Wednesday, October 15, 2008

It Isn't a Never Event if it Isn't Called a Never Event

Over at WhiteCoat Rants, WhiteCoat rants about never events and the potential unintended consequences that we may see from them.  I completely agree that these ridiculous rules are ridiculous and do not anticipate the unintended consequences that will invariably come as they are enforced.
But mostly I remember something said by the ICU nurse who was teaching the ventilator class that I attended when I first started working in the ER (or ED if you are Bayer Pharmaceuticals):

"...we used to refer to it as VAP, or ventilator-associated pneumonia, until the Centers for Medicare Services decided that they wouldn't pay for VAP, because it sounded like something preventable.  So we changed the name, and now they are paying for it again."
Perhaps we could implement this same idea:
  • Falls could be re-labeled as "creative groundings"
  • The Unacceptably long Catheter-associated urinary tract infection could be called "antibiotic seeking behavior"
  • Surgery on the wrong body part might be referred to as "weight loss surgery"
  • Mismatched blood transfusions can be called "diversification therapy"
  • Foreign bodies left in a patient after surgery are now "parting gifts"
  • Preventable post-operative deaths could be simply "applied Darwinism"
  • Major medication errors can be excused because "4 rights don't make a wrong"
  • Decubitus ulcers could be re-labeled as "body modifications"
  • Surgery performed on the wrong patient gets charted as "practice"
  • Administration of contaminated drugs can be "multidrug therapy"
  • Hospital-onset hypoglycemia in the future may be referred to as "low-sugar diet"
  • Air embolism is now "inflationary therapy"
Anybody else have any creative charting tips?


CountyRat said...

I suggest that we stop catheterizing our patients, and instead, treat them with a, "urethral latex challenge."

I like your "inflationary therapy." another term could be, "direct plasma oxygenation."

While we are mucking about the circulatory system, what do you think of calling thromboembolitic disease, “hematological consolidation with passive relocation?”

Finally, grade III and IV decubiti may now be documented as, "non-surgical integamentoplasty in evolution."

Anonymous said...

The man who insists on seeing with perfect clearness before he decides, never decides.