“Never Events” No Longer Covered, Can Be Prevented with Technology

NEWS TRENDS

As several major healthcare insurers begin declining coverage of conditions called never events, clinicians could benefit from using technologies that help prevent such occurrences. Never events are generally preventable, serious occurrences, according to the National Quality Forum, a patient safety advocacy group.

In 2002, the group endorsed a list of events that range from surgery performed on the wrong body part or patient to medication errors. The list currently consists of 28 items. Effective October 1, 2008, CMS and other insurers such as Blue Cross Blue Shield will no longer cover these events.

One of the most common issues is the retention of foreign objects, such as sponges, inside patients. “It should never happen that you go in for a procedure, and something the size of a washcloth or table napkin gets left inside your body,” says Bill Adams, CEO of SurgiCount Medical (Te­mecula, CA). The company, which estimates that there are 3000–5000 cases of retained sponges each year, makes a sponge inventory system that helps prevent this error.

“When you understand the circumstances that lead it to happen, you can understand why it happens,” says Adams. Amid the commotion and multitasking involved in the operating room, nurses must manually count sponges against an initial count taken at the beginning of surgery.

“A lot of people think it's just gross negligence on the part of practitioners, but [that really couldn't be] further from the truth,” says Adams. “I think it's a function of the environment and a function of the systems that the nurses have right now to count [sponges], which is basically a white board.”

Since CMS announced that it would soon stop covering never events, Adams has seen a strong increase in interest in SurgiCount's technology. “I would say in the last 90 days, the amount of activity and interest has gone up exponentially,” he says, adding that more hospitals are feeling an inevitable need for this type of system.

“[Retained] sponges, more than anything else—more than needles or instruments—will do a tremendous amount of damage,” says Adams. “A sponge will metastasize around your organs. You can be asymptomatic for up to a year and then come in with horrible complications.”

The foundation of SurgiCount's device is bar coding, and every sponge can be tracked via a Data Matrix tag. The system recognizes each individual sponge, so it won't let a nurse count a sponge twice. A nurse also can't count a sponge that wasn't originally identified with the patient.

When making the case for hospitals to adopt the technology, Adams cites its clinical effectiveness and affordability. “We're up to 100,000 procedures without having an event, so we're starting to get real statistical evidence,” he says. The system costs around $12–$15 per procedure.

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