Becker's Hospital Review

97 CMO / CARE DELIVERY The safety issues that put UNC Medical Center's Medicare contract at risk By Mackenzie Bean N ew details from a federal inspection report obtained by e News & Observer offer a closer look at the safety issues that put UNC Health's flagship hospital at risk of losing its federal funding last month. State inspectors visited Chapel Hill, N.C.-based UNC Medical Center in June and found the hospital failed to meet four conditions of participation in the Medicare program, including infection control and patients' rights. CMS threatened to revoke the hospital's Medicare contract if it did not correct the issues by July 23. Much of the inspection report, which e News & Observer obtained through a Freedom of Information Act request, centers on the case of a 29-year-old patient who took his own life in April about an hour aer he was discharged from the emergency department against his mother's wishes. "e hospital's governing body failed to provide oversight and have systems in place to ensure the protection and promotion of a patient's rights to provide a safe environment in the emergency department," inspectors wrote in the report. e hospital also failed to have an effective infection control program and quality assessment and performance improvement program for patient safety, the report found. UNC Medical Center submitted a plan of correction to CMS and is now in compliance with regulations, a spokesperson for the system told Becker's. "We are grateful for all of our teammates for their efforts during this process, and their commitment to providing excellent care for all of our patients," the spokesperson said. "Working closely with state and federal regulators is one important way we are able to continuously improve the quality of care." n Why CMS wants to conceal hospital safety data By Mackenzie Bean A July 7 Kaiser Health News report sheds more light on CMS' rationale for its proposed plan to obscure hospital safety data from the public — a move that has been met with strong opposition from patient safety groups and other stakeholders. CMS is proposing to suppress data reported by hospitals as part of a composite measure of 10 serious and potentially fatal care complications, including pressure ulcers, falls that break a hip, lung collapses, blood clots and postoperative sepsis. CMS Chief Medical Officer Lee Fleisher, MD, said these metrics were not designed to account for how pandemic- related disruptions, such as patient surges and staff shortages, would affect health systems. "Safety, transparency and quality of care of patients is not enhanced by the use of skewed or inaccurate data, and, in fact, could result in negative consequences for patients," he told KHN. "CMS wants the public to have complete trust in the data and will make data on quality available when we have a high confidence in its credibility and accuracy." Patient safety organizations such as The Leapfrog Group have vehemently opposed the plan, saying it will put consumers in the dark about hospital safety. n Why 1 nurse will never return to the bedside By Cailey Gleeson D espite wanting to return to the medical field, Theresa Brown, PhD, BSN, RN, said she is unlikely to return because of the "present form" of bedside nurses' work, she wrote July 22 in Medscape. Years of overwork and underappreciation experienced by front-line staff were "merely intensified by the pandemic," and Dr. Brown used an analogy of swimming in an "under resourced pool" to clarify the hardships faced by front-line workers. "If after all that, someone asked me, 'Do you want to keep swimming for exercise?' I would of course answer yes, emphatically, but not in that place," Dr. Brown wrote. "The problem is, from what I hear anecdotally, working as a nurse in so many hospitals right now is very similar to swimming in that underresourced pool." Citing various studies on satisfaction and retention, Dr. Brown went on to explain how patient safety is affected by current workforce shortages. "The connection between inadequate nurse staffing and increased patient mortality has been well established by research," she wrote. I have been talking and writing about this frightening reality for so long to so little effect that I sometimes feel I am talking only to myself. But I'm not going to quit because this is an important and solvable problem." n

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