon, a special assistant to President Bush and the former director of Medicare outreach at HHS.
CMS IS REMINDING HEALTHCARE PROVIDERS who bill Medicare for services rendered that a nine-day hold will be placed on payments for all claims between Sept. 22 and Sept. 30, the end of the federal fiscal year. Claim payment will resume the following Monday, Oct. 2. This one-time payment hold has been mandated by Section 5203 of the Deficit Reduction Act of 2005. For more information, read the Medicare Learning Network article. CMS has also posted a supporting data file for use in modeling the agency's methodology for calculating proposed facility payment amounts under the revised ASC payment system, scheduled to take effect in January 2008. The file contains the pricing and historical utilization data used to established the proposed ASC conversion factor calculation. To obtain the data, visit the CMS's Web page on the subject and click on the link titled "CMS-1506-P" under the "Downloads" heading.
JCAHO HAS ISSUED A SENTINEL EVENT ALERT urging facilities to develop protocols that will keep patients safe in the event of power outages. The alert recommends that organizations match the critical equipment and systems that would be needed in an extended emergency against those actually on the emergency power system; inventory emergency power systems and the loads they serve; provide training for those who operate and maintain the emergency power system; ensure that generator fuel is available and usable; ensure that the organization's management and clinical leaders know how long emergency power will be available, as well as what locations within the facility will and won't have emergency power; and establish contingency plans for doctors and other caregivers to follow during electrical power failures. |
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