Morton Plant Hospital, a 742-bed facility in Clearwater, Fla., briefly found itself at the center of the legal war over Terri Schiavo.
During the week of March 20, "there were multiple times that we were advised by multiple sources" that Schiavo would be transferred from a Pinellas Park, Fla., hospice to Morton Plant, says Beth Hardy, the hospital's spokeswoman. The transfer was to be at the behest of Florida Gov. Jeb Bush, who was looking to take advantage of an exception in a state law that allows public agencies to freeze a judge's order whenever an agency appeals it.
Bush wanted the hospital to be able to restore a feeding tube in Schiavo while legal appeals continued.
Hardy says the hospital formally asked Circuit Court Judge George Greer, who had issued the order removing the feeding tube, what it should do amid conflicting legal orders. The judge then issued another ruling forbidding the transfer.
Calling Dr. Frist
Senate Majority Leader Bill Frist (R-Tenn.) won kudos from some quarters and Bronx cheers from others for his role in stepping into the Schiavo affair, saying her medical situation could be reversed with aggressive treatment. Now he is reaping more unwanted attention for his intervention.
Last week, the senator's office was bombarded with e-mails from patients seeking one of his "long-distance prescriptions." The effort was coordinated by an Austin, Texas-based group called Drive Democracy. One member took a picture of his bunion-covered foot and sent it to Dean Rosen, Frist's top health aide, according to Roll Call, a Capitol Hill newspaper.
Bob Stevenson, Frist's communications director, jokingly dismissed the e-mail campaign, telling Roll Call: "What a shame, even the liberal Democratic activists have lost faith in Dr. (Howard) Dean's capabilities," a reference to the new Democratic National Committee chairman, who has not been making such diagnoses.
Jim Martin, former board chairman of the American Academy of Family Physicians, says Frist brought the criticism on himself. "When you're a first-year medical student, you learn that you don't make a diagnosis without evaluating the patient."
Tracking blood inflation
Even though most people willingly donate it, blood has officially become a commodity in the estimation of the U.S. Bureau of Labor Statistics. The agency last month announced that it would add a blood component survey to its producer price index, or PPI, which measures changes in prices for goods and services.
That's a good thing, according to America's Blood Centers, the umbrella organization for the nation's independent blood banks. The blood transfusion to the PPI will give HHS a more accurate gauge of costs when it recalculates Medicare reimbursements to hospitals for blood products and services provided as part of inpatient treatment, the ABC says.
As it stands now, transfusions to inpatients are indistinguishable to Medicare, just one part of DRGs. But as a result of blood organizations' lobbying efforts, there will be specific tracking of blood costs in the annual "marketbasket update" that is used to adjust DRG prices. The index will measure the percentage price change associated with providing services related to the collection, storage and distribution of blood and blood products and the storage and distribution of body organs based on an annual survey of product and service providers, the ABC says.
Data collection among blood and organ banks will begin in October, says G. Michael Fitzpatrick, the ABC's chief operating officer. However, it will take a few years for blood prices to be reflected in the Medicare calculation as there is currently "no good baseline," he says. The problem in the past was that the PPI incorporated only manufactured blood products such as hemoglobin for hemophiliacs, and those costs have actually gone down in recent years.
Depending on the area of the country, a unit of packaged red blood cells now costs anywhere from $165 to $225, Fitzpatrick says.
A dispenser issue gels
The CMS is making it even easier for healthcare workers to help control hospital bacteria.
Previously dispensers of alcohol-based hand-washing gels weren't allowed in hallways because they are 30% alcohol and could accelerate a fire, the agency says. They were allowed inside patient rooms partly because those rooms are designed to contain fires.
The CMS worked with the National Fire Protection Association to establish guidelines to reduce the fire hazard and placed final regulations in the Federal Register to allow healthcare facilities to place the dispensers in hallways as of May 24. Some of the stipulations include the dispensers must be 4 feet apart, the hallways must be at least 6 feet wide and the dispensers can't be near a heat source.
The federal Centers for Disease Control and Prevention had been pushing for the ruling for years. The CDC cites an August 2003 article in a journal published by the Society for Healthcare Epidemiology of America saying that of 798 healthcare providers surveyed, none reported the dispensers being involved in a fire.
The CDC says the gel dispensers are better than soap because gel doesn't dry out workers' hands and the dispensers are more accessible than sinks. The alcohol-based hand rubs are also more effective than soap for destroying bacteria. Roughly 2 million patients per year acquire infections in hospitals, according to the CDC.
The CMS ruling could be a boon for vendors that sell the dispensers, which typically retail for less than $10. At least one vendor is hoping that more than healthcare workers will use the sanitary solution.
"We hope it will promote greater usage by staff as well as visitors," says Andy Mills, president of Medline, a medical supplies vendor.