Medicare Penalties on Hospitals Reinforce PULSE of NY Message on Public Involvement in Patient Safety

Medicare penalties on payments to hospitals with poor patient safety highlight the problem. Family involvement in promoting best practices is part of the solution.

Several Long Island hospitals made the news recently when the Centers for Medicare and Medicaid imposed penalty reductions in the payments they make to hospitals with high rates of preventable infections and complications. Medicare is now penalizing hospitals based on the quality of care patients receive. 721 hospitals nationwide were penalized in this way.

Payments will be reduced by 1% based on central-line associated bloodstream infections, catheter-associated urinary tract infections, or complications based on injuries such as falls and bedsores. For some hospitals the 1% reduction can mean millions of dollars lost.

Training family and friends to help a chronically ill patient, training volunteers as PULSE of NY does, or even paying a professional patient safety advocate to stay with the patient can reduce costs and injuries.

Ilene Corina, President, PULSE of NY

According to Ilene Corina, president of patient safety group PULSE of NY, one way to reduce the rate of injury and infections is to get the public — the families and friends of hospital patients — much more involved in the whole process of care.

 “We have known for years that patient safety is a problem,” says Corina. “Just look at organizations such as The National Patient Safety Foundation, Institute for Healthcare Improvement or The Joint Commission, all of which are working on it. But the public needs to be told what to do about the problems, not just that there are problems.”

Each of these Hospital Acquired Conditions (HACs) happens at the bedside. But discussions about how to fix them are happening far away, in administrative offices or the boardroom.  Involving the public — patients and their families — in the reduction of medical injury is the way to improve care.

Get the Public Involved

According to PULSE, perfectly good, free resources aren’t being utilized at the patient’s bedside. The family and loved ones of a patient usually want to help but don’t know what to do. An adult child sitting at a parent’s bedside is perfectly capable of reminding staff that mom or dad has not been moved in hours, which can lead to bedsores. They may even learn proper care for a patient while hospitalized, such as how to help avoid falls and infections.

Telling a healthcare professional to wash his or her hands is not easy. But encouraging reminders from family may help. If all staff members who treat a patient realize that they may forget, infections can be reduced.

PULSE of NY encourages compassion in the conversation when addressing medical professionals about patient safety. “Be assertive but respectful,” advises PULSE’s Corina. “Saying ‘I’m sure you washed already but I would feel better if you did it in front of me,’ can put everyone at ease.”  

She also encourages the public to use these news reports of hospital penalties as tools to open discussions about a patient’s safety. The bedside staff may not see these reports so patients are encouraged to let them know about their concerns. 

Families’ Unique Knowledge

Family and friends need to apply their unique knowledge of the patient. A patient who is at risk of falling at home is even more at risk when hospitalized. Encouraging a family member to get out of bed may actually cause more harm than good. Raised bedside rails may cause injury if a patient tries to climb over them.  So family should never assume that bedrails are there to avoid falls. There are other alternatives to avoiding falls. That conversation needs to happen between the patient, family, and care team.

“Training family and friends to help a chronically ill patient, training volunteers as PULSE of NY does, or even paying a professional patient safety advocate to stay with the patient can reduce costs and injuries,” Corina says. “But I hope people don’t use this information to let down their guard – even the ‘best’ hospitals have injuries and infections.”

Ilene Corina is the President of PULSE of NY an independent community based patient safety organization founded in 1996 to educate and advocate for safe patient care.