WASHINGTON-HCFA wants hospitals to kneel at the feet of the quality-improvement gurus.
In the first proposed revamp of Medicare’s conditions of participation since 1968, HCFA would require that hospitals monitor and improve the quality of care. For 30 years, Medicare essentially listed the specific services and processes that must be in place.
“We think it’s a step in the right direction,” says Carmela Coyle, an American Hospital Association senior VP. She particularly likes the added flexibility and emphasis on outcomes. The new rules were patterned on the Joint Commission’s Oryx program, which will soon require hospitals to begin reporting clinical performance measures as a part of accreditation.
But Coyle questions the appropriateness and achievability of a proposed reg that would establish a 2% drug-error rate. HCFA says “research and expert opinion has determined that this is reasonable,” given modern drug packaging and drug information systems.
Coyle is also dubious about HCFA’s proposed requirement that would force hospitals to collaborate with organ-procurement agencies. HCFA cites studies showing that more families consent to donation when the request is made by an agency than by a hospital.
Coyle says that hospitals already have policies in place for approaching potential donors’ families. In teaching hospitals, the attending usually does it, and in Catholic hospitals, it’s a priest.
The proposed rules would eliminate many old requirements. For example, HCFA would no longer dictate how a hospital’s governing body should be structured, nor would it spell out the organization and composition of the medical staff. -Christina Kent
WASHINGTON-HCFA wants hospitals to kneel at the feet of the quality-improvement gurus.
