VOLUME 26, ISSUE 1
Christoper R. Cook, DO TSA Editor
2013 was chalked full of powerful words: Sequestration, Federal Shutdown, Edward Snowden, IRS targeting, drones, Obama Care Website, SGR, IPAB, Selfie, The Cloud, “#” Hashtag, Boston Strong, @ pontifex.
My professional words for 2013 are CPOE, Meaningful Use, AIMS, DNV, CMS, PACE Consulting, TJC, CHC Consulting. These words have had more practical impact on my practice in the last year and the four prior years than any other words.
At times, these acronyms have greater influence on my day-to-day activities than the TSA/ASA/AMA/ TMA. The hospital inspection, accreditation, and consulting entities mentioned above possess the ability, with relatively unquestioned authority, to change an Anesthesiology practice overnight by: locking up syringes, removing tape, frisking employees, disposing of certain brands of IV catheters, changing order sets and Anesthesiology records. They can also do absurd things like removing crosses from Catholic hospital walls, all depending on the whims of the inspector that day.
My personal experience with inspectors has been a mixed bag. The first one I recall, I was medically directing CRNAs and was casually lured into a conversation with a DNV inspector which was subsequently turned into a grill session over the Medicare Conditions of Participation (COPS), Interpretative Guidelines (IGs), and hospital policies on sedation outside of the operating room and credentialing of Non- Anesthesiologists to perform said sedation. None of these items had I committed to memory. I could recall ASA guidelines, Practice Parameters and Standards,
which most of the Anesthesiology policies at our hospital revolve around but that simply annoyed the inspector. The interview ended after 15 minutes, as I needed to return to clinical duties. I promised the inspector to return with answers to some of her more obscure questions, which I did shortly and were easily found. Overall, I felt the experience was negative, but “eye-opening” and one that I would be prepared for in the future.
Following the meeting I contacted my partner and the Anesthesiology Section Chief and debriefed. While we were discussing my DNV oral examination, a hospital administrator stomped into the doctors’ lounge and looked at my colleague and Section Chief and asked, “Who the Hell is Dr. Cook?” I took the opportunity to sit quietly and listen to the diatribe which included why I “volunteered” for such an encounter and that my partner was the one that had reviewed the COPS and IGs in a formal manner.
Before she left I politely introduced myself and assured her I had not volunteered for any interview but had been ambushed and I answered all of the questions to the best of my knowledge and had directed the inspector to any answers I did not have “off the cuff.”
During the day my internal monologue began
