Risk manager: New policy just recognizes reality
For Cathy Sampson, CPHRM, manager of risk management for North Memorial Healthcare in Robbinsdale, MN, the new state policy concerning non-billing for never events is no big deal. In fact, her hospital has been practicing such a policy for years.
"We have not been billing for the never events and we have also done as much as possible for other types of events," she says. "Adverse health care events are pretty much related to some significant harm, but there may be situations where harm has not been that great but it may be a good idea from patients' perspectives [that they not be billed] for care provided."
So, for example, a patient may need to go to a higher level of care for more intensive monitoring and doesn't, but there is no untoward outcome — or even any real effect on the patient's condition.
As for the state's new policies, "I think it's appropriate because we've been doing something similar in varying stages for probably 20 years — but it's never been structured in a guideline format. It helps with consistency and continuity and also helps because other people in the facility are aware of the process; in other words, you are not leaving it in the hands of one person to remember that this is what you want to do," she says.
Sampson says her hospital is not unique in its approach. "I can only speak to the facilities I usually have contact with in the Twin Cities metro areas, or some bigger facilities outside the area, but I would say that with those I've spoken to, they have primarily done the same as we have with some variation," she observes.
How is reporting handled within her facility? "When I am made aware of an event I believe meets the criteria, then I advise our business office to put the account on hold," Sampson says. "We also have a nurse auditor — she reviews the medical records and is pretty much able to identify what care was required as the result of an event."
[For more information, contact:
Cathy Sampson, CPHRM, Manager of Risk Management, North Memorial Healthcare, 3300 Oakdale Ave. N., Robbinsdale, MN 55422. Phone: (763) 520-5200.]