Facility e-Newsletter Header
A publication produced by COPIC
Facility Patient Safety & Risk Management
"The single biggest problem in communication is the illusion that it has taken place."
--George Bernard Shaw, Irish Writer  
In This Issue
COPIC Quick Links
Emergency Department Presentations in Other Hospital Locations?
The Sticky Issue of Pasted EHR Notes
Legislative Update
Online Loss Runs
New from ECRI: Free Webinars!
Pennsylvania Patient Safety Advisory
Institute for Safe Medication Practices
News and Tools
Contact Us
 
Risk Management
24/7 Hotline:
(720) 858-6270 or
(800) 421-1834, ext. 6270
Save the Date!
Plan to attend the COPIC Patient
Safety & Risk Management Forum in 2014!  
October 8th, 9th, & 10th
Upcoming Educational Conferences
Colorado
CASCA Conference
April 9-11, 2014
Embassy Suites Hotel
Denver, CO

Rural Health Clinics Forum
April 9-11, 2014
Sheraton Denver West
Lakewood, CO
  
CHA 37th Annual Rural Hospital Conference
April 23-25, 2014
Cheyenne Mtn. Resort
Colorado Springs, CO
  
Nebraska
COPIC Nebraska Risk Management Symposium
(Registration Closed)
April 17-18, 2014
Embassy Suites Hotel
Lincoln, NE

NHA Mid-Year Meeting
May 21-23, 2014
Younes Conference Center
Kearney, NE
COPIC Quick Links

Visit COPIC's Facility Services page on our website! View archived newsletters, prior year's Forum presentations and more by clicking here

 

Utilize COPIC's on-demand educational courses. 

No travel necessary! Take courses from your home or office computer and apply for CMEs, CNEs and/or COPIC points when available. Visit the Education Courses and Seminars page on our website for the most current offerings.


If you need to obtain a username and password for the COPIC website, please contact Kelsey Gifford.


If you have further questions on how to access the on-demand courses, please contact

Sunny Hessler.

 

COPIC Newsletters: All of COPIC's newsletters, including the Colorado and Nebraska Copiscope, are archived on our website. Click here for our newsletter archive.

Regulatory News
CMS Proposed Regulations for Emergency Preparedness 12-27-13
  
  
Medicare Telehealth Information
Free E-Newsletters
Sign up for these free e-newsletters to have the latest news, tools and resources
emailed to you weekly!
   

Becker's ASC Review

 

  
Infection Control Resources 

ASGE's New Endoscopy Safety Guidelines


Novant Health FREE Hand Hygiene Tools & Posters

 

ASC Quality Collaboration FREE Pre Survey Hand Hygiene Test Checklist

 

Partnering to Heal: Teaming Up to Prevent Healthcare-Associated Infections: An interactive, computer-based training for health professionals and students on preventing HAIs

Information Technology Resources 

HealthIT.gov Safer Guides: The SAFER Guides are a suite of tools for healthcare organizations to self assess the safety of EHRs
  
HealthLeader's Media: Don't Overlook Fraud in EHRs, Office of Inspector General (OIG) Cautions CMS
  
OIG Fraud Safeguards in EHRs Podcast
 
High Five!

Congratulations to Dr. Gloria Beam of Alpine Surgery Center in Gunnison, CO for serving as the Chief Medical Officer of the 2014 U.S. Winter Olympics Team.

 

Congratulations to Community Hospital in Grand Junction, CO for being recognized by Hospital Compare as achieving a 7-minute or less Door-to-Diagnosis ED Wait Time.

 

Congratulations to Poudre Valley Hospital, CO for being named one of Healthgrades 2014 Top 5% of U.S. Hospitals.

 

Congratulations to Box Butte General Hospital, Alliance, NE for being recognized by iVantage Health Analytics as a Health-Strong Award winner for Excellence in Outcomes and Overall Excellence reflecting top quartile performance among all acute care hospitals in the nation.

 

Congratulations to Pioneer Medical Center in Meeker, CO for being recognized for their outstanding leadership in rural health care when they were named the first 2014 "member of the month" by the CO Rural Health Center.

 

Congratulations to Valley View Hospital, Glenwood Springs, CO for being named one of Truven Health Analytics Top 100 hospitals in the nation.

 

Congratulations to Craig Hospital who received the American Nursing Association's top honor in the category of rehabilitation for the third time in four years!

Have You Heard About the Agency for Healthcare Research and Quality (AHRQ)?
The AHRQ is a sector of the U.S. Health and Human Services branch that is home to the National Guideline Clearing House resource and many others. This is a public site and houses a wealth of health care resources.
  
Please take a few moments to access this link and become familiar with the content. Many of the "News and Tools" links are AHRQ resources. You can also sign up for a free electronic newsletter.
COPIC Better Medicine, Better Lives
  April 2014

What Happens When Common Emergency Department Presentations Occur in Other Hospital Locations?

We are used to certain situations that typically present to the emergency department (ED), but what happens when those situations take place in other locations in the hospital facility? We examine several situations that are commonly treated in the ED, but might warrant special considerations when they occur elsewhere.

  1. Forensic Cases
    Cases of alleged rape require a chain of custody, involvement of law enforcement, special attention to confidentiality of what can and cannot be shared with law enforcement, protection and specially trained examinations, generally done by a certified SANE provider. One should consider either involving emergency department personnel directly or moving the patient to the ED when such allegations occur. Other cases that could involve the need for a strict protocol, involvement of law enforcement and potential chain of custody issues include allegations of domestic violence, non-accidental child trauma, or apparent assault of health care workers in the facility.
  2. Trauma
    Patients who suffer trauma while in the facility, but not in the ED, might benefit from the multiple caregivers and resources available in the ED. All facilities have different resources, some ICUs, ORs and rapid response teams have the ability to evaluate and treat trauma effectively, while others might have limited resources and experience and should consider simply transferring the patient to the ED.
  3. Stroke
    A recent study1 showed that the morbidity and mortality of acute stroke was worse in the hospital than that which was suffered out of the hospital and presented to the ED. There were certainly many factors in the study to account for, but one could question whether the higher resources, experience and timeliness of necessary imaging, labs and pharmacy available in the ED were a factor.

In short, consider all the different resources available at the facility to determine the best location to provide treatment. A ready protocol, rapid response teams, simulation drills and other training can improve the care and timely treatment of these patients in locations that are not as accustomed to the types of situations outlined above.

                                                                          

1E Cumbler et. al., "Quality of Care and Outcomes for In-Hospital Ischemic Stroke: Findings From the National Get With The Guidelines-Stroke", Stroke, Published Online November 19, 2013.

Tips from an Expert:
The Sticky Issue of Pasted EHR Notes
Michael Victoroff, M.D., consultant to COPIC's Patient Safety and Risk Management department addresses the issue of using "Copy & Paste" in an EHR.

The burden of clinical documentation is being felt throughout health care. Among the tricks to make note taking faster in EHRs, "Copy & Paste" is one of the most widely used. Almost every EHR allows a user to copy a block of information from one location and insert it into another. Both residents and attending physicians commonly paste material from their own or others' notes into records they author.1

 

Typically, pasted information is unstructured text, but might also be a graph, chart, list or image--even a multimedia clip. As every word-processing user knows, this functionality is extremely valuable. It faithfully copies the original (ignoring potential formatting changes), saving time and avoiding transcription errors. There are occasions when pasted information greatly improves efficiency and accuracy. Discharge summaries, for example, commonly contain medication orders pasted from the last progress note.

 

However, this technique has hazards that can degrade the quality of medical documentation and invite error and liability. Creating inaccurate records potentially generates a cascade of harmful effects. There is a strong expectation on the part of the public (although less on the part of EHR-wise clinicians) that providers take the same care in writing their notes as they do in treating their patients.

 

For further information regarding the use of copy and paste and EHRs, including four particular dangers of pasted notes and tips for policy creation, CLICK HERE for the full article.

                                                                          

1EHRs: "Sloppy and Paste" Endures Despite Patient Safety Risk, amednews.com, February 4, 2013

Legislative Update
COPIC has long believed that taking an active role in following and advocating on legislative issues is an important way to keep medical liability rates appropriate. This approach allows the health care community to devote its resources to quality improvement and patient care.


It is for this reason that COPIC continuously monitors legislation to make sure that new burdens and duties are not placed on health care providers. COPIC works closely with our partners to ensure that no additional barriers to the delivery of care are created. Bills COPIC is currently following include:


FEDERAL:

HR-4302 Protecting Access to Medicare Act of 2014 (Pitts, PA)

  • Current Status: Signed by President on April 1, 2014.
  • Bill summary: The bill enacted another one year "patch" for Medicare's Sustainable Growth Rate (SGR) formula, delayed implementation of the ICD-10 code sets until October 1, 2015 and postponed the realization of a statute that allows a Medicaid program to claim all funds received by a Medicaid beneficiary as part of a liability settlement for two years.

HB-4106 Saving Lives, Saving Costs Act (Bera, CA/Barr, KY)

  • Current Status: The bill was introduced in the House in late February and is being considered in committees of jurisdiction.
  • Bill Summary: The bill attempts to develop and disseminate clinical practice guidelines and establish a right of removal to Federal courts for defendants in medical malpractice actions involving a Federal payor.

COLORADO:

HB14-1186 Release of Medical Records To Third Parties And Fees (Schafer/Aguilar)

  • Current status: The bill has been sent to the Governor.
  • Bill summary: This bill attempts to clarify that medical records in the custody of a health care facility or an individual health care provider may be released to a third party with a HIPAA-compliant authorization, valid subpoena or court order. The bill requires the facility or provider to deliver the medical records in electronic format if requested and if there is no additional cost to the facility or provider. The bill defines what reasonable fees may be charged for the copies of the medical records.

HB14-1283 Modify Prescription Drug Monitoring Program (McCann/Newell/Kefalas)

  • Current status: The bill is in the Senate for consideration.
  • Bill summary: The bill attempts to creates a mandate to register with the PDMP system for all providers with DEA registrations and opens up access to the PDMP system to individuals working with physicians in order to input medications prescribed to patients.

NEBRASKA:

LB961 Change the Amount Recoverable Under the Nebraska Hospital-Medical Liability Act (Cook)

  • Current status: The bill is up for final reading.
  • Bill summary: The bill, among other things, attempts to change the amount recoverable under the Nebraska Hospital-Medical Liability Act to $2.25 million for any occurrence after December 31, 2014.

As always, COPIC will continue to keep you aware of specific legislative priorities involving health care and alert you so you can be informed and get involved. You can always find the latest information by visiting COPIC's Legislative Action Center. When you're on the Legislative Action Center, scroll to the bottom of the page and make sure you are signed up for the Action E-List. By doing so, you will get emails when important issues arise and have an opportunity to make your voice heard to help educate legislators.

News from COPIC
Did you know hospital and facility loss run information can be retrieved from COPIC's online Service Center?
In the last 12 months, COPIC has been busy enhancing our website to make information available when you need it. Follow these steps to pull a loss run report for your insured facility or hospital:
  1. Visit callcopic.com, click the Service Center button at the top right corner of COPIC's homepage, and enter your appropriate username and password. (Access to your hospital/facility's account in the Service Center requires the Policyholder's login information*.)
  2. Once logged in to the Service Center, click the "Loss Runs" tab in the navigation menu located along the right side of the screen.
  3. Enter the policy number and click "Generate Report." Use the available fields, defined below, to filter information and generate a specialized report.

Terminology Definitions

  • Loss date: the date the incident occurred
  • Report date: the date the incident was reported to COPIC
  • Policy number: the policy number associated with the facility
  • Claim status: Allows filtering of open and closed claims
  • Report type: Filters a report to include or exclude claimant name 

*Login Types

Please note, only policyholder login profiles may access a facility's Service Center account. COPIC provides proprietary information on our website which is also password protected. Other login profiles may be provided to additional contacts at the facility for individual use of online courses and secure medical guidelines and tools. These supplemental login profiles will not provide access to the Service Center.

 

Continued Improvements

We hope the tools and resources on our website are helpful to you, and we're continuously working to enhance your Service Center experience. Scheduled to launch in 2015, we will implement a tiered authorization system where policyholders will be able to grant access to the Service Center to other individuals in the organization as they
deem appropriate.

 

If you need assistance regarding login information, or do not have a username or password, please contact your underwriter. For questions regarding loss runs, please contact Demetrius Jacobs at (720) 858-6146.

New from ECRI: Free Webinar Series
ECRI now offers a new webinar series for members of its Healthcare Risk Control (HRC) program.
There is no additional cost for members to attend an HRC webinar. You will need your ECRI username and password to register.

While visiting ECRI's website, check out the January/February newsletters. Topics include safe patient handling and movement, clinical alarms, occasional exposure to blood or body fluids, pediatric care in the ER, and much more! Visit ECRI's website for more information.
Pennsylvania Patient Safety Advisory 

The March 2014 issue of the Pennsylvania Patient Safety Advisory (PPSA) contains the following articles:

  • Reviews and Analysis
    --Aligning the Lines: An Analysis of IV Line Errors
    --The Use of Patient Sitters to Reduce Falls: Best Practices
    --Preoperative Screening and the Influence on
       Cancellations and Transfers: An Ambulatory Surgical
       Facility Collaboration
  • Focus on Infection Prevention
    --Peripheral Vascular Catheter-Related Infection:
       Dwelling on Dwell Time
Read the March 2014 issue here.
Institute for Safe Medication Practices (ISMP) 
In Case You Didn't Know:
The Nurse Advise-ERR Newsletter is being offered FREE to acute care hospitals, behavioral health facilities, community health clinics, surgical centers and birthing centers, as well as faculty at academic settings.

Please refer to the ISMP website for more information on signing up for your free newsletter. This newsletter is a great resource reference when creating policies, so check it out! Recent newsletters include the following:

  • December 2013: As U-500 Insulin Safety Concerns Mount, It's Time to Rethink Safe Use of Strengths Above U-100
  • January 2014: 2014-2015 Targeted Medication Safety Best Practices for Hospitals
  • February 2014: Mistaken Identity: Will the Real EPINEPHrine Please Step Forward 
News and Tools
Thank you for your commitment to patient safety and improving the practice of medicine. Always feel free to contact COPIC with any questions you may have about Patient Safety and Risk Management services.
  
Sincerely,

Carol Anne Tarrant, RN, MS, JD, CPHRM

Director, Facility Patient Safety and Risk Management

Phone: 720-858-6000//Toll Free: 800-421-1834