Discussion: Medical Apologies

Discussion: Medical Apologies

Discussion: Medical Apologies

I’m expecting ALL ORIGINAL work like always. Please follow the directions below. DO NOT CHANGE FILE NAME WHEN RESUBMITING THE WORK TO ME. Case Study & Critical Thinking: Never Events, Medical Apologies, and Healthcare Legislation Instructions: In addition to consulting resources provided in the course readings list(I included some slides from course) you may consult any other source(s) that you wish for information regarding never events, medical apologies, and certain aspects of healthcare legislation. In all instances, please be sure to provide APA style references, including in-text citations, Question 1 Point Value: 5 Which of the following would NOT be considered a “never event”? 1) An infant that has been discharged by the hospital to the right family is kidnapped in the parking lot of a grocery store shortly after leaving the hospital. 2) Artificial insemination with the wrong donor sperm or donor egg 3) Surgery performed on the wrong patient. 4) A patient dies or becomes disabled, the cause associated with the use of restraints or bedrails while being cared for in a healthcare facility. Question 2 Point Value: 5 According to the article, “To Err is Human: Building a Safer Health System,” what are the four types of errors? Additionally, provide an explicit example of each of these errors. Question 3 Point Value: 20 A well-respected advocacy group for improved transparency, quality, and safety in hospitals has asked hospitals to commit to 4 actions in the event of a “never” event: 1) apologize to the patient, 2) report the event, 3) perform a root cause analysis, and 4) waive costs directly related to the event. Providing your references, and in 500 words or less, please describe WHY you think this group has selected these four measures. Question 4 Point Value: 10 Among other sources, your textbook talks about the “moral hazard” argument from the perspective of a consumer. Think again to an earlier assessment question about training residents to be more cost conscious. Citing your references if you’re able and in 250 words or less, how can knowing, or at least being exposed to the cost of an entire formulary help residents make better decisions when evaluated from a cost-benefit perspective? To help you formulate your thoughts, try to think about things such as: function of the formulary, variations of the formulary, e.g., “open” or “closed”, etc. Question 5 Point Value: 5 In our course materials, we’ve briefly discussed healthcare-associated infections, sometimes referred to as HAI. One such HAI is a Central Line-Associated Bloodstream Infections (CLABSI). Discussion: Medical Apologies

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The U.S. National Benchmark for CLABSI is “1” (the units aren’t so important). If I told you that one hospital had a CLABSI ratio of 0.762, and another had a ratio of 0.716: 1. How is each hospital performing when compared to the national benchmark? (2.5 points) 2. Providing some type of justification, explain which of the hospitals is performing better than the other. (2.5 points) Question 6 Point Value: 7.5 In 150 words or less (I’m not looking for an essay here, and feel free to use bullet points), and providing your sources, tell me the following information about Dennis Quaid’s medical error “adventure”: i. Why were his twins re-admitted to the hospital? (2.5 points) ii. What drug were they given and what does it do? (2.5 points) iii. In the simplest terms, what was the error? (2.5 points) Question 7 Point Value: 5 We’ll go very easy on the calculated numeric for this case study. Based on the Dennis Quaid twins case, how much more concentrated was the dose of drug they received vs. the dose of drug they were supposed to receive? Question 8 Point Value: 5 True or false: Safety/Rx check protocols weren’t followed at multiple hand-off locations within Cedars Sinai Hospital? Question 9 Point Value: 7.5 Providing your sources and in 150 words or less, list where (if it’s easier, “who”) each of the errors happened within Cedar Sinai that led to the eventual incorrect dosing. Question 10 Point Value: 15 Please answer the following questions in no more than 500 words total, being sure to provide your sources: i. Who did Dennis Quaid eventually end up litigating, and why? (2.5 points) ii. What was Quaid’s overall demeanor towards the nurses that administered the wrong dose? (2.5 points) iii. Did Cedars Sinai follow any of the 4 suggested actions listed in Question #3?Discussion: Medical Apologies

(Granted, this was a preventable errors case, not a never event) If so – which ones did the hospital follow? (10 points) For these final sets of questions, there’s no need for you to be a legal expert. However, it is important to be familiar with a few legal and legislative concepts, particularly if they are tied into our healthcare system. Question 11 Point Value: 15 1) Citing your source(s), briefly describe the intentions behind antitrust laws, and provide one (1) federal regulation that governs antitrust related activities. (2.5 points) 2) Citing your source(s), provide two (2) documented cases of antitrust in an industry other than healthcare, and explain how these cases specifically violated antitrust laws (5 points) 3) Citing your source(s), provide two (2) document cases of antitrust within the healthcare industry, and explain how these cases specifically violated antitrust laws (5 points) 4) How might your discussion of answer 3 above conflict directly with, or not mesh well with, one (1) current quality initiative? As a reminder, please be explicit and provide citations and/or references as appropriate. (2.5 points) Question 12 Point Value: 20 In the same manner that students may struggle differentiating between aspects of Medicare and Medicaid, they may also find the differences between the Anti-Kickback Statute and the Stark Law to be problematic. Providing proper citations, please compare and contrast the following parameters of these two regulations: 1) What are the explicit prohibitions of each regulation? (2.5 points) 2) What types, or if it’s easier, “who can give” a referral that would be subject to each regulation? (2.5 points) 3) What types of items or services are subject to each regulation? (2.5 points) 4) What does each regulation say about intent? If there have been amendments to intent clauses after recent legislation, please be sure to include those. (2.5 points) 5) What type(s) of penalties can be assessed for those who violate each regulation? (2.5 points) 6) Are there exceptions to each regulation, and if so – describe at least two (2) for each regulation. (5 points) 7) Which Federal Health program(s) does each regulation cover? (2.5 points) Question 13 Point Value: 5 points I happen to be general internalist who among other duties, has a steady stream of family practice patients.Discussion: Medical Apologies

Looking into the future and trying to be as careful as possible, I decide to invest in an imaging center, specifically one where I don’t refer my Medicare and Medicaid patients. I have a longtime friend who’s an orthopedist and one day I find out that he ordered an MRI from the imaging center. 1) Does this violate Stark? (2.5 points) 2) Why or why not? (2.5 points) Question 14 Point Value: 5 I’ve changed careers now, and am now a physical therapist. I’ve opened up my own office inside a building that houses multiple specialties, including family physicians. As part of my lease conditions, I’m only in the building when the family physicians have patients for me to evaluate and/or provide physical therapy. 1) Does this agreement violate the Stark Law? (2.5 points) 2) Why or why not? (2.5 points) Question 15 Point Value: 10 points I’m a physician again, and now I focus on family practice. For years I’ve tried to convince my sister, who happens to be a hospital laboratory service expert, to move to my city. Luckily, one of the three groups in town that performs pathology services has an opening, and my sister gets a job. She also becomes a shareholder in the group. I refer my Medicare and Medicaid patients to the hospital services group where my sister works, and the pathologists, including my sister, bill Medicare for their own services. 1) Does this arrangement violate the Stark Law? (2.5 points) 2) Why or why not? (2.5 points) 3) If this arrange does violate the Stark Law, what are two (2) options that I can take to remedy the situation? (5 points Discussion: Medical Apologies


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