MSSPNexus Blog

Friday, February 1st - Go Red for Women's Heart Health

Increase awareness of women's heart health by wearing red on Friday, February 1st.

Thanks to the participation of millions of people across the country, the color red and the red dress now stand for the ability all women have to improve their heart health and live stronger, longer lives.

Go Red For Women celebrates the energy, passion and power we have as women to band together to wipe out heart disease and stroke.

As a public service to my readers, I've done a bit of shopping to help get you started. : )

How about an elegant gown from Nordstrom?

http://shop.nordstrom.com/S/2952482/0~2376776~2374327~2374331~6001837?mediumthumbnail=Y&origin=category&searchtype=&pbo=6001837&P=2

Or a pair of red high-heeled pumps from Zappos?

http://www.zappos.com/n/p/dp/35286193/c/5360.html

Or the always-convenient one-size-fit's all Ruby and Diamond heart pendant from Macy's?

http://www1.macys.com/catalog/product/index.ognc?ID=156818&CategoryID=553

Whatever your style, don't forget to show off a bit of red this Friday for the cause of women's heart health!

Grand Rounds 4.19

Grand Rounds 4.19 "Rocks On" this week over at Emergiblog.  Nurse Kim is our host, and there are guest appearances from the Beatles.  Stop by for the best of this week's medical blogosphere.

Legal Privilege and Hospital Patient Grievance Records

by Lisa Venn, J.D., M.A.

This article examines the issue of whether hospital patient grievance records are privileged i.e. protected from discovery when a patient sues a hospital and requests the production of the patient grievance file.

In 1999, the Health Care Financing Administration (HCFA; later renamed the Centers for Medicare and Medicaid Services or CMS) mandated that hospitals establish a patient grievance process. Effective September 19, 2005, CMS issued Interpretive Guidelines clarifying the patient grievance process, requiring hospitals to identify a grievance committee to investigate and resolve patient grievances. CMS mandated that in its resolution of the patient grievance, the grievance committee must provide the patient with written notice of its decision. This notice must include the name of the hospital contact person, the steps taken on behalf of the patient to investigate the grievance, the results of the grievance process, and the date the grievance investigation was completed. CMS also requires hospitals to document its efforts to resolve the grievance and demonstrate compliance with CMS requirements.

In the course of its investigation, the grievance committee will often incorporate into its documentation information generated by the hospital’s peer review or quality assurance committee. During its investigation, the grievance committee may also seek the direction from the hospital’s legal counsel and document the legal advice into the patient grievance record. Particularly in the case of smaller hospitals, the grievance committee might function as the hospital’s quality assurance, peer review and risk management departments.

Whether the patient grievance file is privileged may well depend upon (1) whether the federal or state court hears the case; and (2) whether the party seeking the privilege can convince the court that the grievance committee and its records fall under an available statutory privilege.

Read the rest...

Diabetes Mine Blog Featured in Newsweek Health

Congratulations to Amy Tendrich from Diabetes Mine!  Amy and her blog are featured this week in Newsweek.com's Health Section:  http://www.newsweek.com/id/104413

"I'm just astounded to think that one sick mom in California can reach out to so many fellow patients, create a community, and actually turn the whole thing into a business. It sure has helped me feel a lot less alone and a lot less frightened about living with diabetes."

 

Puppy Love in the Hospital Hallways

Several times over the past few days I've watched therapy dogs and their owners travel through the hallways of the hospital where I work.   

The well-behaved dogs, proudly sporting handsome blue coats identifying their special role, walk through the crowded corridors with purpose.  They have a job, and they seem anxious to get on with it.

I love the concept of therapy pets.  I have every confidence that they do a world of good as they work with our patient population.  But it's more than that.  Staff and visitors alike smile as the dogs pass by.  In fact, it's difficult to find even one stoic face in the crowd. 

Just catching a glimpse of those furry, friendly faces makes my whole day better.

Here's to puppy love.

Research Tips for Finding a New Physician

If you're looking for a new computer, chances are you're spending time comparing models, brands, and features before making a final decision. After all, a computer is an important purchase.

If however, you're in the "market" for a new primary care physician or specialist, you know that finding trustworthy comparative information is a whole lot tougher.  Because of that, most of us rely on recommendations from friends, co-workers, and family.  While that's not a bad place to start, more information is available if you're willing to do a bit of research. 

The Nursing Online Education Database has provided a list of search tips in 12 Tools To Do A Background Check On Your Doctor.  Many of the listed resources provide free data, some require payment of a small fee. 

Being a proactive patient can provide definite healthcare benefits for you and your family.

Grand Rounds 4.18

Grand Rounds 4.18 is up this week at "But You Don't Look Sick."  Grand Rounds is the weekly collection of the best posts from around the medical blogosphere. 

Joint Commission Field Review - 2009 National Patient Safety Goals

Joint Commission has released a field review, open until February 28th, on their proposed 2009 National Patient Safety Goals. 

http://www.jointcommission.org/Standards/FieldReviews/09_npsg_fr.htm

The field review focuses on new and revised National Patient Safety Goals for the following topics:

• Goal 1 Patient Identification
• Goal 3 Safe use of Medications
• Goal 7 Hospital Acquired Infections focusing on methicillin-resistant staphylococcus aureus   (MRSA) and clostridium difficile-associated disease (CDAD); catheter-associated bloodstream   infections (CABSI); and surgical site infections (SSI) in acute care hospitals
• Goal 8 Medication Reconciliation
• Goal 13 Patient Involvement in their Care
• Universal Protocol.

http://www.jointcommission.org/NR/rdonlyres/5928FA30-6BAB-4017-8DF6-5545E5470154/0/09_Hospital_NPSG_FR.pdf

Proposed NPSG's for hospitals: 

Online response survey for hospitals:  http://www.surveyconsole.com/console/TakeSurvey?id=422725

Suffering Loss

This patient's catastrophic death struck me and everyone else involved in his care as a complete and utter surprise. I had been trying to help this boy, and he suddenly and unexpectedly died. Never, until the moment the process server showed up in my new office, did it occur to me that what I had and had not done could be construed as malpractice. When I opened the envelope and read these things about my being "negligent, careless, and without skill", I picked up the phone and called my personal lawyer. I thought I was being accused of manslaughter. I had suffered the loss of a patient and now I was being accused of having killed him, or so I thought.

My lawyer calmly explained that I was being sued for malpractice, not manslaughter and advised me to call my malpractice carrier. I put the envelope in my top drawer and went in to see my first patient of the day. My new practice had been open for two months.

Dr. Robert Lindeman, a pediatrician from the Boston area, blogged anonymously as Flea.  The combination of that blog and the trial noted above changed his life when he unexpectedly landed on the front page of the Boston Globe last May.

The medical blogosphere was rocked by the impact of the case, but of particular interest to those of us who work with physicians are Dr. Lindeman's words about how it felt to be named in a medical malpractice suit.  He speaks to that during an insightful interview with Eric Turkewitz, author of the New York Personal Injury Law Blog.

Waiting for the Doctor

I visited the friendly neighborhood primary care doc recently.  First the vital signs, where the nurse reminds me that "if it comes out of a can, a jar, a cellophane wrapper, or a fast-food restaurant, odds are it contains a high level of salt; an issue for someone with a slightly elevated BP."

I sigh, knowing she's right, but thinkingly longingly of some favored food that fits into one or more of those categories.

These routine visits always bring a myriad of conflicting emotions.  My internist is a funny, friendly, bright woman, so I look forward to our little chats.  But as I wait my turn, another part of me is six years old.  A nervous little girl, sitting with her feet dangling from the high examining room table, wondering if she's about to be scolded for some bad behavior or other.

As I sit there I wonder how a physician goes about deciding the best way to handle a patient with life-style issues. When to soothe, when to "spank", when to simply ignore.  I can't imagine the challenge of figuring that out ten or twenty times a day for a myriad of patients and personalities.  Once again I'm grateful for physicians, and grateful that I'm not one of them.

"What if I tell my patient that he needs to start x-y-z and he storms out angrily, shouting that he's going straight to administration?  What if I remind this one that she hasn't followed through with something I instructed her to do last time and she bursts into tears, pouring out all the reasons she can't possibly comply?  What if she simply gets discouraged and gives up, never to return?"

Talk about stress!

Traditionally my internist has been a bit of a soother.  During my most recent visit she apparently decided that soothing wasn't working to her satisfaction.  I walked out with a stack of instructions and a return-visit deadline for compliance.  The iron fist in the velvet glove approach.

So long salt shaker, it was fun while it lasted.