Medicare has stopped paying for care related to surgical site infections. Further, it fines hospitals whenever too many patients need to be readmitted within 30 days of discharge. How is this affecting care at the physician and patient level? As Karen Sibert writes, some odd things are happening:
An edict just came down in one big-city hospital that all scrub tops must be tucked into scrub pants. The “Association of periOperative Registered Nurses” (AORN) apparently thinks that this is more hygienic because stray skin cells may be less likely to escape, though there is no data proving that surgical infection rates will decrease as a result…One OR supervisor stopped an experienced nurse and told to tuck in her scrub top while she was running to get supplies for an emergency aortic repair, raising (in my mind at least) a question of misplaced priorities.
Improving quality of care and reducing infections is important. Achieving this goal using evidence-based, practical rules, however, is equally important.