Medline Physician Education Program On Pressure Ulcer Prevention To Help Hospitals Comply With New CMS Reimbursement Policy

Main Category: Public Health
Also Included In: Dermatology;  Nursing / Midwifery
Article Date: 30 Jan 2009 - 4:00 PDT

email to a friend   printer friendly   opinions  

In an effort to help hospitals comply with the recently enacted Centers for Medicare & Medicaid Services (CMS) Medicare Inpatient Prospective Payment System (IPPS) rule, Medline Industries, Inc. today introduced a new educational CD to instruct physicians on assessing and documenting pressure ulcers.

The MD Education CD, which is a newly created module of Medline's comprehensive Pressure Ulcer Prevention Program originally created for nurses and certified nursing assistants, is an interactive and highly graphic tool encompassing four components: the Deficit Reduction Act of 2005 and its financial implications on the hospital; assessing skin conditions that are present on admission; recognizing wound types and stages of pressure ulcers and how to document pressure ulcers present on admission.

The IPPS Rule for Hospitals, which became effective October 1, 2008, is designed to help improve quality of care and contain costs. Under the new guidelines, without proper physician determination and documentation during hospitalization that the pressure ulcer was present at the time of admission, facilities will no longer be eligible for the higher diagnosis related group (DRG) level of reimbursement for this secondary diagnosis. This means that hospitals might not get paid for the treatment of pressure ulcers if they occur while the patient is in the hospital being treated for a different diagnosis.

"The truth is, many physicians have not been educated on how to examine pressure ulcers so they are not ready for the new inpatient prospective payment system," said Diane Krasner, PhD, RN and noted wound and skin care consultant. "Medline's new education program will go a long way in training physicians on assessing and documenting pressure ulcers of patients at the time of admission."

This need for more physician education was emphasized by a pilot study* in which 67% of physicians surveyed identified a description of a stage I pressure ulcer and only 52% identified a description of a stage IV (more severe level) pressure ulcer. The study concluded that "Geriatric fellows need to improve their knowledge and confidence with regard to pressure ulcer care to become competent as clinicians and educators for this condition."

"Nursing has traditionally been the discipline which has been assessing and documenting pressures ulcers," said Elizabeth A. Ayello, PhD, RN and Co-Secretary of the World Union of Wound Healing Societies. "So there is clearly room for more education and training for physicians."

Underscoring the importance of pressure ulcer prevention, in 2007 CMS reported 257,412 cases of preventable pressure ulcers as secondary diagnoses. The average cost per case in which pressure ulcers were listed as a secondary diagnosis is estimated to be $43,180 per hospital stay.

"Medline's new MD Education component is critical for acute-care facilities to ensure that physicians understand their role in recognizing and accurately documenting present-on-admission pressure ulcers," said Michael Raymond, MD, Co-Chief Medical Officer at NorthShore University HealthSystem, Skokie Hospital, Skokie, Ill.

"This CMS POA reimbursement change is a big shift as documentation by the physician is now essential," said Dr. Ayello. "If the physician does not document pressure ulcers upon admission or if a patient acquires a pressure ulcer while in the hospital, that hospital could lose thousands of dollars as a result of not receiving the higher DRG government reimbursement."

The CD and Medline's Pressure Ulcer Prevention Program are available through Medline's sales representatives or learn more by visiting http://www.medline.comor call 1-800-MEDLINE.

About Medline Industries, Inc.

Medline, the nation's largest privately held manufacturer and distributor of healthcare products, manufactures and distributes more than 100,000 products to hospitals, extended care facilities, surgery centers, home care dealers and agencies and other markets. Headquartered in Mundelein, IL, Medline has more than 800 dedicated sales representatives nationwide to support its broad product line and cost management services.

Meeting the highest level of national and international quality standards, Medline is FDA QSR compliant and ISO 13485 registered. Medline serves on major industry quality committees to develop guidelines and standards for medical product use, including the FDA Midwest Steering Committee, AAMI Sterilization and Packaging Committee and various ASTM committees.  For more information on Medline, visit our Web site, http://www.medline.com.

*Odierna E, Zeleznik J. Pressure ulcer education: a pilot study of the knowledge and clinical confidence of geriatric fellows. "Advances in Skin & Wound Care." Jan/Feb 2003.

Medline Industries, Inc.

• Additional
• References
• Citations