Medicare administrative contractor Noridian has updated its website with important information about patient order authentication requirements. With input from CHA, the site now reflects the current medical records condition of participation, which allows physician authentication orders to be signed by another practitioner who has responsibility for a patient, rather than only by the ordering physician.
Noridian previously published a response in one of its FAQ documents stating, “Orders may be accepted and put in writing by personnel authorized to do so by applicable State and Federal laws and regulations. The order must be countersigned and dated by the ordering physician within an acceptable timeframe.”
The statement now correctly reiterates, “All orders, including verbal orders, must be dated, timed, and authenticated promptly by the ordering practitioner or by another practitioner who is responsible for the care of the patient only if such a practitioner is acting in accordance with State law, including scope-of-practice laws, hospital policies, and medical staff bylaws, rules, and regulations.”
The Centers for Disease Control and Prevention (CDC) has released guidance for improving antibiotic prescribing in outpatient settings, focusing on commitment, action for policy and practice, tracking and reporting, and education and expertise. The guidance supplements previously released guidance and is intended for clinicians in primary care, outpatient specialty and subspecialty clinics, as well as emergency departments, nurse practitioners, physician assistants and health care systems. The CDC recommends implementing at least one policy aimed at improving antibiotic prescribing and encourages clinicians to educate patients on appropriate antibiotic use.
The California Public Protection and Physician Health, Inc. (CPPPH), in collaboration with several other stakeholder groups, is seeking review and comment on recently published draft guidelines for medical staff and groups. Titled Behaviors that Undermine a Culture of Safety — Policies and Procedures for Medical Staffs and Medical Groups, the guidelines are intended to assist in identifying policies and procedures that support professional behavior, as well as maintaining a culture of safety and professionalism within medical staff and the medical centers. CPPPH asks that those interested in reviewing the document send their comments by Dec. 5 to email@example.com.
Last month, the National Quality Forum (NQF) launched the Medicaid Innovation Accelerator Project, which will identify and recommend a set of Medicaid-relevant performance measures, measure concepts, or measures under development to the Medicaid Innovation Accelerator Program (IAP). The IAP targets four main program areas: reducing substance use disorders; improving care for Medicaid beneficiaries with complex care needs and high costs; promoting community integration for beneficiaries using long-term services and supports; and integration of physical and mental health.
The Centers for Disease Control and Prevention (CDC) today announced that Stӧckert 3T Heater-Cooler devices manufactured by LivaNova PLC (formerly Sorin Group Deutschland GmbH) may have been contaminated with Mycobacterium chimaera (M. chimaera) in the manufacturing process, and that patients for whom these devices were used during cardiac surgery may be at risk of developing infections. As reported previously in CHA News, M. chimaerahas been the subject of an ongoing investigation by the California Department of Public Health.
CDC advises providers to alert patients who have had open heart surgery involving one of these devices, and has released a toolkit to assist hospitals in their outreach, including a sample notification letter, a letter for clinicians and a questions-and-answers document. Also today, the Food and Drug Administration issued a Safety Communication providing further recommendations for providers.
The California State Board of Pharmacy has finalized regulations governing the preparation of compounded drugs by pharmacies, culminating a major effort to strengthen the oversight and enforcement of pharmacies that produce or ship compounded drug products. The new regulations have been approved by the Office of Administrative Law and will take effect on Jan. 1, 2017.
The comprehensive changes to regulations cover a broad range of topics related to general drug compounding, including requirements for recordkeeping, labeling, policies and procedures, maintaining facilities and equipment, staff training and quality assurance. The regulations have also been amended to expand sterile compounding requirements to drug products that are produced for administration by inhalation or into the eye as well as by injection. CHA’s sterile compounding web page includes several tools that hospitals might find helpful in planning to comply with the new regulations. The full text of the final requirements is available on the Board of Pharmacy website.
The Centers for Medicare & Medicaid Services (CMS) issued the attached survey and certification memo in May, clarifying requirements for providing services to justice-involved individuals in skilled-nursing facilities, nursing facilities, hospitals, psychiatric hospitals, critical access hospitals and intermediate care facilities for individuals with intellectual disabilities. CHA has reviewed the memo and is seeking information on how these changes might affect member organizations, as well as non-compliance citations that might be issued. More information, when available, will be shared with members through CHA News.
In response to the 2012 New England Compounding Center tragedy — where contaminated injections led to 64 deaths and hundreds of illnesses nationwide — federal and state laws have been reexamined to provide increased oversight and better safeguards for compounded pharmaceuticals. To meet the new federal and state requirements, CHA urges hospital leaders and pharmacists in charge (PICs) to review the new regulations immediately, perform a gap analysis and develop a plan to meet federal and state requirements.
The California Department of Public Health — in consultation with the California Conference of Local Health Officers — has updated the list of diseases that health care professionals and laboratories must report to their local health departments within a specified time frame, as required by the California Code of Regulations Title 17, Division 1, Chapter 4, Subchapter 1, Article 1, Section 2500 (reporting from providers to local health departments) and Section 2505 (reporting from laboratories to local health departments). The changes, effective May 24, are summarized below.
On May 13, the Centers for Disease Control and Prevention (CDC) issued interim guidance that recommends diagnosing Zika virus via real-time reverse transcription–polymerase chain reaction, a highly specific method that can be performed rapidly. Based on new data, CDC recommends testing urine collected less than 14 days after symptom onset, along with patient-matched serum samples collected less than seven days after symptom onset. CDC will continue to review and update guidance for Zika virus testing as new data becomes available.
The Clinical Infectious Disease journal has published guidelines for implementing an antibiotic stewardship program, authored by the Infectious Disease Association of America and the Society for Healthcare Epidemiology of America. Developed by a multidisciplinary expert panel including clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties, the guidelines address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics.
The U.S. Food and Drug Administration (FDA) last week issued an emergency use authorization for a Zika virus diagnostic tool that will be distributed to qualified laboratories. The Centers for Disease Control and Prevention (CDC) will begin distributing the test during the next two weeks to qualified laboratories in the Laboratory Response Network; the test will not be available in U.S. hospitals or other primary care settings. The tool — Trioplex Real-time RT-PCR Assay — allows doctors to tell if an individual is currently infected with chikungunya, dengue, or Zika using one test, instead of having to perform three separate tests to determine which infection a patient might have. More information is available on the CDC website.
The Center for Disease Control and Prevention (CDC) this week issued guidance recommending standard health care precautions – including the use of personal protective equipment (PPE) – in all health care settings to prevent potential spreading of Zika virus. The guidance notes the precautions should be in place at all times, regardless of whether infection has been confirmed, because individuals infected with the virus are often asymptomatic. The guidance also details standard precautions and other prevention strategies specific to labor and delivery settings. Based on the premise that all body fluids might contain transmissible infectious agents, the standard precautions include hand hygiene, use of PPE, respiratory hygiene and cough etiquette, safe injection practices and safe handling of potentially contaminated equipment or surfaces. Additionally, CDC directs health care providers to use soap and water or alcohol-based products before and after a patient contact and after removing PPE, including gloves.
The Centers for Medicare & Medicaid services will host a Dec. 14 webinar on the Hospital Value-Based Purchasing (VBP) program, addressing surgical site infection rates for colon surgeries and abdominal hysterectomies within the Hospital VBP program. The webinar will include health care-associated infection standard population updates from the Centers for Disease Control & Prevention and methods to improve surgical site infection standardized infection ratios. Webinar slides will be available for download from www.qualityreportingcenter.com under “Upcoming Events” the day before the presentation. Registration is available online.
You’ve received a licensing violation. You may have been expecting it from a recent survey, or it may have come as a complete surprise. One thing is for certain, survey activity — and subsequent violations — will be more common now that California Department of Public Health (CDPH) has issued new regulations for hospital penalties, including non-immediate jeopardy violations.
The CHA Joint Committee on Accreditation & Licensing is currently accepting new member applications. The committee, which meets quarterly in Sacramento, addresses hospital accreditation, regulatory and licensing issues and makes policy recommendations to the CHA Board of Trustees. To be eligible to serve on the committee, individuals must be employed with a CHA member hospital and serve as liaison for accreditation and licensing issues at their facility. To apply, send a biography to Lori Woolsey at firstname.lastname@example.org by April 4.