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Speaker |
Laura A Dixon |
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Industry |
Nursing |
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Speciality |
Nursing |
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Available |
All Days |
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Duration |
120 Minutes |
Description
If CMS or The Joint Commission showed up tomorrow at your door would you comply with the advance directive requirements? Did you know there was a federal law that addresses advance directives that all hospitals must be in compliance with? Did you know that CMS reimburses some physicians for advance care planning? Did you know better end-of-life care can reduce readmissions? Hospitals need to do this right or they can face a wrongful death or medical malpractice case.
Advance care planning is making decisions about the care a patient wants to receive if they become unable to speak for themselves. It was a big step for CMS to allow physicians to be compensated for advanced care planning. Providers are spending time discussing advance directives and end-of-life care and they deserve to be paid for it. Practitioners must have an understanding of the CMS advance directive requirements when doing advanced care planning. Advance care planning reduced the cost of end-of-life care without increasing mortality.
Better end-of-life care can result in reduced readmissions. 2,573 hospitals were penalized 564 million dollars for having a higher readmission rate. It is important to engage with the patient on what matters to them at end-of-life care and to respect their wishes for care.
Have you heard of the 16.5 million dollar case in which the plaintiff won because of the failure of the physician and hospital to follow a patient’s advance directives? Many experts are advocating that he is a new wave of lawsuits if a hospital fails to honor the advance directive. Another recent case involved a brain-dead girl who is moved from a California hospital and a pregnant woman that was brain dead who had been life support until the husband obtained a court order. Do you ask every inpatient if they have any advance directives and do you discuss the end-of-life wishes?
This webinar will discuss the CMS hospital Cops on advance directives along with the Joint Commission standards to help hospitals ensure compliance with the standards. Hospitals have received a high number of deficiencies in this area. This program will cover in detail advance directives such as the living will, durable power of attorney, organ donation, mental health declaration, organ donor cards, patient advocates and do not resuscitate orders. It will discuss the rights of patient representatives such as DPOA, support persons, parents, or guardians. It will discuss the IHI conversation starter kit regarding discussions about end-of-life care since it has been downloaded over 100,000 times. Also discussed will be asking patients about end-of-life wishes, resources on advance care planning, and a toolkit CriSTAL to identify dying patients. The checklist has 29 predictors.
The program will discuss case law, organization position statements on DNR (do not resuscitate), and other federal laws on advance directives. CMS made revisions to the hospital visitation CoP regulation which included changes to advance directives and visitation advance directives. CMS has issued a memo that will be discussed outlining the number of deficiencies received by hospitals regarding advance directives. The program will discuss the Joint Commission visitation standard which is found in the patient-centered care standard.
The CMS hospital CoP standards require that the information about the hospital’s advance directive policy be provided to inpatients, and three categories of outpatients; observation, emergency department patients, and same-day surgery patients. Staff will have to determine if there are any patient representatives including support persons or patient advocates and those with visitation advance directives. Do you know the four rights provided to patient representatives? The standard changed about what a hospital must do if a patient has no advance directives on file and a support person shows up. These are very interesting changes to the CMS hospital CoP manual.
Learning Objectives
Outline
Who Should Attend
(BS, JD, RN, CPHRM)
Laura Dixon | Laura A. Dixon recently served as the Regional Director of Risk Management and Patient Safety for Kaiser Permanente Colorado where she provided consultation and resources to clinical staff. Prior to joining Kaiser, she served as the Director, of Facility Patient Safety and Risk Management and Operations for COPIC from 2014 to 2020. In her role, Ms. Dixon provided patient safety and risk management consultation and training to facilities, practitioners, and staff in multiple states. Such services included the creation of presentations on risk management topics, assessment of healthcare facilities; and development of programs and compilation of reference materials that complement physician-oriented products.
Prior to joining COPIC, she served as the Director, of the Western Region, Patient Safety and Risk Management for The Doctors Company, Napa, California. In this capacity, she provided patient safety and risk management consultation to the physicians and staff in the western United States. Ms. Dixon’s legal experience includes medical malpractice insurance defense and representation of nurses before the Colorado Board of Nursing.
Ms. Laura Dixon has more than twenty years of clinical experience in acute care facilities, including critical care, coronary care, peri-operative services, and pain management.
As a registered nurse and attorney, Laura holds a Bachelor of Science degree from Regis University, RECEP of Denver, a Doctor of Jurisprudence degree from Drake University College of Law, Des Moines, Iowa, and a Registered Nurse Diploma from Saint Luke’s School Professional Nursing, Cedar Rapids, Iowa. She is licensed to practice law in Colorado and California.