AllMed Webinar Shares Insights With Hospitals On How To Improve Quality And Patient Care In Cardiovascular Programs
Cardiology programs continue to undergo intense scrutiny, with hospitals now being forced to demonstrate that patients meet strict medical necessity criteria and guidelines. During a recent AllMed, Dr. Roger Osborn, a board-certified cardiologist, discussed issues related to improving quality of care for patients undergoing diagnostic and interventional cardiology procedures. "One of the reasons that cardiac procedures are being targeted for scrutiny," said Dr. Osborn, "is that the average length of stay for cardiology procedures, especially interventional procedures, has gradually decreased, leading auditors to believe that they can routinely be performed in an outpatient setting."
Identifying and correcting overutilization and/or substandard physician performance issues before they spiral out of control can help hospitals minimize malpractice and litigation costs. As a number of recent high-profile cases have shown, the consequences of retaining or contracting incompetent providers include potential legal liability for any injuries to patients, exclusions from federal and state health benefit program participation, loss of commercial contracts, and loss of accreditation by healthcare standards organizations. Dr. Osborn pointed out that some hospitals have paid millions of dollars in fines without admitting any liability in order to avoid the expense and uncertainty of litigation and to allow the hospital to move forward.
Although national databases and appropriate use criteria help hospitals to measure, evaluate, and improve performance, optimizing patient care remains difficult. According to Dr. Osborn, there are many reasons for this, including the continual introduction of new devices and the barrage of data on novel strategies both from clinical trials and large registries. Advances in diagnostic and interventional cardiology have led to an increase in the utilization of various procedures and devices. Risk management professionals must identify and evaluate initiatives for quality improvement so that these options can effectively and safely be used in clinical care.
"As hospitals continue to face pressure to demonstrate that invasive and expensive interventional cardiology procedures result in improved outcomes for patients," said Dr. Osborn, "ongoing external peer review can be used to supplement hospitals' internal review processes." Outsourcing peer review to an unbiased third party, not only tackles issues such as conflicts of interest and timeliness, but also ensures that physician performance is objectively evaluated, and gives hospitals the means to tighten clinical criteria and provide additional training to physicians.