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You guys may or may not know, but over the past couple years, CMMS has initiated, among its various quality improvement measures, the Surgical Care Improvement Project, or, SCIP. They outline a couple dozen quality indicators, measure individual hospitals performance on these measures, and then report those data publicly (I forget the website offhand). We spend a fair bit of time in our dept's M/M conferences discussing our performance on these metrics, but also the evidence base (usually the lack thereof) of the recommendations (requirements, really), and scratch our heads a lot.
Some of the metrics include things like post-op normothermia, which has dubious evidence base for a very limited population, timing and selection of Abx, and appropriate discontinuation of Abx, DVT prophylaxis, and others. The responsibility for meeting many of these requirements is shared (meaning, we don't often pick the Abx, but we do administer them and time them).
Anyway, it doesn't take a rocket scientist to see that payment will be tied to meeting these requirements, and hospital marketing efforts will be tied to the fact that our performance is in the public record. Know, too, that at least in our institution, there are several executive VPs whose bonuses are tied to performance on these measures. When viewed from above, this looks like to me like this:
1) We've got of new rules that don't always make sense or that don't have any basis in reality.
2) Compliance with these rules (with which we may not agree) is now required in order to get paid and keep getting patients to come to our hospital.
3) Complying with these things and documenting compliance is actually a lot harder than it looks, both in terms of actually DOING it, and also swallowing your pride as you do something you are forced to do but don't think matters.
4) Some *****hole VP gets a $hitpile of money as a result of all the little scattering, meaningless work we do. Or, to put it another way, it makes me feel like even more of a low-level employee, busting my balls over something I don't care about just to make some rich corporate D-bag a little richer. All while patients' outcomes don't actually change.
Anyway, this was partly to vent and partly to ask if SCIP has infiltrated the private world and what kinds of things you are doing to be in compliance.
Some of the metrics include things like post-op normothermia, which has dubious evidence base for a very limited population, timing and selection of Abx, and appropriate discontinuation of Abx, DVT prophylaxis, and others. The responsibility for meeting many of these requirements is shared (meaning, we don't often pick the Abx, but we do administer them and time them).
Anyway, it doesn't take a rocket scientist to see that payment will be tied to meeting these requirements, and hospital marketing efforts will be tied to the fact that our performance is in the public record. Know, too, that at least in our institution, there are several executive VPs whose bonuses are tied to performance on these measures. When viewed from above, this looks like to me like this:
1) We've got of new rules that don't always make sense or that don't have any basis in reality.
2) Compliance with these rules (with which we may not agree) is now required in order to get paid and keep getting patients to come to our hospital.
3) Complying with these things and documenting compliance is actually a lot harder than it looks, both in terms of actually DOING it, and also swallowing your pride as you do something you are forced to do but don't think matters.
4) Some *****hole VP gets a $hitpile of money as a result of all the little scattering, meaningless work we do. Or, to put it another way, it makes me feel like even more of a low-level employee, busting my balls over something I don't care about just to make some rich corporate D-bag a little richer. All while patients' outcomes don't actually change.
Anyway, this was partly to vent and partly to ask if SCIP has infiltrated the private world and what kinds of things you are doing to be in compliance.
