Re: Brain damaged baby case (long)

From: Seele, Mona (Mseele@tmh.tmc.edu)
Wed Mar 29 11:31:46 2006


JCAHO and other regulatory bodies are the "kings of the kingdoms". Hospitals are herded by them in order to stay in business. There are sooooo many rules now that do not make sense to us on the front lines, but we are required to follow or face sanctions by those regulatory bodies. Mona Seele, RN, MSN, CNS ________________________________ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn=2Enet] On Behalf Of Henry=0D=0AGregor=0D=0ASent: Wednesday, = ____________________________ From: ob-gyn-l@obgyn.net [mailto:March 29, 2006 11:17 AM To: Multiple recipients of list OB-GYN-L

Subject: Re: Brain damaged baby case (long) Oh yes,,,, years ago, I was in a hospital that :"disappeared" letters critical of its processes, Docs that gave a crap about standards and process were quickly tagged disruptive and subjected to treatment worhthy of KGB techniques. Saddest thing was the willingness of the administration to devote dozens of administrative work hours to denial and coverup and whitewashing, as opposed to one or two simple corrective hours. Part of the process, I thought, then and now, involved for profit management contracts by a national firm, in a non profit institution. Though have seen similar issues in nonprofit with inhouse management. Hank Joe Cutchin <forcep@intercom.net> wrote: Lynn: I'll bet that most of us have similar stories. Hospitals are little kingdoms unto themselves ,supported by a national and state hospital associations ,made legit by JACHO,herd MD's with hy-laws that the hospital uses for its own purposes,etc. Oh my, here I am getting cynical. Joe C Lynn Montgomery, MD wrote: > Now I am not advocating suing physicians, but let me play the
devil's > advocate here based on my personal experience:
>
>
>
> -Current hospital setting without ANY quality assurance in the
OB > Section for eight years.
>
> -Two JCAHO inspections during that time and
> passed with flying colors.
>
> -Several previous hospitals with QA programs, but when
deficiencies > identified, no action is taken.
>
> -At least two instances where a significant problem was
identified with > patient management where the physician refused to respond to
any inquiry > on advice from his counsel - despite the supposed
confidentiality of > peer review. No action taken regarding the cases.
>
> -Two and now possibly three physicians with a literal stack of
charts > with untoward outcomes. QA recommendation that privileges be
suspended > pending additional training, etc, only to be laughed at by
hospital > counsel who state that we will all be sued and the suspension
will not > likely stand.
>
>
>
> So, given these issues, how are we supposed to accomplish
"Physician > police thy self". And if we cannot police ourselves, which we
have > apparently shown we can't; who is going to?
>
>
>
> It is easy to be critical of lawyers suing us, but I feel that
we bear a > good share of the responsibility by engendering a "good ole
boys club" > and rubber stamping our peer's practice patterns, whether
appropriate or > not - fearing that if we are critical of a peer's practice
patterns, we > may be next...
>
>
>
> I learned quality assurance from Bob Carpenter and Ray Kaufman
and have > been struggling my entire career to duplicate their approach,
only to be > met with frustration at every turn.
>
> Lynn
>
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