Anesthesiologists underreporting medical errors: 5 insights

Anesthesiology News reported on a study examining Ann Arbor-based University of Michigan’s medical error reporting rates among anesthesiologists.

University of Michigan Assistant Professor Mark Hausman, MD, and colleagues used self-reported institutional quality assurance data from the Multicenter Perioperative Outcomes Group from July 2006 to November 2015 and searching for medication error incidents. The researchers used University of Michigan Health System data.

Here’s what you should know.

1. Researchers found 238 instances of self-reported medication errors out of 434,554 cases; a rate of 5.5 self-reported medication errors per 10,000 cases.

2. Antibiotics and opioids were the most common drugs involved in medication errors. Half of reported errors were IV boluses.

3. Concerning severity, 9.7 percent caused temporary harm. Adverse outcomes included mechanical ventilation in the PACU, unplanned admission or escalation of care, unplanned intubation or case cancellation or delay.

4. Dr. Hausman said to AN, the reported medical error rate is too low for more than nine years of data.

5. Dr. Hausman said the results show anesthesiologists “grossly” under report medical errors at University of Michigan.

Researchers concluded, “These results demonstrate that there is significant room for improvement when it comes to self-reporting of medication errors among health care providers.”

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Dr. Robert Johnstone: Excessive anesthesia guidelines a disservice for providers: 5 insights

Robert Johnstone, MD, penned a column for Pain Medicine News on the excess of anesthesia practice guidelines.

Here’s what you should know.

1. Dr. Johnstone said the recent rash in issued guidelines stems from medical societies vying for members and attention.

Dr. Johnstone said that he would ignore contradicting guidelines, but noted lawyers cite guidelines as practice standards in malpractice suits, leaving anesthesiologists viable.

2. The Society of Anesthesia and Sleep Medicine issued one such contradictory guideline. The society recommends patients wear their positive airway pressure device at appropriate times in hospitals, both pre- and postoperatively. However, Emergency Care Research Institute guidelines recommend hospitals prohibit the use of patient-owned medical equipment after several deaths.

3. Dr. Johnstone claims if an anesthesiologist attempted to read every operating room practice standard for eights hours a day, five days a week, it would take more than 2,000 years to read them all.

4. Dr. Johnstone said conflicts of interest could also affect guideline-writing groups.

5. Dr. Johnstone recommends eliminating ineffective guidelines, leaving only the clinically proven ones to free up industry clot.

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SurveyVitals recognizes Cedar Orthopaedic Surgery Center, Cedar Anesthesia Group as top performing organizations: 3 key notes

Boise, Idaho-based SurveyVitals recognized Cedar Orthopaedic Surgery Center and Cedar Anesthesia Group among the top performing anesthesia organizations across the country in 2016, Iron County Today reports. Both businesses are in Cedar City, Idaho.

Here’s what you should know.

1. SurveyVitals collects patient feedback via text message, email or interactive voice response calls. It used composite mean scores from more than 1 million anesthesia patient satisfaction surveys to recognize the top 10 percent of healthcare organizations.

2. SurveyVitals President Bob Vosburgh said the company believes the providers have “done right by their patients” and deserve recognition.

3. Surgery Center Medical Director Randy Delcore said the award was “more of an affirmation than an honor.” He said to Iron County Today, “When you put an awesome surgical team together with an awesome anesthesia group, patients can expect a very high level of personal satisfaction.”

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Forest Park Medical Center anesthesiologist pleads guilty to $40M kickback scheme: 8 things to know

Dallas-based Forest Park Medical Center founder and anesthesiologist Richard F. Toussaint, MD, pled guilty to a count of conspiracy to pay healthcare bribes and kickbacks and a count of offering or paying illegal remuneration and aiding and abetting under the Travel Act on March 17, 2017, according to a press release from The United State’s Attorney Office of the Northern District of Texas. The Travel Act prohibits the use of U.S. mail, interstate or foreign travel for criminal acts.

Dr. Toussaint faces up to five years in prison and a $250,000 fine for each count. The court will sentence him at a later date.

Co-defendants Andrea Kay Smith, Kelly Wade Loter and Israel Ortiz also pled guilty to their roles in the case. Seventeen other defendants will undergo a trial scheduled for July 10, 2017. Those pending trial will remain unnamed.

According to court documents,

1. Dr. Toussaint met with a co-defendant in 2003 and began providing anesthesia services for the man in 2005. Dr. Toussaint and the man decided to form the physician-owned hospital, Forest Park Medical Center, in 2008.

2. The center targeted bariatric and spinal surgeons for monetary reasons. The center stayed out-of-network to collect higher reimbursement rates.

3. Dr. Toussaint and FPMC’s other founder as well as several co-defendants said they were aware of an arrangement where the center would pay surgeons “marketing checks” for performing procedures there. They paid approximately $40 million from 2009 to 2013.

4. A co-defendant allegedly kept tabs on the procedure amounts each surgeon brought to the center and used a metric to calculate surgeon payments on their anticipated case loads. Dr. Toussaint was copied on emails discussing how much the center paid certain surgeons.

5. Dr. Toussaint and FPMC waived coinsurance or reduced it to in-network levels to attract more patients. Dr. Toussaint misrepresented the practice to payers so they accepted the center’s reimbursement claims. FPMC guaranteed patients they would either not pay, or pay only an in-network equivalent.

6. Dr. Toussaint and a co-defendant owned a commercial real estate company they used to funnel bribes and kickback payments through.

7. Dr. Toussaint and FPMC paid kickbacks to chiropractors to refer their patients to the clinic.

8. Dr. Toussaint and FPMC also offered surgeons stock options in the center to attract more referrals. According to court documents, “the more surgeries a surgeon could bring to FPMC, the more they were allowed to invest and profit from the hospital’s billings.” Dr. Toussaint helped decide how many shares a surgeon could invest. If a surgeon cutback on his cases, FPMC divested or cut his shares.

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