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NPI deadline, perioperative errors, more

April 2007

Perioperative settings prone to medication errors
Poor handoffs and a fragmented perioperative process have led to a high rate of medication errors among surgery patients, a new report has found.

The report, which was created by the U.S. Pharmacopeia, analyzed 11,000 errors reported voluntarily by 500 hospitals from 1998 to 2005. Researchers found that a higher rate of drug errors caused harm for surgery patients than among the general patient population. The study found that 5% of adult patients and12% of children undergoing surgery were affected by drug errors.

Most of those errors involved antibiotics and painkillers. Typical errors included failure to correctly set pumps to dispense blood thinners or pain medications; failure to note drug allergies; failure to administer antibiotics before surgery; and administering overdoses to infants.

Problems typically occurred as a result of perioperative handoffs from the preoperative team to the operating room, recovery room and wards.

Among several dozen recommendations, the report advises using dedicated pharmacists in perioperative units to oversee medication distribution. It also calls for better coordination of patient handoffs to avoid the loss of patient information.

Internal medicine holds steady in record-setting Match
A record number of U.S. medical seniors participated in the Match in March 2007, resulting in the highest number of residency slot matches in the program’s history.

Close to 28,000 applicants vied for almost 22,000 program positions. The percentage of U.S. senior medical students matching to categorical internal medicine programs essentially remained the same, even though more positions were offered in that category. The results included the following:

  • Internal medicine: Among categorical positions, 55.9% were filled by U.S. seniors (2,680), compared to 56.3% (2,668) in last year’s Match.
  • Family medicine: One hundred fewer residency positions were offered in the 2007 Match. Of those, U.S. graduates filled 42%.
  • Pediatrics: Programs offered 40 more residency slots than last year, with U.S. seniors filling 72.8%.
  • Emergency medicine: U.S. seniors filled close to 79.7% of available PGY-1 slots this year.
  • Ob/gyn: The specialty has seen an uptick of interest from U. S. graduates in recent years. In this year’s Match, 72.5% of positions were filled by U.S. seniors, up from a low of 65.1% in 2004.

The 2007 Match also featured a 7% increase in the number of non-U.S. medical graduates applying. This year, 621 couples were also involved in the Match, a number that has been rising steadily since 347 couples entered the Match in 1987.

NPI deadline is almost here
The National Provider Identifier (NPI) compliance date is only a month away. By May 23, 2007, clinicians must be using NPIs in standard transactions to receive Medicare payments.

The NPI is a new identification number for providers doing business with insurers. The new number was mandated by HIPAA and replaces most other provider numbers, including the unique physician identification
number.

To apply for an NPI, visit the National Plan & Provider Enumeration System Web site.