31 January 2012

 

NJ Today

The Senate Health, Human Services and Senior Citizens Committee unanimously approved legislation today that would require single-room surgical practices to conform to the same level of oversight and regulation reserved for facilities that have two or more surgical rooms in order to protect patients.

“This legislation is about patient health and safety,” said state Sen. Joseph Vitale (D-Middlesex), a sponsor of the bill. “As the practice of medicine advances and more and more procedures can be done on a same-day basis right in a physician’s office it’s imperative that we know care is being provided in a safe and sanitary environment.”

The bill, S-1210, would make changes to the law governing regulation and licensing of health care facilities in New Jersey. By bringing all health care facilities under the umbrella of licensure, the bill would ensure that single-room surgical practices which, under current law, are held to the same patient safety standards as surgical practices with two rooms.

“The NJ Health Care Quality Institute’s work to expose the inspection reports of 40 surprise CMS inspections last year should serve as a wake-up call that our current system of double standards in patient safety simply does not work,” said Vitale. “When more than half of the single-room surgical centers inspected are found to be deficient and unsafe and seven of them are so unsafe they have to be temporarily closed, something needs to change. This bill creates an equal high standard of patient safety to ensure that, no matter where you access health care, basic patient safety and sanitary precautions are being followed.”

The New Jersey Health Quality Institute evaluated the reports of 40 random inspections conducted by the Department of Health on behalf of the Centers for Medicare and Medicaid Services. Of the 40 one-room facilities which were inspected for the report, 17 were found to be in “immediate jeopardy” and seven were temporarily closed. Violations included: not having mandated emergency equipment and medications on site; no tracking of controlled dangerous substances such as narcotics; physicians and staff not having proper licenses or credentials; not cleaning or sanitizing surgical instruments correctly; and using single use items more than once, on more than one patient.

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30 January 2012

 

Most anyone who follows health care in New Jersey has figured out by now that I am talking about Joe Vitale, who will soon return as Chair of the Senate Health, Human Services and Senior Citizens Committee. No one has been more important to the issues that directly impact the delivery of health care in New Jersey than Joe Vitale. If you look behind most every initiative protecting patient safety, improving access to health care; advancing the nursing profession and advocating transparency in health care, you will find Joe. He is kind of like the “Where’s Waldo” of health care in the Garden State. Not in your face, but always there.

Joe Vitale is committed to many of the initiatives we support at the Quality Institute such as the public release of health care information. He knows sunshine is the best disinfectant. Joe is passionate about health care, and, if necessary, he will take the political hits that come his way. He will leave the room with the best idea, even if that idea came from someone else. He cares less about who gets the credit and more about who will be helped.

I have walked out in the 19th Legislative District with Joe and his connection and compassion for people is deep and abiding.

In a legislature filled with degrees – especially law degrees – Joe lists his education as follows: John F. Kennedy High School. He is, shall we say, a regular Joe. But if he lacks formal education he does not lack for common sense and that thing called “street smarts.” And I’ve always wondered if his own background makes him especially connected to the struggles of every day New Jerseyans.

None of this, or course, should be construed as a slap against Loretta Weinberg, who did a more than admirable job as chair for the past two years.

But we just can’t help but cheer the return of Joe Vitale. We look forward to our continued relationship and to our efforts to work together to make health care in New Jersey safer and more accessible than ever before.

30 January 2012

 

NJ Senate Democrats

Measure Would Ensure Greater Patient Safety, Licensing and Inspection on Par with Larger Ambulatory Care Facilities

TRENTON – The Senate Health, Human Services and Senior Citizens Committee unanimously approved legislation today sponsored by the Committee’s Chairman, Senator Joseph F. Vitale that would require single-room surgical practices to conform to the same level of oversight and regulation reserved for facilities that have two or more surgical rooms in order to protect patients.

“This legislation is about patient health and safety,” said Senator Vitale (D-Middlesex). “As the practice of medicine advances and more and more procedures can be done on a same-day basis right in a physician’s office it’s imperative that we know care is being provided in a safe and sanitary environment.”

The bill, S-1210, would make changes to the law governing regulation and licensing of health care facilities in New Jersey. By bringing all health care facilities under the umbrella of licensure, the bill would ensure that single-room surgical practices which, under current law, are held to the same patient safety standards as surgical practices with two rooms.

“The NJ Health Care Quality Institute’s work to expose the inspection reports of 40 surprise CMS inspections last year should serve as a wake-up call that our current system of double standards in patient safety simply does not work,” said Senator Vitale. “When more than half of the single-room surgical centers inspected are found to be deficient and unsafe and seven of them are so unsafe they have to be temporarily closed, something needs to change. This bill creates an equal high standard of patient safety to ensure that, no matter where you access health care, basic patient safety and sanitary precautions are being followed.”

Read full article…

27 January 2012

 

We had a running joke in my family when our children were younger. I would return home from work and my sons would inquire about my day.

I would start to talk and my boys would stop me:

“Wait! Don’t tell us, Dad. Something new happened in health care today?”

Well, as a matter of fact something new inevitably did happen – in those days and still today. Is there a more dynamic, exasperating, challenging and exciting world than the world of health care? I live and breathe health care. I forever think about health care. My wife Diane says that the dreams that I forget about are probably about health care.

I travel the dense forest of impenetrable health policy tomes. I debate elements of health care reform, draw up hospital quality initiatives, and harangue our elected officials to envision their own lives without health insurance.

Several times each month I will write – in this space – about what I see as I trek from Trenton to Washington and back again in pursuit of health care quality for our state and nation. Sometimes you will get the inside scoop and learn something you did not already know. You will always get “my take.” I intend to release breaking health care news on this site. I think those who care about the world of health care will be interested, informed and, I hope, sometimes amused. If you are, tell me. Provide a comment. If you are not, tell me. Provide a comment. I want to have a dialogue with you. I expect to be just as interested in your thoughts as you are in mine.

For lengthy, carefully crafted White Papers turn to our website – www.njhcqi.org. You won’t get that here. On KnowltonKnotes, you get the first draft. You get my opinion – my cut-to-the-chase views on health care issues. Perhaps you will disagree, or decide to add your own perspective. I encourage the conversation. Social media gives us all a chance to connect as never before, and I would like to learn about your neck of the woods.

Our organization, impartial and non-partisan, works to improve patient safety and quality of care. We don’t work for hospitals, or government, or doctors, or nurses, or surgery centers or pharmaceutical companies. We work to make sure the voices of consumers are heard when important decisions are made. Our responsibility is to the patients who lie down on the surgery table, or unfurl their arms for injections, or take their pills – anyone who puts their trust in our medical system.

As we move forward in an ever-changing health care environment the quality institute works to give consumers a seat at the table. Sit down and join us.

27 January 2012

 

This past spring, the Quality Institute organized a seminar examining end-of-life issues in New Jersey, and our keynote speaker was Pauline Chen, the noted physician and New York Times writer who mesmerized us all with her heartfelt stories from the front lines of medicine.

At the end of the seminar, Don Sico, our public relations expert, videotaped an interview with Dr. Chen (available to members on our website) and asked her a simple question:

f you could reach a nationwide audience and say just one thing about end of life care, what would you say?

Dr. Chen was silent for a rather long and uncomfortable moment. As she thought deeply, Don began to think that he had caught her off guard and should have let her know the question ahead of time to give her time to prepare.

But what she said was something so important and so spontaneous that the awkwardness quickly disappeared. Dr. Chen said, “We owe it to those we love to be clear about our wishes for the end of our lives.” Dr. Chen offered up a simple, free, essential health care initiative to help all of us have the death we envision.

When we think of death, most of us do not envision a death in an ICU, perhaps on a respirator, surrounded by strangers and with a series of doctors coming around to prescribe futile interventions.

But in New Jersey that is exactly how many of us will die.

In New Jersey we will see more specialists, spend more days in the intensive care unit, and get more tests in the last six months of life than patients in any other state, according to the Dartmouth Atlas Study. It is a top ranking for which no other state envies us.

Yes, there is a monetary cost associated with this type of death – but the human cost is considerably higher.

Nobody wants to talk about death, and some doctors, trained to save lives, may see death as a failure of medicine and not as a natural course of life. Medicine and research continually raise our expectations of what our doctors can do to save us. What we need at the end is candor and honesty.

What are the repercussions of putting an elderly person in the last stages of Alzheimer’s Disease on a gastro-intestinal tube? Does putting a dying person on kidney dialysis change the course of an illness?

We need to ask questions and doctors need to give us honest answers..

These are emotional issues fraught with complications. I recall a friend with a life-threatening cancer, a brilliant physician. He said he wanted a bone marrow transplant that was experimental. There was no evidence that it would cure his disease. The intervention caused him great pain and, in the end, failed to save him.

But he had children and a family. He said he felt he had to try. Who wants to be the one to tell him he cannot?

Our seminar did not answer all the questions surrounding our efforts to improve end-of-life care in New Jersey. But we promoted a much-needed dialog. We agreed we need a better language to talk about death. Just what does it mean when the doctors asks, “Do you want us to do everything?” What does “everything” mean?

Hospice professionals are trained to help us through these difficult days. But in New Jersey we use hospice less than almost every other state in the nation. Perhaps we need to re-think hospice. Must hospice require a doctor to certify the patient will likely die in six months? Must we require that patients forego all curative treatments?
Perhaps some flexibility will allow more people to benefit from hospice, save us all money on futile, in-hospital care, and give more people the peaceful deaths they envision.

There are a lot of questions about end of life care … I hope we all begin asking them soon.

27 January 2012

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NJ Spotlight

An analysis of the inspection reports by the New Jersey Health Care Quality Institute found the rate of serious safety violations was significantly higher …

Health committee chairman cites urgency after inspections reveal safety issues

By Beth Fitzgerald

Sen. Joseph F. Vitale (D-Middlesex), chairman of the Senate’s health committee, is moving swiftly on a bill that would require all operating rooms to be licensed and inspected by the state Department of Health.

The measure was pocket-vetoed by Gov. Chris Christie earlier this month in part because it exempted one-room surgery practices from a tax that is levied on multi-room ambulatory surgery centers.

While it hasn’t yet been decided how to deal with the tax issue, the measure has broad support and carries a sense of urgency after inspections of single-room surgeries last year found serious safety violations.

“We realized there are safety issues in many of those facilities,” Vitale said. “We need to make sure that people who choose these facilities can be sure they’re inspected and properly licensed and they can rest assured that the facility is safe.”

Vitale said he will move the bill for a vote Monday by the Senate health committee. “Then we will go to work on the issue of whether or not the tax is ultimately necessary. We are still working on the issue but I want to move the legislation along to provide the necessary sense of urgency.”

Read full story…

21 January 2012

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The Star-Ledger

By Star-Ledger Editorial Board

Gov. Chris Christie ignored the findings of his own health department when he failed to sign a bill that would have placed more than 300 same-day surgery centers under state license and inspection. The governor’s pocket veto needlessly puts patients at risk by allowing same-day surgery centers to fly under the radar.

He knows better.

The state Department of Health and Senior Services conducted random inspections of 40 unlicensed surgical centers between August 2009 and February 2011, utilizing a federal grant. Inspectors found alarming deficiencies, including improper sterilization of equipment and failure to correct unsanitary conditions at more than a dozen centers. Other centers administered drugs after their expiration date, did not properly label syringes, split single-dose medications between several patients or discharged patients without a doctor’s exam.

Seven centers were temporarily shut down until the problems were corrected.

Read full article…

20 January 2012

njspotlight_300

NJ Spotlight

Inequity in taxes with ambulatory surgery centers hangs up health department oversight

By Beth Fitzgerald

A bill that would have placed single-room surgical practices under the same Department of Health licensing and inspection system as ambulatory surgery centers with two or more operating rooms has been pocket-vetoed by Gov. Chris Christie.

According to the Department of Health, because the bill exempted the single-room surgeries from a tax levied on ambulatory surgery centers, it conflicted with a federal rule that to qualify for federal matching funds from Medicaid, states must have uniform policies for taxing healthcare providers.

“The department recognizes the importance of consumer protections, but there were a number of concerns with this bill, including the fact that it would create new licensed facilities not subject to the same assessment as other licensed facilities, in contravention of the federal requirement that assessments be broad-based in order to qualify for federal matching funds,” said Donna Leusner, the health department’s spokeswoman.

Read full article…

20 January 2012

 

Insurancenewsnet.com

By Rowland, Dean
Proquest LLC
Most New Jersey companies of all sizes have begun doing at least some of their homework on how the 2014 health care reform law will impact employee health care insurance – or if they will provide coverage at all.

By all accounts, small businesses of 50 or fewer employees likely will undergo the most changes, with midsize and big companies of more than 200 workers opting to keep the status quo.

Currently, 1.3 million New Jerseyans are without health insurance. Of that number, about 900,000 will join the ranks of the insured by 2014, while another 400,000 residents are undocumented, said Dave Knowlton, CEO and president of the New Jersey Health Care Quality Institute.

“It’s a big deal,” he said of the expected surge.

Joel Cantor, director of Rutgers University’sCenter for State Health Policy, pegs the number of newly insured in a couple years at about 440,000, based on studies conducted by the center. He expects the percentage of uninsured, non- elderly New Jerseyans to drop from 14.5 percent to 8.6 percent by 2014.

The expected upswing of newly insured can be credited to one of the primary provisions of the 2014 Patient Protection and Affordable Care Act: Most Americans are required to get health care coverage, many with government subsidies if their income level qualifies. It also mandates that no one can be denied coverage because of a pre-existing medical condition, and also removes caps on coverage in most cases – provisions currently being reviewed by the U.S. Supreme Court.

“It’s advantageous for both the employer and the employee,” said Ray Castro, senior policy analyst with New Jersey Policy Perspective. “Most of the uninsured are already employed.”

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