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The Centers for Medicare & Medicaid Services (CMS) formed its no-pay policy based on the growing work of National Quality Forum (NQF)

The Centers for Medicare & Medicaid Services (CMS) formed its no-pay policy based on the growing work of National Quality Forum (NQF) of “never events.” Meaning, CMS will no longer pay for certain conditions that result from what might be termed poor practice or events that should never have occurred while a patient was under the care of a healthcare professional.

Discuss specific examples of “never events” and their impact in your workplace.
What issues are you considering for your clinical project and why?
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

Sample Answer

Never Events: A Catalyst for Quality Improvement

The Centers for Medicare & Medicaid Services (CMS) “no-pay” policy for “never events” signifies a significant shift in healthcare reimbursement. This policy, based on the work of the National Quality Forum (NQF), aims to incentivize hospitals to prioritize patient safety and eliminate preventable medical errors. Never events are serious, often catastrophic, medical errors that should never occur under any circumstances.

Examples of Never Events:

Wrong Site Surgery: Performing surgery on the wrong body part (e.g., operating on the wrong leg, removing the wrong organ).
Wrong Patient, Wrong Procedure: Performing a procedure on the wrong patient.
Foreign Body Retained in Patient After Surgery: Leaving surgical instruments, sponges, or other foreign objects inside a patient during surgery.

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Air Embolism: The accidental introduction of air into the bloodstream during medical procedures.
Patient Death or Serious Disability Associated with Medication Errors: Errors such as administering the wrong medication, administering the wrong dose, or administering medication to the wrong patient.
Pressure Ulcers (Stage III or IV): Developing severe pressure ulcers (bedsores) while the patient is under the care of a healthcare facility.
Falls and Trauma: Serious injuries resulting from falls within the healthcare facility.
Vascular Catheter-Associated Infections: Infections acquired from intravenous catheters.

Impact on Workplace:

The “no-pay” policy has significant implications for healthcare organizations.

Increased Financial Pressure: Hospitals face significant financial losses when never events occur, as they are not reimbursed for the associated costs.
Focus on Patient Safety: The policy incentivizes hospitals to prioritize patient safety and implement robust systems to prevent these events.
Improved Quality of Care: By eliminating preventable errors, hospitals can improve the quality of care and enhance patient outcomes.
Increased Accountability: Hospitals are held accountable for the safety and quality of care provided to their patients.

Clinical Project Considerations:

Given the focus on patient safety, my clinical project will investigate the implementation and effectiveness of a “Root Cause Analysis” (RCA) program within our healthcare facility. RCAs are systematic investigations conducted to identify the underlying factors that contributed to a medical error.

Rationale: RCAs are crucial for identifying system-level issues and implementing corrective actions to prevent future occurrences of never events. By analyzing the root causes of medical errors, we can learn from past mistakes and implement strategies to improve patient safety.

This project will involve:

Reviewing existing RCA protocols and procedures.
Analyzing past RCA reports to identify common themes and areas for improvement.
Developing and implementing strategies to improve the effectiveness of RCA investigations.
Educating healthcare providers on the importance of RCA and their role in the process.
Monitoring the impact of RCA interventions on patient safety outcomes.

By focusing on improving the RCA process, we can enhance patient safety, reduce the occurrence of never events, and ultimately improve the quality of care provided to our patients.

References:

Agency for Healthcare Research and Quality (AHRQ). (n.d.). Never Events. Retrieved from https://psnet.ahrq.gov/primer/never-events
The National Quality Forum. (n.d.). Never Events. Retrieved from

https://www.qualityforum.org/Home.aspx

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