U.S. & News & World Report July 21-28, 2008 identified American’s best hospitals.  Wonder what criteria are used to qualify as “best”?  First, hospitals are not judged on routine procedures but rather on difficult cases across an entire specialty.  This year’s survey ranked hospitals on 16 specialties spanning cancer and heart disease to respiratory disorders and urology.  Out of 5,453 hospitals considered, only 170 met the rigorous ranking in the specialty rankings.

Criteria for consideration includes hard data, nominations by specialists, membership in the Council of Teaching Hospitals, affiliation with a medical school, and availability of at least six of 13 key technologies (ex. robotic surgery). 

The top ten hospitals to make the Honor Roll are:

1                    Johns Hopkins Hospital

2                    Mayo Clinic

3                    Ronald Reagan UCLA Medical Center

4                    Cleveland Clinic

5                    Massachusetts General Hospital

6                    New York – Presbyterian University Hospital of Columbia and Cornell

7                    University of California, San Francisco Medical Center

8                    Brigham and Women’s Hospital

9                    Duke University Medical Center

    10               Hospital of the University of Pennsylvania

It would be interesting to hear from the MSPs who work at these facilities to learn how their roles influence the Honor Roll status.  Future article? 

Carole La Pine, MSA, CPMSM, CPCS

NAMSS Certification Programs recently received Accreditation by the National Commission for Certifying Agencies.  This news should be of particular interest to those who currently hold the Certified Professional Medical Services Management (CPMSM) and/or the Certified Provider Credentialing Specialist (CPCS) designation and those who are considering sitting for the exams in the near future.  NAMSS has awarded certification to over 4,200 professionals in the medicals services industry beginning in 1981 with the first CPMSM exam (which was previously called Certified Medical Staff Coordinator) and in 1996 with the CPCS exam. 

The importance of NCCA accreditation is that the NAMSS certification programs meet the high standard of quality certification standards.  NCCA is the accrediting body of the National Organization for Competency Assurance (NOCA) and has awarded accreditation to over 90 programs. 

As a past Chair of the NAMSS Certification Program, I know this has been a long awaited goal for NAMSS.  I have always been proud of earning the two certification designations.  Today I am extremely proud of NAMSS for achieving it’s certification!  This is an outstanding accomplishment.  Well done, NAMSS! 

Carole  La Pine, MSA, CPMSM, CPCS

With the new numbering of The Joint Commission standards, the controversial MS.1.20 is now MS.01.01.01.  However, it is still too early to look at the renumbered EPs (elements of performance) in this specific standard because the Task Force on MS.1.20 has not completed it work to clarify the issues which have been a major cause for concern expressed by many MSPs and their facilities. 

On preliminary review of the new 2009 format, it appears that the efforts for improvement have been successful to some extent.  As an example:  MS.1.40, EP 6 now becomes MS.02.01.01 EP 8.  This change actually establishes a more logical flow when describing the Medical Executive Committee. 

It will be well worth the time to carefully review the Cross Walk of 2008 to 2009 standards.  We have been assured by TJC that there are no changes in the standards nor EPs; rather the new format is merely renumbering and a more logical flow. 

Carole La Pine, MSA, CPMSM, CPCS

A new accreditation organization is seeking deemed status from the Centers for Medicare and Medicaid (CMS); National Integrated Accreditation for Healthcare Organizations (NIAHO) offered by DNV Healthcare, Inc., Cincinnati, OH.  This program integrates ISO 9001 Quality Management System required with the Medicare Conditions of Participation for Hospitals.  Although not yet recognized by CMS, DNV is rolling out the program as an alternative to The Joint Commission accreditation program.

I’ve received a copy of NIAHO Interpretive Guidelines and Surveyor Guidance as well as NIAHO Accreditation Program, Accreditation Process.  A statement on the web site states:  DNV HealthCare Inc. has identified that in order to truly improve healthcare, hospitals need to implement a program that adheres to the international ISO 9001 Management System standard.

In an upcoming posting, I will highlight the comparison with The Joint Commission standards.

Carole  La Pine, MSA, CPMSM, CPCS

The Joint Commission recently issued a statement regarding the impact to performance and patient safety when medical staff demonstrates intimidating and disruptive behaviors.  TJC indicates that such behavior can lead to medical errors, contribute to poor patient satisfaction, increase the cost of care, and be the reason some professionals would chose new positions. 

For those of us responsible for credentialing and privileging, it is reassuring to know that rude and intimidating behavior is not acceptable.  I’ve encouraged my staff to write a “Note to File” whenever a practitioner behaves inappropriately.  This information is then shared with the Department Chair when the completed file is reviewed and also noted to the Credentials Committee during their evaluation. At first this type of information was given only a quick glance.  Today it is taken much more seriously. 

We all realize the time required to complete the credentialing process and how it can be frustrating to eager-to-start practitioners.  However, MSPs, as well as nursing and other support service staff, should not endure bad behavior.  It is time to make professionalism part of our assessment of practitioners’ qualifications. 

Carole La Pine, MSA, CPMSM, CPCS

We’ve heard about the “secret shoppers” who go into retail stores to evaluate customer service. We even know about the “food critics” who eat out then write reports on their dinning experiences. I must admit to being a little surprised by the latest “mystery patient” methodology. 

It was announced in an article by Dave Gershman published in the Ann Arbor News, Sunday, July 6, 2008 that an outside firm was hired to test patient satisfaction at Saint Joseph Mercy Health System. Although this approach is frequently used by the retail industry to rate customer services, does this really work in a health care setting? One of the down sides of this practice is the additional strain it puts on an already busy office, clinic, and/or practitioner. Dr. Ronald White, President of New Jersey Physicians stated it is “a horrendously bad idea” employing marketing techniques that do not evaluate medical care. Recently the American Medical Association discussed this topic and now is having this type of practice evaluated by its Ethics Committee. 

From the MSP standpoint, testing our procedures with fake applications would significantly impact already limited resources. Before considering such a practice, it is critical to know exactly what goal the exercise would accomplish and then look for other methods to obtain the same information. We know how much time we spend with each application, sometimes looking for what is NOT there, in order to ensure the public that they will get safe care from our practitioners. 

We need to ask: Is the “undercover” approach similar to the practice of pulling a fire alarm to test the response time of the fire department?  

Seems we surely could come up with a more acceptable practice. 

Recent travel has made me consider the comparison/contrast between the role of MSPs and Transportation Security Agents (TSA).  This idea began with the comment I’ve heard lately that the public feels safer traveling by air than it does being a patient in a hospital.  Why is that? 

The answer may include public awareness and acceptance of the following:  (1) the scrutiny the FAA required of all pilots, (2) the training and performance evaluation of flight attendants, (3) the requirements for maintenance of all aviation equipment. and (4) the screening of all passengers before boarding (troublesome as it may be).  It is this last area that I will use for my comparison/contrast. 

MSPs usually have limited authority while TSA have a high level.  This is evident by the extensive screening process implemented at airports.  Any one may be asked to step aside for a more thorough search which may include a search of carry-on luggage, handbags, computer cases, etc. 

Current MSP job qualifications often do not require certification nor advanced education degrees; TSAs go through extensive training.  I can’t imagine a TSA position filled with an individual without sufficient training and yet we know that this happens all too frequently in health care organizations. 

As long as we continue to read about serious patient errors occurring in hospitals, no amount of education will change the public’s perception.  No amount of activity to promote awareness of our responsibilities for extensive processing of practitioners before they are allowed to provide clinical services at health care facilities will alter public opinion. 

So how can we change the public’s perception of safety within health care facilities?  Who should lead this agenda?  We can’t wait for administration.  We can’t wait for marketing departments.  We must work with our professional organization to exert a positive influence.  In the end, the charge falls to our health care institutions and to you and me as advocates for patient safety - all the time; every time. 

Carole La Pine, MSA, CPMSM, CPCS

Reading Comprehension - Solution to previous challenge

A previous posting presented a challenge for our reading comprehension skills.  We were asked to read the first paragraph of the Declaration of Independence and then summarize it is 15 words of less.  Here is one of the possible solutions: 

When a people decide to separate politically, respect for others mandates an explanation.

How did you do?  Remember less than 50% of the population could solve this on the first attempt. 

Carole La Pine, MSA, CPMSM, CPCS