When Medicare and Medicaid legislation was passed and signed into law in 1965, the US Congress formed the precursor federal agency to the Centers for Medicare & Medicaid Services (CMS) to write the rules and regulations spelling out the “Conditions of Participation” (CoPs) required to obtain federal funding under these…

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Nurse bullying is a hot issue, even in the lay press—consider the 2015 Marie Claire article, “Mean Girls of the ER: The Alarming Nurse Culture of Bullying and Hazing.” Numbers vary, but the American Nurses Association reports that between 18% and 31% of nurses have experienced bullying at work. The…

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Efforts in 2017 to dismantle the Affordable Care Act (ACA) were largely unsuccessful, but a tax reform bill that includes a provision to abolish the ACA’s individual insurance mandate seems likely to pass. As a result, 13 million fewer Americans will be insured by 2027, and premiums will go up…

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The following “success story” describes the PEER initiative at Geisinger Medical Center, which has involved staff in making decisions to improve processes and communication. OR Manager periodically publishes success stories like this from nurse leaders or other healthcare providers who want to share their experience with our readers. Recent examples…

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Healthcare providers are straddling a variety of payment models while many regulatory changes remain in flux under the Trump Administration. Although the shift from fee-for-service to value-based payment began some years ago, not everyone is on board. Opinions about bundled payments also remain mixed, despite reports of improved outcomes and…

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Robotic-assisted surgery offers many potential advantages, including shorter operative time, less morbidity, and faster patient recovery. But rigorous comparisons with traditional surgical methods and cost-effectiveness analyses are still limited, and the price tag of the robot (in the neighborhood of $1 million) and annual maintenance contract (roughly $150,000) may give…

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On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2018 Medicare Hospital Outpatient Prospective Payment System/ASC Payment System and Quality Reporting Programs. In summary, several ambulatory surgery center (ASC) measures (ASC-1 to ASC-14) are unaffected, except that three measures (ASC-5, -6,…

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A new study by Ofstead & Associates (St Paul, Minnesota) is the latest to raise concerns about infections associated with endoscopic procedures. The study, which focused on ureteroscopes, found that the techniques used to clean and sterilize or high-level disinfect flexible ureteroscopes are not sufficient and leave behind contamination including…

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