Good External Peer Review Could Have Prevented This

This physician's surgical errors were allegedly widely known to his fellow practitioners, yet no one said anything. The role of medical staff and the peer review committee is to make sure that under-performing doctors like this one are identified and evaluated through the peer review process. If the person is in a position of power or authority where his/her peers are fearful of retaliation, having an external peer review policy and vendor in place will ensure transparency and accountability.

Dr. Patel could face more than 100 years in prison, if convicted
06:44 PM PDT on Tuesday, March 11, 2008 By kgw.com and AP Staff

First New York, then Oregon, and now Australia. Dr. Jayant Patel has left a bloody trail of mistakes as a surgeon, finally resulting in manslaughter charges.
His arrest Tuesday morning started the legal clock ticking on an extradition request by Australia, where he was director of surgery at Bundaberg Base Hospital in Queensland from 2003 to 2005.

KGW Patel Arrest Story
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Payers Should Reward Hospitals That Are Serious About Patient Safety

This article is another example of how health insurance payers are putting more pressure on hospitals to reduce unnecessary errors as a condition for reimbursement. This raised level of accountability for quality and patient safety improvements will benefit us all in the long-term, and is something that is long overdue. However, we'd like to see payers push for a more robust set of hospital quality measures and the presence best practices, and tie their reimbursements to them consistently. For example, a hospital that is consistently using systematic external peer review (a best practice which too few hospitals follow today) should be rewarded with better reimbursements than one that is not, since they're not meeting the intent of the new Joint Commission standards for focused and ongoing professional practice evaluation.

Featured Story February 21, 2008

More Health Plans Adopt 'Never-Event' Policies That Don't Reimburse for Treatment Needed to Correct Medical Errors

Reprinted from HEALTH PLAN WEEK (formerly Managed Care Week), the industry's leading source of business, financial and regulatory news of health plans, PPOs and POS plans.

More payers say they are adopting so-called "never-event" payment policies, under which providers will not be reimbursed for procedures and treatments needed as a result of certain preventable errors made in hospitals. But choosing which errors to focus on, incorporating language into hospital contracts and auditing hospitals' claims can pose challenges, experts warn.

Read the rest of the article: http://www.aishealth.com/Bnow/hbd022108.html