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by Evan Sweeney
If you had any doubt that federal prosecutors are serious about bringing the hammer down on healthcare executives who oversee fraud schemes, look no further than the sentences handed down to three administrators at Riverside General Hospital over the last month.
Collectively, three administrators of the notoriously mismanaged hospital will be spending 115 years in prison. That includes a 45-year sentence for Riverside's president, Earnest Gibson III, and a 40-year sentence for Mahammad Khan, the hospital's former assistant administrator and Gibson III's right-hand man. Gibson's son, Earnest Gibson IV, who operated a satellite psychiatric facility linked to Riverside, will also receive 20 years for his role in a scheme that netted more than $150 million. Another administrator that operated a separate satellite location is awaiting sentencing.
There's no shortage of sordid details in the multi-million dollar theft. The three administrators worked with seven others to concoct a scheme that took advantage of mental health and drug rehab patients. The hospital billed for intensive outpatient therapy known as a partial hospitalization program (PHP) for these patients even though many of them were watching TV in place of therapy.
To hear the elder Gibson tell it (as he did months ago according to The Houston Chronicle), other than some misplaced trust in his subordinates, he was an exemplary hospital executive. It reminds me of a job applicant who offers up "caring too much" as a professional weakness.
I recently had the opportunity to visit a number of well-respected healthcare organizations and meet with amazing servant leaders who are all striving to bring healthCARING back into the healthcare system.
Today I would like to share one of those experiences and what I learned.
At a critical access hospital in the Midwest, I met a chief nursing officer (CNO) who has worked throughout the country to implement systems to better position nurses to be successful and again find joy in their work, and improve the care of patients and their families. We had the opportunity to share stories, best practices and barriers to optimal care provision. And during this time I shared the story that I have shared on many occasions in many forums of the impact of childhood abuse on the health of adult patients.
I explained how I've witnessed firsthand far too many patients being declared "non-compliant" because they did not adhere to treatment protocols when in fact we healthcare leaders have not created care models that allow for time, relationship, trust and for the patient's whole story to be told and heard. These patients were not positioned to share their whole story, and clinicians were not positioned to hear their whole story, e.g., how sexual abuse in patients' past had led them to form an unhealthy relationship to food or how abuse from a coach during their childhood has led to an aversion to exercise. And thus we healthcare leaders have not created systems that allow both patient and clinician to identify and address the root cause of "non-compliance" but rather, we have given up on patients who truly needed us.
As we have been working with healthcare organizations on their urgent care centers (UCCs), we have been fascinated by what we hear from urgent care patients. Often what those patients tell us differs greatly from the expectations of healthcare organizations that created the UCCs in the first place.
Given this disparity, we thought it would be timely to share our early insights and inquire about what you might be seeing in terms of UCCs, as well.
While two-dozen interviews over a few hours at two different UCCs in New York do not amount to a sample, what we've found so far shows several potential patterns emerging. Each one is worth more observation.
As a longtime healthcare reporter, I am shocked every time I read about a surgeon who operated on the wrong site or wrong patient or accidentally left a surgical instrument inside a patient's body. It seems hard to believe that in 2015 these "never events" could occur at all. Yet they do, and, if recent studies are correct, they occur far too often.
One way to solve this problem in the operating room once and for all is to eliminate distractions and adopt best practices followed by the aviation industry--basically turning the operating room into a cockpit, Kimberly Danebrock, R.N., senior risk management and patient safety specialist for the Cooperative of American Physicians' "CAPAssurance" program, told me during an exclusive interview.
We spoke shortly before the release this week of a study conducted by researchers at the Mayo Clinic that found never events occurred at their campus during 1 of every 22,000 procedures. But the national rate for never events is much higher. A 2013 study published in Surgery estimated it to be closer to 1 in 12,000 procedures.
And JAMA Surgery published another study this week that took a systematic review of surgical never events, including wrong-site surgery, retained surgical items and surgical fires, to try to determine why they still happen despite the implementation of patient safety efforts at hospitals across the country.
The study found that poor communication is behind most of these catastrophic events, a problem also identified by Mayo Clinic researchers. The Mayo study also identified a series of as many as nine missteps that can lead to a surgical error.
by Lynn McVey
My recent trip was actually a spring vacation rather than a summer one, but I still learned a lot. After a three-week trip to nine European countries, I learned Americans are not healthy. I'm not surprised that of 198 countries in the world, America spends the most on healthcare. The average Medicare patient costs us $6,700 per year while the super-users spend $67,000 per year. The "why" became as clear as the nose on my face.
Living in America is particularly efficient. Our flat driveways are next to our homes. Some garages allow us to walk straight into our homes without stepping outdoors. Most suburbs are surrounded by strip malls and convenient shopping. As I visited Dubrovnik, Croatia, I climbed at least one million steps--no exaggeration. The most astonishing thing was to witness Dubrovnik's senior citizens climbing the steps faster than younger Americans. Not only did they move a lot and fast, they only ate a fraction of what we eat in American restaurants.
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