Substandard Patient Care

SUBSTANDARD QUALITY OF CARE

SUBSTANDARD QUALITY OF CARE

Introduction

Substandard quality of health care is duly recognized as a major form of medical crises with potential to jeopardize the functioning and purpose of the American health care system . Whereas on the one hand medical costs of treatment are rising , on the other malpractices and non compliance on the part of medical professionals and institutions compounds the problem and seriously questions the quality of health care being provided to citizens

However , before proceeding further it 's important to understand what is

br exactly meant by the substandard quality of care . The substandard quality of care implies that one or more of the requirements mandatory under the federal regulations 42 CFR 483 .13 involving resident behavior and facility practices , 42CFR .15 involving quality of life or 42CFR 483 .25 regarding quality of care are not complied with leading to actual jeopardy to the resident health or safety or having potential for causing more than minimal harm (HealthCare information , 2007 . Any nursing home found with delivering substandard quality of healthcare or carrying significant deficiencies in its healthcare treatment plans would be required to immediately address the issue

A case of substandard health care

The following case presents an example of injuries from utilization control healthcare delivered resulting in grievous and permanent injuries to the patient (Flannery , 2007

The case presented here is about Lois Wickline who was diagnosed with Leriche 's syndrome , which is a vascular occlusion . Upon diagnosis , her doctor recommended surgery where a part of an artery was to be replaced with a Teflon graft . The program providing medical care to Ms . Wickline was California 's medical assistance program , Medi-Cal that was responsible for controlling costs and authorizing treatment . As such the approval and authorization from state was a requirement to perform surgery

When Ms , Wickline 's doctors sought approval from Medi-Cal for the surgery , Medi-Cal agreed and also allowed ten days of post-surgery treatment in hospital . However , Ms . Wickline 's recovery did not take place as estimated and a day before due discharge date , the surgeon and his assistant felt that Ms . Wickline required additional eight days of recuperation in hospital . Medi-Cal was again approached for the approval for this extended stay , butt on this occasion Medi-Cal differed from surgeon 's recommendations for eight days extension . The Medi-Cal representative , who was himself a certified surgeon , merely consulted a Medi-Cal nurse on phone , and after evaluating progress of Ms . Wickline on basis of her temperature , diet and bowel function , declined the request and approved only four day extension . In the process he neither reviewed any documents related to the case nor consulted any other vascular-surgery specialist (Flannery , 2007

On denial by Med-Cal , the surgeon attending the case of Ms . Wickline decided not to push for the additional days of care and complied with Med-Cal directives by discharging her at the end of the stipulated period . Both the surgeon and the assistant admitted in their testimonial that they did not push for the...