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Duke Institutes Corrective Safety Plan Approved By CMS

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DURHAM, N.C. — Duke University Hospital is making changes to ensure patient safety, especially among infants and children.

The Centers for Medicare and Medicaid Services has accepted the corrective plan, so Duke can keep its eligibilty for those programs.

Federal authorities investigated Duke three times this year because of problems involving young patients. A teen-aged girl got a heart- lung transplant with the wrong blood type, and two infants were burned.

Duke's changes include establishing a Pediatric Safety program, which will review all hospital areas that might affect patient safety.The hospital also will hire a doctor whose sole job is to oversee patient safety.

CMS directed Duke to make patient safety changes following an Aug. 31 incident in which a premature infant suffered burns from heated air in an incubator.

"Traditionally, CMS would be issuing notices proposing to revoke Duke's hospital certification," CMS Administrator Tom Scully said. "Duke would appeal, and a long, cumbersome process would begin. Instead, we have avoided that normal bureaucratic dance and engaged in a real workout plan with Duke.

"This will more quickly improve patient safety -- and result in real change at Duke Hospital -- which is what this is all about. We appreciate the constructive approach that Dr. (Ralph) Snyderman and his team have taken to resolving some major issues."

The Pediatric Safety Program will be headed by Karen Frush, M.D., chief medical director for children's services, and advised by Marlene Miller, M.D., director of quality and safety initiatives at Johns Hopkins Children's Center.

In addition, the hospital's newly appointed chief operating officer, Kevin Sowers, will intensively review all operations that might affect patient safety throughout the hospital.

Sowers, who previously served as interim chief executive officer at Durham Regional Hospital, this week succeeds Robert Clapp, who is returning to a senior position with the Duke University Health System.

"We are pleased that CMS agrees that we are implementing the steps needed to further improve patient safety and to ensure the public that the highest quality care they expect from Duke is provided with the highest possible commitment to patient safety," said Snyderman, DUHS President and CEO. "It is not good enough that our statistical record of protecting patients, especially tiny, premature infants like the one involved in this incident, is among the best in the country. We need to do more, immediately, to ensure the safety of every single patient we treat."

Following its review, CMS informed hospital officials on Sept. 19 that it would terminate its eligibility for Medicare and Medicaid reimbursement unless Duke University Hospital addressed issues the agency had identified.

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