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Twenty-Eight Items Included in National Quality Forum’s List of ‘Never Events’

March 1, 2008
Written by: , Filed in: Practice Management
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The National Quality Forum (NQF) has developed a list of 28 ‘never events’–
health care-related adverse events that are serious, largely preventable, and
of concern to both the public and health care providers.

In 1998, the Joint Commission on Accreditation of Healthcare Organizations
recognized the need to identify serious, yet preventable adverse health care-
related events which were occurring consistently across the United States that
were associated with bad patient outcomes. These events were labeled as
‘sentinel events.’

In 1999, the NQF was created by presidential decree, and its members were
given a charge to look at the overall health care system, issues of quality
within the health care system, and setting performance standards for patient
safety. The NQF is a “think tank” based in Washington, D.C.

Also in 1999, the report To Err Is Human: Building a Safer Health
System
was published (Kohn LT, Corrigan JM, Donaldson MS, eds. Washington,
D.C.; National Academies Press; 2000), which identified systematic problems
across the health care industry that caused harm, and sometimes death, to both
inpatients and outpatients.

For the purpose of public accountability, the NQF worked from its inception in
1999 until 2002 to develop a list of adverse events that are serious, largely
preventable, and of concern to both the public and health care providers. The
NQF labeled these events as ‘never events.’ The initial list of ‘never events’
was 27 items and has since been increased to 28 items. These ‘never events’
are applicable broadly across the health care industry.

In 2007 and 2008, the Centers for Medicare and Medicaid Services (CMS) joined
the effort to get rid of these ‘never events’ by informing hospitals that
there would be payment ramifications if an event of this kind occurred in
their hospital. These ramifications deal with reimbursements: how much or how
little a hospital will receive for not only the care that resulted in the
‘never event,’ but also for subsequent care. As such, this is becoming an
incredibly complicated issue.

To be simplistic, if there is an operation in which a sponge is left in the
patient, then whether you can bill for the underlying operation becomes a
concern. Obviously, you are not going to get paid for removing the sponge. How
much or how little of the underlying operation you get reimbursed for is a
whole issue.

This billing issue is important, especially with CMS. Now commercial insurers
are following the Government’s lead, and they are imposing the same type of
restrictions. They are not going to pay for these supposedly preventable
‘never events.’ This is an issue that must be worked out with your billing and
compliance people.

Reference:
Kathleen Hale, RN, BSN, MHSA, and Richard P. Kidwell, JD Historical
Perspective on Identifying and Defining ‘Never Events’

The National Quality Forum (NQF) has developed a list of 28 'never events'-- health care-related adverse events that are serious, largely preventable, and of concern to both the public and health care providers. In 1998, the Joint Commission on Accreditation of Healthcare Organizations recognized the need to identify serious, yet preventable adverse health care- related events which were occurring consistently across the United States that were associated with bad patient outcomes. These events were labeled as 'sentinel events.' In 1999, the NQF was created by presidential decree, and its members were given a charge to look at the overall health care system, issues of quality within the health care system, and setting performance standards for patient safety. The NQF is a "think tank" based in Washington, D.C. Also in 1999, the report To Err Is Human: Building a Safer Health System was published (Kohn LT, Corrigan JM, Donaldson MS, eds. Washington, D.C.; National Academies Press; 2000), which identified systematic problems across the health care industry that caused harm, and sometimes death, to both inpatients and outpatients. For the purpose of public accountability, the NQF worked from its inception in 1999 until 2002 to develop a list of adverse events that are serious, largely preventable, and of concern to both the public and health care providers. The NQF labeled these events as 'never events.' The initial list of 'never events' was 27 items and has since been increased to 28 items. These 'never events' are applicable broadly across the health care industry. In 2007 and 2008, the Centers for Medicare and Medicaid Services (CMS) joined the effort to get rid of these 'never events' by informing hospitals that there would be payment ramifications if an event of this kind occurred in their hospital. These ramifications deal with reimbursements: how much or how little a hospital will receive for not only the care that resulted in the 'never event,' but also for subsequent care. As such, this is becoming an incredibly complicated issue. To be simplistic, if there is an operation in which a sponge is left in the patient, then whether you can bill for the underlying operation becomes a concern. Obviously, you are not going to get paid for removing the sponge. How much or how little of the underlying operation you get reimbursed for is a whole issue. This billing issue is important, especially with CMS. Now commercial insurers are following the Government's lead, and they are imposing the same type of restrictions. They are not going to pay for these supposedly preventable 'never events.' This is an issue that must be worked out with your billing and compliance people. Reference: Kathleen Hale, RN, BSN, MHSA, and Richard P. Kidwell, JD Historical Perspective on Identifying and Defining 'Never Events' [text_ad]
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