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Feigin:
JCAHO review was resounding success |
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From
the physician-in-chief
After a successful JCAHO review,
the focus turns to important legislative
and strategic planning issues
By Ralph D. Feigin, M.D.
The recent visit to Texas Children’s Hospital by the Joint
Commission on Accreditation of Hospital Organizations was a
resounding success. The Joint Commission had great praise for
the efforts made by our medical staff, the patient care services
provided, the quality of our facility and the overall care that
all of our staff provide for their patients.
The Joint Commission no longer provides a numeric score and
utilizes a completely different system called tracer
methodology for facility evaluation. They literally find a
patient at the point of entry to the hospital and track the
patient through every encounter in all of the units that the
patient may utilize. The surveyors reviewed many different
patients representing different types of disease processes
during the course of their accreditation visit. During the exit
interview the leader of the team had with Mark Wallace and me,
he stated if he were to score the institution, he would give it
a score of 99.8 percent.
I would like to personally thank all of the medical staff for
the tremendous effort they made to prepare for the visit and for
their outstanding performance. Most importantly, I want to thank
you for the continuously superb care you provide for patients
who use Texas Children’s Hospital every day of the year.
Your support is needed on legislative issues
In late February, we were informed by a number of groups that
President Bush’s proposed budget includes $60 billion in budget
cuts for Medicaid. The president’s budget is used as a blueprint
for Congress to determine how federal money will be spent. It
proposes reducing or eliminating several programs important to
children and adolescents, including a proposal to abolish
funding for universal newborn hearing screenings, emergency
medical services for children and Title VII physician training
grants, and cutting children’s hospitals graduate medical
education funding by 33 percent.
During the past week, an intense battle took place on the floor
of the Senate in which an amendment authored by Senators Smith
and Bingaman was directed toward eliminating the proposed cuts
and creating a Medicaid study group to examine where in the
future Medicaid efficiencies and cost-cutting measures could be
found. Through intensive lobbying efforts of senators across the
country by members of the American Academy of Pediatrics and by
many members of the lay public, the amendment was successfully
passed 52 to 48. Although Texas Republican senators did not vote
in favor of this proposed amendment, that just means that the
challenge is ahead of us to continue to educate them on the
importance of Medicaid and how important the Medicaid funding
stream is to this hospital. It
should be noted there were Republicans who voted on behalf of
this amendment and that Senator Smith from Oregon is a
Republican. Thus, some Republicans joined the Democrats in the
Senate to support programs for children.
The fight continues because the House of Representatives has not
taken similar action. Thus, this issue will be decided at a
joint conference committee meeting of the House and Senate. It
is important for you to contact your legislators – both
congressmen and senators – indicating your support to rollback
the president’s proposed $60 billion in budget cuts for the
Medicaid program.
Equally important are proposed cuts for the children’s graduate
medical education program. Unlike general hospitals that contain
pediatric training programs and are reimbursed for the training
of those residents through Medicare, children’s hospitals have
little or no Medicare funding other than for patients with renal
dialysis. Therefore, they received no support for training
programs until the passage of the children’s graduate medical
education bill several years ago. This bill has strong
bipartisan support from both the House and Senate and,
fortunately, over a three-year period of time this program has
been
fully funded. Even at its fully funded level, the program pays
for less than 40 percent of the graduate medical education
programmatic support required in children’s hospitals across the
country. We believe there will once again be strong bipartisan
support to prevent the cuts in these programs, but such support
is not assured without your help. Please contact your senator
and congressman to indicate that you want them to restore the
children’s hospital graduate medical education funding to the
same levels as authorized for the FY2005 year.
Physician input is vital to strategic planning
Texas Children’s physicians will play a key role in the special
Strategic Planning Steering Leadership Committee formed by Mark
Wallace and me. Four physicians – Drs. Richard Friedman, Edmond
Gonzales, Morey Haymond and Sheldon Kaplan – are on the
eight-member steering committee.
The steering committee will contact all department and service
chiefs and other members of the medical, surgical, diagnostic
imaging and pathology departments to obtain their detailed input
into the overall planning process. The committee is particularly
interested in finding out from members of the medical staff what
changes in health care may ensue through 2010 and beyond
that may specifically impact each general, specialty and
subspecialty area so that appropriate plans can be made for
future clinical, educational and research space. That
information will be brought into the steering committee’s
planning, and the committee will then bring the results back to
the physician leaders for validation.
Members of the medical staff can ask questions and share
suggestions or concerns by sending an
e-mail directly to the
steering committee.
Ralph D. Feigin, M.D., is physician-in-chief at Texas
Children’s Hospital and professor and chairman of the Department
of Pediatrics at Baylor College of Medicine.
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