LETTER OF
UNDERSTANDING NO. 35
SUBJECT:
PATIENT SAFETY STANDARDS
Consistent with the Parties’
commitment to ensuring that employees have access to cost effective, quality
health care coverage as detailed in Letter of Understanding No. 15, the parties
agree that the term “patient safety standards”, as set forth in Attachment A
and Attachment B of the parties’ 2005-2008 Collective
Bargaining Agreement, shall be modified to be defined in its entirety as
follows, effective immediately and continuing until the expiration of the
Collective Bargaining Agreement.
Patient safety standards refer
to nationally recognized criteria for making hospital services safer. A hospital meets patient safety standards if
it meets established criteria such as those listed below. The hospital must publicly certify upon
request that it meets all criteria and the statements pertaining to standards
are accurate and reflect normal operating procedures at the hospital. The criteria include:
A. Criteria for
Evidence-based Hospital
Referrals: for patients admitted for one
of several complex procedures (coronary artery bypass grafts, percutaneous
coronary intervention, abdominal aortic aneurysm repair, pancreatic resection,
esophagectomy and high risk deliveries), network hospitals must meet experience
criteria, consisting of process, volume, and/or outcome measures, for the
performance of the specific procedure.
If complex procedures as identified by national standards change in the
future, the parties agree that they will meet and discuss the changes.
B. Criteria for Other
For patients admitted for all
other procedures or conditions, network hospitals must meet the following
standards:
Computerized
Physician Order Entry: Prior to January 1, 2005, the
hospital must publicly assure that by January 1, 2005, physicians will enter at
least 75 percent of inpatient medication orders via a computer linked to
error-prevention software. The software
must be capable of alerting physicians to at least 50 percent of common,
serious prescribing errors. On and after
January 1, 2005, the hospital must publicly assure that it actually fulfills
these capabilities.
Intensive
Care Unit Staffing: On and after July 1, 2004, the hospital
publicly assures that its adult and/or pediatric intensive care unit is managed
or co-managed by critical care specialists who:
1.
Are
present during daytime hours and exclusively provide clinical care in the ICU,
and
2.
At
all other times, can return urgent ICU paging calls within five (5) minutes and
arrange for a physician or FCCS-certified non-physician specialist to reach ICU
patients within five minutes at least 95 percent of the time.
In geographical areas where
scientifically rigorous, risk-adjusted outcome comparisons are publicly
reported for intensive care unit performance, favorable risk-adjusted outcomes
may replace the above criteria for intensive care unit staffing.
Dated:
September 4, 2008