Another Example of VA Neglect

The Los Angeles Times (1/28, Holland, 3.49M) is reporting that the U.S. government “has agreed to settle a lawsuit accusing the Department of Veterans Affairs of misusing its sprawling West Los Angeles health campus while veterans with brain injuries and mental impairment slept in the streets, people familiar with the agreement said Tuesday.” The settlement will require the VA “will develop a master land-use plan for the campus that identifies sites for housing homeless veterans.” The ACLU of Southern California brought the lawsuit contending “that the VA should develop housing for veterans on the 387-acre campus.” The ACLU of Southern California “accused the agency of illegally leasing land to UCLA for its baseball stadium, a television studio for set storage, a hotel laundry and a parking service.” In 2013 a Federal Judge “struck down the leases, saying they were ‘totally divorced from the provision of healthcare.’” More recently, US District Judge S. James Otero “halted construction of an amphitheater on the property.”

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GM Faulty Ignition Switch Death Claims Rise To 50

The AP (1/26, Krisher) is reporting that “with only five days left before the deadline to seek payments, compensation expert Kenneth Feinberg has decided that 50 death cases are eligible for money due to crashes caused by faulty General Motors ignition switches.” Seventy-five injuries have also been declared eligible in details released on Monday by Feinberg, who General Motors hired to oversee the claims. The GM fund “has received 338 death claims and 2,730 claims for injuries,” according to the AP. “Of those, 58 death claims have been rejected as ineligible for compensation, as have 328 injury claims. Feinberg is either reviewing or awaiting documentation on 230 additional death claims and 2,327 injury cases.”
According to Bloomberg News (1/26, Sandler, 2.94M) the 50 death claims ruled as eligible on Monday are four times larger than GM’s initial estimate. Bloomberg reports that Feinberg said his findings relied on circumstantial evidence. “GM engineers were looking for definitive proof of ignition switch failure,” Feinberg said, “So of course there will be a greater number of eligible death claims.” The story was also reported by Reuters (1/26), Auto World News (1/26, Ecarma, 1K), and Autoblog (1/26, Bigelow, 454K).

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According to GM There Are Nearly 900,000 Defective Ignition Switches Still On The Road

Auto World News (1/26, 1K) is reporting that GM filed documentation with the NHTSA last week that shows “almost 900,000 GM vehicles with potentially defective ignition switches are still being used.” General Motors “says that out of a recall of approximately 2,190,934 vehicles, just 1,229,529 vehicles have been repaired by dealers.” Furthermore Auto World News reports that “The total number of ‘unreachable’ vehicles is up to 80,122, according to the Detroit automaker.”

Source:    Auto World News

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NHTSA Scrutinizes Ford Recall

In an article appearing on the front page of its “Business Day” section, the New York Times (1/21, B1, Jensen, Ivory, Subscription Publication, 9.97M) reports that a week after NHTSA Administrator Mark R. Rosekind said he planned on being “more vigilant on safety,” the NHTSA has “taken the unusual move of revisiting the 2013 recall of Ford’s biggest pickup trucks.” The initial recall, which was issued to repair a stalling problem, was limited to nearly 3,000 trucks that were used as ambulances. However, citing several complaints from drivers, the NHTSA notified Ford that “it is now investigating whether that recall should be” expanded, to include almost “197,000 additional pickups that have similar engines but are not used as ambulances,” according to the report. The Times goes on to note that recall queries, such as the investigation into the Ford recall, are “unusual,” noting that there were only four recall queries in 2014.

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NHTSA Investigates Jeep Cherokee Vehicles After Reports Of Fires

Bloomberg News (1/17, Plungis, 2.94M) reports that NHTSA has begun “a defect investigation into the latest model of the Jeep Cherokee sport-utility vehicle after an owner reported 20-foot flames shot out of its engine compartment after being parked,” which spreads across 50,415 vehicles built for the 2015 model year. The article states that NHTSA routinely starts investigations “based on a single complaint” when the agency “believes the alleged defect is especially dangerous.”
Reuters (1/17) reports that Fiat Chrysler spokesperson Eric Mayne stated the company plans to cooperate to the fullest with NHTSA.
The Auto World News (1/16, 1K) reported that NHTSA Deputy Administrator David Friedman told the press back in November that Jeep has “to get their act in gear,” adding that “They’ve got to make sure that they are getting those parts in the hands of consumers.”

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Dietary Supplements Manufacturer Shuts Down After Federal Lawsuit

The Los Angeles Times (1/17, Panzar, 3.49M) reported that a pharmaceuticals manufacturer in Los Angeles “agreed to close its operations and to recall and destroy all the dietary supplements it has sold since 2011 as part of an agreement with” the FDA. According to a lawsuit filed by the DOJ and FDA, the manufacturer “distributed unapproved supplements that claimed to treat diabetes, allergies and cancer. “ The AP (1/16) and Medical Daily (1/18, Olson, 85K) also reported on the story.

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Auto Parts Suppliers Step Up Quality Control

The Wall Street Journal (1/14, Kubota, Subscription Publication, 5.62M) reports that parts suppliers for automakers are working to improve their quality control process following the record recalls in 2014, including the issues with Takata’s exploding air bags and Delphi Automotive’s faulty ignition switches in GM vehicles.

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Liability Claims Reduced by Hospitals in National Program

December 6, 2012 – Claims Journal
Initial results from a national perinatal improvement initiatives suggest hospitals can reduce harm to babies and mothers, and lower associated liability claims and pay-outs, through the use of high-reliability perinatal teams.
Results from Phase 1 (2008-2010) of the Premier Perinatal Safety Initiative (PPSI), a Premier healthcare alliance project, show that the 14 participating hospitals have reduced harm and liability since the program’s baseline period (2006-2007).
In relation to harm, PPSI hospitals have reduced, on average:
• Birth hypoxia and asphyxia, which can cause infant brain damage, by 25 percent.
• Neonatal birth trauma, which can range from minor bruising to nerve or brain damage, by 22 percent. In addition, all hospitals were below the 2008 AHRQ Provider Rate, a national comparative rate measuring perinatal harm.
• Complications from administrating anesthesia during labor/delivery, which include cardiac arrest and other cardiac complications, by 15 percent.
• Postpartum hemorrhage, the most common cause of perinatal maternal death in the developed world, by 5.4 percent.
• The adverse outcome index rate, which measures the number of patients with one or more of the identified adverse events as a proportion of total deliveries, by 7.5 percent.
Because of these improvements, approximately 110 fewer mothers and babies experienced these harms.
Reduced liability claims
In addition, participants decreased the number of annual liability claims filed per delivery by 39 percent vs. 10 percent at non-participating hospitals. PPSI hospitals averaged a total of 18 claims per year and project wide during the baseline period, that number dropped to 10 in 2009 and is trending to be at 8 in 2010.
Findings on liability claims and losses are current through November 2012. Because it typically takes two years or longer for a claim to be filed after an injury, final liability claims and losses will not be closed for some time. These results, however, provide clear insight into the trend in claims and losses.
Launched in 2008 by Premier and affiliate liability insurer American Excess Insurance Exchange, RRG (AEIX), PPSI participants are large and small, teaching and non-teaching, system-based and stand-alone, with employed and non-employed physicians. They represent 12 states, in which approximately 250,000 babies will be delivered over the collaborative’s five years (2008-2012).
“There’s no other area in a hospital where providers routinely treat two distinctly different patients at the same time,” said Susan DeVore, Premier president and CEO. “Even though childbirth is so complex and unique, serious adverse events during labor and delivery are rare. But they do occur – sometimes they’re preventable, but they’re always devastating for babies, mothers, families and care providers.”
“The PPSI seeks to better define preventable perinatal harm and identify care practices that can result in improved outcomes,” continued DeVore. “Our results to date suggest that doing so can lower the incidence of certain infrequent, though serious, birth injuries and their associated liability claims. And the diversity of the participating hospitals also lends well to possible replication of the project and its results nationwide.”
Leveraging knowledge gained from previous initiatives, including an Institute for Healthcare Improvement (IHI)/Ascension Health/Premier collaboration, PPSI hospitals use two powerful methods to create high-reliability healthcare teams: increased adherence to evidence-based care bundles and enhanced communication and teamwork.
Increased adherence to evidence-based care bundles
Research shows that grouping essential processes together in care bundles helps clinical staff remember to take all of the necessary steps to provide optimal care to every patient, every time. Although many hospitals have long followed some or all of these individual care practices to improve perinatal outcomes, the key is consistently using all of them in concert.
Care bundle adherence is scored in an “all-or-none” fashion; the care team must provide all elements of care in the bundle to be given credit for its use. For example, one care bundle is focused on reducing the risks associated with augmenting labor, particularly in using oxytocin, a drug that accelerates a slow labor. This bundle has four elements that must be practiced consistently. If a team neglects to estimate the fetal weight before administering the medication, it would not receive credit for the work, even if team members successfully implemented the three other elements of the bundle.
PPSI hospitals have significantly improved compliance with care bundles over the course of Phase I. These improvements led to 106,000 additional mothers receiving evidence-based care bundles.
“Over the past several years, our team has established a number of quality interventions designed to increase safety for moms and babies and reduce the incidence of already very rare perinatal injuries,” said Tiffany Kenny, RN, MSN, C-EFM, OB informatics administrator at Summa Akron City Hospital in Akron, Ohio. “By following evidence-based care models, we’ve improved the quality of our Elective Inductions, lowered the C-section rate for low-risk first time mothers and improved overall safety.”
Enhanced communications and teamwork
PPSI hospitals have implemented the following proven strategies for certain high-risk protocols:
• TeamSTEPPS: Developed by the U.S. Department of Defense and the Agency for Healthcare Research and Quality (AHRQ), TeamSTEPPS produces highly effective medical teams that optimize the use of information, people and resources to achieve the best clinical outcomes.
• Situation Background Assessment Recommendation (SBAR): An effective situational briefing strategy, used by the U.S. Navy, to communicate relevant case facts in a respectful, focused and effective manner.
• Simulation drills: Exercises featuring actresses and mannequins reacting as real patients during the birthing process.
“These principles and strategies provide a foundation of clear communications tools and close to real life scenarios for use by obstetric, NICU, anesthesia, blood bank and lab teams,” said Becky Gams, RN, MS, APNL, University of Minnesota Medical Center, Fairview, and University of Minnesota Amplatz Children’s Hospital.
The PPSI’s Baseline Phase consisted of the retrospective collection of harm outcome data from 2006 and 2007 to establish a baseline of performance. During Phase I, healthcare teams implemented interventions and actively worked on performance and perinatal safety improvement across approximately 145,000 births.
Phase II began in January 2011 and will be completed in December 2012. In June 2010, AHRQ awarded a three-year demonstration grant to PPSI participant Fairview Health Services to extend the initiative. The grant allowed for the Phase II extension, which is examining hospital bundle compliance and associated outcomes, and the role of hospital culture in perinatal performance improvement to further reduce harm and liability. The University of Minnesota School of Public Health and the National Perinatal Information Center will continue providing specialized data and analytic services during the grant phase. Premier will begin analysis of Phase II results when the PPSI concludes. Results from the entire initiative will be made public in the summer or fall of 2013.

Source: Premier healthcare alliance

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Liberty Mutual’s Top 10 Causes of Work Place Injuries

By Denise Johnson | January 14, 2015 Claims Journal

Overexertion and falls account for more than $25 billion in workers compensation costs in the U.S., according to Liberty Mutual Research Institute for Safety’s 2014 Workplace Safety Index.
In its 15th year, the annual ranking of top 10 causes of serious, nonfatal workplace injuries is based on the company’s workers’ compensation claims data and data from the Bureau of Labor Statistics and the National Academy of Social Insurance.
The research institute examined 2012 claims data (the most recent available) for injuries lasting six or more days and ranked the injuries by total workers compensation costs.
10 Leading Causes and Direct Costs of Workplace Injuries in 2012:
1. Overexertion $15.1B 25.3%
2. Falls on same level $9.19B 15.4%
3. Struck by object or equipment $5.3B 8.9%
4. Falls to lower level $5.12B 8.6%
5. Other exertions or bodily reactions $4.27B 7.2%
6. Roadway incidents involving motorized land vehicle $3.18B 5.3%
7. Slip or trip without fall $2.17B 3.6%
8. Caught in/compressed by equipment or objects $2.1B 3.5%
9. Repetitive motions involving micro-tasks $1.84B 3.1%
10. Struck against object or equipment $1.76B 2.9%
Overexertion
The leading cause of injury on the list, overexertion, was typically related to lifting, pushing, pulling, holding, carrying or throwing. Other exertions, which came in at number five, includes injuries due to bending, crawling, reaching, twisting, climbing, stepping, kneeling, sitting, standing or walking.
According to statistics compiled by the City of Denver, 311 overexertion claims were reported by employees in 2013. Injuries most often occurred as a result of holding, carrying or lifting.
Falls
Recently, Accident Fund Insurance Company of America and United Heartland reported that close to a third of all Midwestern workers’ comp claims with lost time were due to slip and falls on ice and snow.
According to the insurers, winter-related slip and fall claims doubled between 2013 and 2014.
The top five states were:
1. Indiana – 37 percent
2. Wisconsin – 33 percent
3. Michigan – 32 percent
4. Illinois – 32 percent
5. Minnesota – 29 percent
Road deaths
According to the BLS, there were 105 worker deaths at road construction sites in 2013. Texas, Florida, Illinois, Pennsylvania and California were the top ranking states for roadway worker deaths. The top cause (69 percent) were pedestrian workers killed by motor vehicles.
In 2013, 63 percent of occupational fatalities in work zones were to the following occupations: construction laborers, highway maintenance workers, heavy and tractor trailer truck drivers, first-line supervisors of construction an extraction workers and construction equipment operators.
Private sector construction – primarily heavy/civil engineering construction and specialty trades contractors – accounted for 60 percent of worker fatal injuries in work zones.
Service producing industries in the private sector, such as the transportation and warehousing industry and the administrative and support services industry, accounted for an additional 27 percent of worker deaths in work zones. Ten percent of workers fatally injured in work zones were in the government sector.
According to the Occupational Safety and Health Administration, worker deaths in America are down. In 1970, there were on average 38 worker deaths a day and in 2012, the figure was down to 12 deaths a day. OSHA reports workplace fatalities have been reduced by more than 65 percent and occupational injury and illness rates have declined by 67 percent. At the same time, U.S. employment has almost doubled.

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GM Recalls Will Not Hurt Its Profitability

The Detroit Free Press (1/14, Gardner, 974K) reports that GM CEO Mary Barra told analysts said that the company expects higher profitability in every region during 2015. The article reports that GM CFO Chuck Stevens said that while the company may announce more recalls over the next few years, “the cost per recall should fall, partly because the company can respond faster.” The Free Press reports that the company will spend between $400 million and $600 million on the compensation fund related to the faulty ignition switches, but the exact figures will not be released until later in the year.
Bloomberg (1/15, 2.95M) reports that Barra spoke on the changes the company made to its recall process, saying that the faulty ignition switch defect was ignored because “people had a different view of stalling,” treating it as a “customer satisfaction issue” instead of a safety issue. She noted, “a series of mistakes were made.”

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