Becker's Hospital Review

163 FINANCE CMO / CARE DELIVERY 9:12 AM Letter Exposes Mistakes That Led to United Medical Center Obstetrics Ward Shutdown By Alia Paavola A letter dated Aug. 7 from the District Health Department to Washing- ton, D.C.-based United Medical Center, obtained by The Washington Post, disclosed the mistakes that caused district regulators to impose a 90-day obstetrics ward shutdown at UMC in early August. The letter revealed, in one case, that UMC staff did not take proper steps to pre- vent the transmission of HIV from an infected mother to her baby, such as pro- viding antiretroviral medication after birth or delivering via Caesarian section. The letter also highlighted a case where the hospital improperly monitored and treated a 35-week pregnant obese woman with a history of serious blood pressure problems. The letter also stated the hospital failed to phys- ically screen a newborn at the right time after birth. The letter does not dis- close names or outcomes of these patients. In a statement issued Aug. 9, United Medical Center attributed the shutdown to "three separate cases involving deficiencies in screening, clinical assess- ment and delivery protocols." A hospital spokeswoman, Jennifer Devlin, said HIPAA regulations prohibited the hospital from releasing details. Rosemary Gibson, a patient advocate and adviser at the Hastings Center research group, told The Washington Post that hospitals often cite patient privacy as a reason to withhold information the public deserves to know. n Swedish Health CEO Dr. Guy Hudson Overhauls Concurrent Surgery Policy By Emily Rappleye L ess than two months into the job, the new CEO of Seattle-based Swed- ish Health, Guy Hudson, MD, changed health system policy in August about how many cases surgeons can work on at the same time, he told The Seattle Times. Dr. Hudson took the helm at Swedish Health in late June, a few months after The Seattle Times published an investigative report about how some sur- geons frequently performed overlapping surgeries at the health system. His new policy requires surgeons to be present for the "substantial major- ity" of the surgery, which includes everything except minor activities at the beginning and end of a case, such as closing the incision, according to the report. Staff will also record every time a surgeon enters or exits the OR. The policy was not adopted because concurrent surgeries were unsafe, nor is the practice uncommon at teaching hospitals, Dr. Hudson told The Seat- tle Times. However, the new policies aim to address patient concerns and expectations that a surgeon would be present for the majority of a case, ac- cording to the report. The policy could limit patient access to surgeons, he said, so the health sys- tem plans to evaluate the need for more ORs and surgeons going forward, according to the report. n Inpatient Satisfaction With Pain Control Improves When More Nurses Are Present By Anuja Vaidya A study, published in Pain Management Nursing, shows a strong link between hospitalized patients' satisfaction with pain treatments and nurse staffing. Researchers studied hospital characteristics, staffing and nursing care factors associated with patient perception of poor pain control by conducting a secondary analysis of the HCAPHS survey in California, Massachusetts and New York hospitals. e study shows patients' satisfaction with pain control significantly improved with high- er numbers of registered nurses, nursing staff and hospitalists. eir satisfaction worsened, however, with higher numbers of residents or interns. e following four factors increased the like- lihood patients reported poorly controlled pain: • Patients did not receive help as soon as they wanted • Poor nurse communication • Poor medication education • Teaching hospitals ese two factors decreased the likelihood pa- tients reported poorly controlled pain: • Higher numbers of nursing staff • Nonprofit hospitals us, nurse staffing and nurse-patient com- munication are highly predictive of inpatients' perception of pain management. n

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