Medical Staff e-Update

  • John Mogerman, MD

    Medical Director, Allegiance Behavioral Health & Chief of Staff

  • Ray King, MD

    Senior Vice President, Medical Affairs & CMO

Issue 15 - June 9, 2014

Last month, we updated you on the due diligence process that is taking place as part of the potential affiliation between Allegiance Health and the University of Michigan Health System (UMHS). This process will continue throughout the year and is an important step that will make sure both organizations feel confident about establishing an affiliation that benefits the community, staff, physicians and both organizations.

In addition to the due diligence process that is now underway, Allegiance and UMHS are proceeding through a regulatory review by the Federal Trade Commission (FTC). This independent third party review, which is standard procedure for proposed affiliations of this size, is done by the FTC to make sure the affiliation will not reduce competition for the services provided by Allegiance and UMHS.

The FTC’s role in this review process is similar to the role the Food and Drug Administration (FDA) plays as the entity responsible for assuring the safety of our nation’s food supply. While we may fully trust a food manufacturer and their intent to produce food that is safe to eat, the FDA serves as an independent third party that reviews food companies and their processes so that consumers can be confident the groceries they buy are safe.

In this case, the FTC is reviewing the proposed agreement to be sure that an affiliation between the organizations does not result in reduced competition, which is important in any healthy marketplace. Specifically, the FTC is reviewing information from Allegiance, UMHS and those that utilize the services of both organizations (patients, insurers, etc.) to assess the likely impact of the affiliation on consumers. They aim to ensure that an affiliation is unlikely to lead to higher prices, a reduction in necessary services or a reduction in the quality of those services.

“Allegiance Health and UMHS are fully committed to making sure this affiliation puts the needs of the community first and strengthens our ability to provide high-quality healthcare,” said Georgia Fojtasek, president and CEO. “Our ultimate goal is to provide the right care at the right time and in the right place for members of this community.”

We will continue to keep you updated on the due diligence process, including the FTC review, and continue to provide regular updates in the months ahead.

A new process started on Monday, April 28, regarding how direct admits will be brought into the hospital. There is no longer a House Shift Manager in the hospital, Monday through Friday 7 a.m. to 7 p.m.

This new process will occur 7 days a week from 7 am to midnight.

If you would like to admit a patient, please:

  1. Complete the attached form and fax it to the ED case manager at (517) 841-1367.
  2. Call the ED case manager at (517) 788-4800, ext. 6588.
  3. The ED will review the case with you. At that time, depending on the individual’s medical condition and how long you expect the patient to be hospitalized, the case manager will suggest:
    • Observation - if you feel the length of stay will be less than two midnights and medical condition does not warrant longer hospitalization.
    • Inpatient - if you feel length of stay will be greater than two midnights and medical condition and your documentation support longer hospitalization.
  4. The ED case manager will request a bed and the Organizational Throughput Dept will assign the bed and call your office with the room number.
  5. If patient is being admitted to Hospitalist Service, please complete and fax form to the ED case manager at (517) 841-1367. After the hospitalist calls to notify us they are accepting, we will request a bed and the Organizational Throughput Dept will call you with the bed assignment.
  6. Please let the case manager know where the patient will be so we can call them if they are not going to be in your office waiting for the bed assignment.

From the office of Allegiance Patient Safety and Advocacy Services

In order to avoid any confusion regarding who is responsible for recording the time and date on the Informed Consent document, the signature area of the form was revised to more clearly state that the Witness is required to write the time and date that the patient/parent/guardian signed the consent form. i.e., it is the witness’ responsibility to make sure this is recorded, as it is one of the requirements for Informed Consent under the Medicare Conditions of Participation.

Previous versions of the Informed Consent document should be disposed of and the new form should be used. The updated form can be ordered through ReqDirect using document number 40150-1_IC.

From the office of Allegiance Infection Prevention

This article provides updated guidance for MERS CoV from the Michigan Department of Community Health.   In addition, the link to the CDC guidance for MERS CoV on our Infection Prevention page on IDA will take you directly to the most recent CDC information which is frequently being updated.  The key take aways for us at this time are:

  • Travel history
  • Prompt initiation of airborne, contact and standard precautions
  • Obtaining recommended laboratory specimens
  • Staying abreast of the situation as updates are issued by the CDC and MDCH

These bullet points are covered in detail in this MERS-CoV Guidance Michigan document.

John Mogerman, MD, Chief of Staff
May 23, 2014

The Determination of Death and the Expired Patient Policy has been updated to include non-medical examiner autopsy criteria. The revised policy was approved by the Medical Executive Committee in April.

The updated autopsy criteria are as follows:

In addition, at the time of the patient’s death, the physician’s documentation must reflect an autopsy was considered and determined to be appropriate or not.

The revised policy is attached for your reference and can be found on IDA via:

IDA -> Policies and Procedures -> All Policies and Procedures -> Rights and Responsibilities of the Individual –> Determination of Death and the Expired Patient Policy.

Credentialing Resource Center Insider, April 11, 2014

An orthopedic surgeon accused of slapping anesthetized patients on the buttocks and making crude

comments about them faces possible criminal charges, and the Syracuse, N.Y. hospital that reportedly ignored staff complaints about his behavior may be sanctioned, according to Syracuse.com. The slapping and other inappropriate behavior by the surgeon went on for at least a year and St. Joseph’s Hospital Health Center allegedly did nothing about it until a complaint was filed with hospital administrators in December, stated a CMS report.

One staff member told federal investigators the hospital did nothing after the staffer reported the surgeon’s behavior to operating room administrators early last year. Others said they did not report the surgeon’s behavior because they doubted anything would be done, they feared their jobs could be at risk, or they did not want to confront the surgeon. The hospital faces sanctions including a possible termination from Medicare and Medicaid programs.

Source: Syracuse Media Group

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