#jcaho

[mon221b]

I’ve listened to a lot of TMA recently and when this landed in my inbox it hit me that it would be a perfect nightmare domain for nurses �� you can treat those wounds using all the best practices, but they will. Never. Heal.

[adricthemindnimon]

I really love the X Files, but it does drive me crazy when Mulder is immediately convinced that a supernatural explanation is more likely than a very very likely natural explanation. There's being open to the possibilities, and then there's forgetting that the real world exists...

Like in Sanguinarium (4.6). Everything about that hospital is begging for accidental patient deaths. Surgeons going in and doing procedures solo? No time outs? Patients left alone in ORs, already sedated? Doors that would be really hard to get through without breaking scrub?

Mulder thinks witchcraft is more likely than "a doctor mistaking a beer belly for a bald head", when the vast majority of surgical harm comes from simple but egregious mistakes - wrong patient, wrong procedure, etc. He really thinks it's that unlikely that a surgeon could've walked into the wrong OR? The ORs are identical, the patient is already unconscious, there's nobody else in there, and there's clearly no protocol in place to confirm surgical details before surgery begins. That set up almost guarantees a mistake like that. Plus the doctor had addiction issues and possibly hadn't been sleeping?

In episodes like this, Mulder is just as much a skeptic as Scully, it's just that he's skeptical about basic reality. And it really irks me! I love the X Files episodes where normal reality just doesn't add up to an answer and Mulder is able to figure it out because he's open minded and notices something other people have overlooked or dismissed. But when he looks at a completely comprehensible normal set up, deduces an elaborate supernatural plot for no apparent reason (or some incredibly tenuous reason), and then is proved right? Ugh.

[trollcross42]

Dislodge the tube!? We would never! And our estimates of surgery times and blood loss are impeccable. *cough cough* I almost said that with a straight face.

But yeah, the lights (and monitors) are a menace.

What is OLV? I saw it when I was doing research about chest injuries but they didn't explain it

one lung ventilation!

at least, that's what i would assume it is

simply put: one lung ventilation, sometimes called "single lung ventilation", is where we isolate one lung from the other, allow one lung to collapse while we ventilate the other.

we can do this with a double lumen ETT (DLT). this is a DLT compared to a standard ETT:

so the top tube is the double lumen ETT (DLT). the white cuff (usually clear but ig some be like that) at the end is the tracheal cuff, the blue one is the bronchial cuff.

the bottom is a standard ETT. the clear bit on the end is a tracheal cuff.

the little sort of "tags" are the spring loaded one-way valves and pilot balloon, they let us inflate and deflate the cuff as well as check the pressure. what's good about a DLT is that we can use a fiberoptic scope in the tracheal tube to identify landmarks and watch as we inflate the bronchial cuff to make sure it doesn't "herniate" and that it is adequately inflated.

here's a DLT on it's own:

the blue is bronchial, clear is tracheal.

most DLTs also come with a stylet which helps us sort of shape the tube for easier intubation but stylets are a whole other thing*.

it's hard to explain but basically under the tracheal cuff, there is an opening (a hole basically) then under the bronchial cuff the tube opens. if we clamp off the top of tracheal tube (the clear part but leave the blue open), oxygen can only flow through to the hole under the bronchial cuff and therefore only ventilates one lung as the oxygen won't get past the cuff.

a right sided DLT looks different to a left sided one but again, that's a whole other thing.

i hope that makes sense!

*a stylet is different to a bougie

[purplehanfu]

Snowy Night Timeless Love: Ep 1-5

notes: Spoilers! If even one person enjoys the joke, my efforts will not have been in vain. Master list of all recaps

(Knocks on the door to Apothecary Valley, the preeminent medical facility of the jianghu)

"Hello, yes, you must be Xue Ziye, the Valley Master."

"Me? I'm a site surveyor from the Joint Commission - JCAHO. Yes I do have a Fate Reversal Token but that is something we definitely need to discuss because jade tokens cannot be considered a prerequisite to medical treatment."

"Don't close that giant door- let me in!"

"Thank you for eventually letting me in since you are legally required to do so. I've made my preliminary assessment and I do have some questions. Who is this pharmaceutical rep that I see running around everywhere? He says his name is Huo Zhanbai."

"He also says that he's the 7th disciple of the Celestial Alp Sword Sect but I just see someone who's not a PharmD procuring unregulated medicine."

"I know there are shortages, but you can't just pluck fungus out of a tomb and call it a day.

I see, he's collecting five precious medicinal ingredients to save the child of his sworn brother and junior sister?"

"Some of the nurses told me Huo Zhanbai actually had a thing for his junior sister Qui Shuiyin and that Huo Zhanbai was the one who killed his sworn brother because he was trying to defect to an evil sect- that's some good gossip. So good I might let it slide that I also noticed that there were open beverage containers at the nurses' station. Just kidding, I'll have to report that."

"Who is the guy frozen in ice out on the lake?"

"Oh that's your first love who sacrificed himself to save you Titanic style and now you're obsessed with reviving him?"

"I know he's technically neither dead nor alive, Valley Master Xue, but I don't see him listed on the census as a patient."

"The only positive thing I can say so far is that your staff to patient ratios are excellent, well within ANA standards. Your use of restraints is questionable though."

"But everything else, well, I'll be honest- there are a lot of violations that will require regulatory action. Wait- why are you coming over here with that knife?"

"Valley Master Xue, stop right there! I still have to give my report on your National Patient Safety Goal compliance… Put that dagger down!! Why are you stabbing me in the shoulder? Who even does that? Oh no- poison!!! ARGGHHH! "

(dies)

Bonus: Good Looking Bad Guys

Eye

Miao Feng

Miao Shui

They all belong to Yuan Li Palace, and their leader Chang Wujue is also looking for the special ingredients to aid his cultivation. Chang Wujue is over-the-top, his motivations make no sense and I love his very extra lifestyle.

It's just so nice to see a bad guy living in a greenhouse full of flowers instead of the usual dank and dark aesthetic.

Time to Get Catty

Do we think Zeng Shunxi had buccal fat removal?

master list of all recaps

[middleearthpixie]

Better Days ~ Chapter Six

A/N: This is the follow up to Playing With Fire, but can be read as a standalone. I thought Frerin deserved a nice, steamy romp just like his older brother got with Leda, so this is his story. I know I’ve got like three other fics to update, but I thought maybe I’d throw this out there and see what everyone thought of it… 

Summary: Frerin Durin had the perfect life, until he found out his wife was cheating on him. Now, he’s navigating uncharted territory as an about-to-be divorced single dad. Dating is a mess, he’s dealing with the fallout where his kids are concerned, and really, he would just love a vacation away from all of it. 

Elena Madison is new to Sidleburg, and also navigating life as a newly single parent. The last thing she needed was for her daughter to come down sick, when she hasn’t even had time to unpack the moving boxes, never mind find a pediatrician. And the last thing she ever expected was to meet a man like Dr. Frerin Durin…

Neither Elena nor Frerin were looking for anything, but fate has a way of messing up even the best laid plans. However, both have been hurt and both aren't at all sure they trust themselves, never mind trusting someone else...

Pairings:  Modern!Frerin  x ofc Elena Madison

Characters:Frerin, Carol Kingsley, Ashley, Vanessa, Flynn, Maura, Jake

Warnings: None

Rating: T

Word Count: 3.9k 

Tag List: @mrsdurin @i-did-not-mean-to @lathalea @linasofia @fizzyxcustard @legolasbadass @kibleedibleedoo @xxbyimm @arrthurpendragon @exhausted-humxn-being @rachel1959 @laurfilijames @sketch-and-write-lover @sherala007 @enchantzz @knittastically @notlostgnome @myselfandfantasy @medusas-hairband @guardianofrivendell @jotink78 @sorisooyaa @ruthoakenshield @frosticenow @quiall321 @dianakc @buckybarnes-thorin @glassgulls @evenstaredits @heilith @asgardianhobbit98 @albionscastle @absentmindeduniverse @way-too-addicted-to-fandoms @sazzlep @court-jobi

If you’d like to be added (or removed) to the tag list, please just let me know!

Previous chapters can be found here. 

Frerin stared at his inbox as if it had personally insulted him. How did the paperwork double in the span of a day? It seemed like he no sooner beat the stack into submission before it sprouted up three more inches. A hydra of JCAHO, Medicare, Medicaid, and insurance forms, all needing to be filled out, reviewed, or signed and when he did, more would just reappear. It never ended. 

His pager went off as he reached for the first binder-clipped sheaf of papers. They went ignored as he glanced down at the number. Three-three-one-five. The ER. It was nearly three in the morning and things had been quiet, so he’d managed to plow through at lease some of the paperwork. But a page to the ER at that hour was never anything good. 

His chair squeaked as he rolled back from his desk and stood, hooking a finger in the neck of his lab coat to swing it around. His new pink stethoscope lay coiled on his desk, compliments of Jerry, who handled procurement, and he smiled as he picked it up to drape about his neck. It was Thursday night, well, technically early Friday morning, and he had about three hours left in his shift. He’d go home in time to get the kids ready to go to school, and then come tomorrow morning, they’d be going off with Toni for the weekend and he was not looking forward to it. As the week had progressed, Jake grew more and more insistent that he didn't want to go with his mother and as much as Frerin wished he could just let him stay home, he knew Toni would be on the phone with her lawyer so fast, his head would spin. 

Lawyers. Arguments. Court dates. Those were what filled his free time and while he’d sat in on meetings with the hospital lawyers for various reasons, he’d never had to keep one on retainer until last winter. He found that all things considered, he preferred when he didn't have a lawyer on speed dial.

The pediatric ward was quiet, the rooms all mostly dark, the nurses, doctors, orderlies all walked softly and spoke in hushed tones. The nurses had been busy decorating the floor with red and green garlands, a six foot tall blue spruce tree stood in the corner across from the desk, draped with paper chains he’d seen some of the kids in the pediatric unit gluing together earlier. Candy canes and colored balls of varying size hung from the branches and a menorah stood on the desk itself. 

“If anyone needs me,” he said, pausing by the desk, “I’ll be down in the ER.”

“Go with God, Dr. Durin,” Angela said. “It’s a zoo down there tonight. I bumped into Carol Kingsley earlier and she said they’ve got them stacked three deep in some areas. Christmas parties in addition to the bar mayhem.”

“I just hope none of them are kids,” he replied softly.

Angela’s eyes grew sympathetic. “They paged you down, Frerin. That can’t be good.”

“I know.” He rubbed his eyes and then rapped his knuckles lightly against the desk. “Keep your fingers crossed just the same.”

“Will do.”

Labor and Delivery and the Neo-Natal ICU were at the far end of the corridor and he passed by them on his was to the elevators. The walls in the Pedes ward were bright and festive, but down here, the colors were sedate and tranquil—mostly soft blue and pale dusty rose—and it was noisier as well. Especially in the NICU, where monitors and alarms went off seemingly nonstop. Labor and Delivery was quiet for the moment, but that could always change in the blink of an eye.

When his own kids were babies, Frerin had a hard time just looking at the NICU. Jake was six weeks premature and had spent some time there and Frerin remembered all too well how awful it felt to be in that small room, standing over his newborn son, helpless despite all of his medical knowledge and training to do anything more. 

There were two couples and one single woman doing just that over three separate hospital bassinets now and Frerin sighed softly as the NICU team swarmed around the single woman’s child, monitors blaring, a doctor gently—but firmly—moving the mother (Frerin assumed she was the mother) aside.

He tried not to think about it as the elevator doors opened and he stepped in, but as the doors began to slide shut, the woman looked over at him and her expression was a like a punch to the gut. He’d seen it before, more times than he’d cared to think about—pleading, resigned, and numb all in one exhausted face. 

The doors slid shut and he leaned against the back wall with a sigh. Sunday couldn't get here soon enough. He looked forward to seeing Elena again.

He looked forward to kissing her again. 

It had been a long time since the thought of a woman sent anticipation fluttering through him, but Elena did just that. He couldn't stop thinking about her—her laugh, her smile, the way her eyes sparkled, the feel of her against him. He wanted to feel that again. Soon. 

The doors opened into chaos. The ER always picked up when the bars closed at two AM and the holiday situation only made it worse. He stepped out into the hallway, and was promptly grabbed by a guy parked in the hallway.

“You a doc?”

“Yes, I am, but,” Frerin jerked his wrist free, “I’m not a grownup doctor.”

“So we’ve heard. What are you doing down here again?”

“Funny.” He looked over at Carol. “I was paged, where’s the kid?”

Carol shook her head as she snapped on a pair of gloves. “I don't know. I didn't page you.” 

The guy on the gurney grabbed for him again. “Hey, doc, you aren’t doing anything important, take a look at my foot, will you?”

“Pipe down, Tony,” Carol snapped, moving to the end of his gurney. “What did you do this time?”

“I put my foot through a fucking picture frame, that’s what.”

She sighed. “How did you manage that?���

“I dunno. I’m clumsy.”

This time, Tony reached for her, and Frerin snagged his wrist before he could grab her. “Enough. Let her look at it. Carol, if you need me to stitch it—”

“Mark’s coming. He’s dealing with another frequent flyer in Curtain Two, it won’t be long.”

“You touch Nurse Kingsley again,” Frerin turned to Tony, “and you go in restraints. Got it?”

“Yeah, man. I got it.”

“Good.” Frerin released him. “Carol, he gives you any more trouble—”

“Security isn’t far.” She smiled up at him as she peeled off Tony’s bloody sock. “Go.”

Frerin skirted them to make his way to the front desk. “Someone paged me?”

“Dr. D,” Ashley smiled up at him, “I did. We’ve got a nine year old in anaphylactic shock rolling up in five.”

“Do we know what caused it?”

“No. Collins didn't say.”

“Okay. I’m going to grab a cup of coffee. Let me know when they get here.”

He crossed over to the lounge and sighed at the nearly-empty coffee pot left on the burner, which baked the last remnants of the previous pot into the glass. “Wonderful.”

He’d just put the pot in to soak when the door banged open and a nurse in dark green said, “Dr. Durin? Rig’s pulling up with your anaphylaxis kid.”

“What’s open?”

“Trauma One.”

“I’ll meet you there.”

She bobbed her head and the door swung shut. He grabbed a paper towel to dry his hands, then hurried back out to Trauma One just as the paramedics wheeled in the nine year old. “Give me the bullet.”

“Max Gonzales,” the paramedic said, “nine years old, apparently allergic to cashews and only found out about half an hour ago. Mom and dad are on their way. His BP is—”

Frerin listened with one ear as he smiled down at the wheezing, dark-haired boy on the gurney. “Hi, Max. Can you understand me?”

Max nodded. 

“Good.” Frerin let his hand skim lightly along Max’s tousled dark hair. “I’m Dr. Durin and I know you’re having trouble breathing, but it’s going to be okay, all right? Your mom and dad will be here in a few minutes, but I’ve got you.”

“I—can’t—br—breathe…”

“I know. And I’m going to fix that for you, promise.” He looked over at the nurse who’d alerted him to the rig rolling up. She had to be new, because he had no idea who she was. “I’m sorry, I don't know your name.”

“Vanessa.”

“Vanessa, let’s start with point-three of epi, IM.”

She nodded. “On it.”

“Good.” He turned back to Max. “Hang in there, buddy. Medicine’s coming.”

Max reached for him, and Frerin smiled as he caught the boy’s hand. “It’s going to be okay, Max.”

Max’s fingers tightened about his as Vanessa administered the epinephrine, and within a few seconds, his breathing eased. Frerin eased his hand from Max’s and fit his stethoscope ear pieces in, then slid the diaphragm under the boy’s dinosaur pajama top. “Can you sit up for me, Max?”

“I think so.”

He did as Frerin asked, stiffening slightly when Frerin slid the stethoscope over his back. “I know, it’s a little cold and I’m sorry about that. It’ll warm up quickly.” He moved it from left to right, then down lightly and back to the left. 

“Sounds pretty good, buddy. Is breathing easier now?”

Max nodded. “A lot easier.”

“Good.” He looked up at Vanessa and bobbed his head. “Let’s put him on point-seven albuterol and move him into a quiet room for observation. Are his parents here yet?”

With that, the doors to the trauma room opened and Ashley said, “Dr. Durin, I’ve got Mr. And Mrs Gonzales.”

“Perfect timing.” Frerin pulled the earpiece free and draped the stethoscope about his neck. “I’m Dr. Durin. Did you know Max was allergic to cashews?”

“No. He’s never been allergic to anything,” Mrs. Gonzales replied, staring at her son with glinting eyes. “He’s a healthy kid.”

“What were you doing eating nuts in the middle of the night, kiddo?” Mr. Gonzales asked. “You were supposed to be sleeping.”

“I was hungry.”

“Well, next time, maybe have something else,” Frerin told him. “At least, have something you know you can eat. Mom, Dad, I think it’d be a good idea to set up an appointment with an allergist, so we don't have to do this again.”

Mrs. Gonzales looked from her son to him. “I wouldn’t know where to start.”

“Don’t worry, we can give you a few names,” Vanessa assured her with a smile. 

“Thank you.” Mrs. Gonzales looked back at him and gestured to her son with one hand. “Can I touch him?”

“What? Oh, yeah, sure.” He stepped aside and gestured for her to come closer. “We’re just going to move him to a quieter room and keep an eye on him for a little while, but I don't think he’ll need to be admitted. Vanessa, would go with them?”

“Of course.” She smiled as one of the residents wheeled Max toward the doors. 

“Thank you, Dr. Durin,” Mr. Gonzales said softly, his hand at the small of his wife’s back. 

“I’ll come by in a bit to check on him. Vanessa, any changes, let me know at once.”

“Will do, doctor.”

The doors swung shut and the room was strangely quiet. He glanced up at the clock. Ten to four. Two more hours.

His pager went off and he sighed as he reached up to rub his eyes. NICU. Fuck.

The house was quiet and dark when he pulled into the driveway and as he killed the Infiniti’s engine, Frerin leaned his head back and let his eyes close. Working with kids was great most of the time, but like he told Elena, when it went south, it was horrible.

The human body was as fragile as it was resilient and some of the worst moments of his career were those when he had to pronounce an infant. Those moments aged him. When his kids were younger, he’d come off a shift like this one and just stand over their bassinet, their crib, their toddler bed, and silently thank whatever higher power was at work in making sure his children remained healthy and whole. 

They were older now, but his need to check on them hadn’t waned. He went inside, crept noiselessly up the main staircase, and began in Flynn’s room, which took a bit of navigational skill, as it often looked like a bomb had gone off in there. But, his firstborn was sound asleep, snoring like a buzzsaw, as Toni used to say about him.

Maura was next. Her room was far neater than her brother’s and definitely girlier, with its soft pink walls and sheer pink curtains dotted with silver sequins in a butterfly pattern. A salt lamp glowed from pink to blue to purple on the small wood and tile-top table she’d made the previous year in woodshop and she was sound asleep beneath the fluffy pink comforter that was part of the bedding set he and Toni had given her for Christmas the previous year.

He bent over to lightly kiss her forehead, smiling as she mumbled, “Go ’way,” and rolled over to offer him her back. 

He tugged the comforter up to her shoulder and crept from her room to Jake’s, at the end of the hall closest to the bedroom Frerin once shared with Toni. With a soft sigh, Frerin just gazed down at his baby. He was almost eleven years old, but to Frerin, he would always be his baby and asleep, as the others did, Jake looked even younger. 

Pulling Jake’s door by, Frerin stepped out into the hallway and sighed softly as he made his way to his own bedroom, where he unknotted his dark blue and silver swirled tie, and then unbuttoned his pale blue dress shirt. The tie went back on the rack in the closet, his belt on the hook alongside it, and as he came back out of the closet, he tossed the shirt and his socks into the laundry basket on the floor alongside his high chest of drawers. His trousers would go into the pile to go to the cleaners before work on Saturday, and clad in only his dark gray Calvin Klein boxer briefs, he padded into the bathroom and started the shower. 

He stood under the hot spray, eyes closed, water sluicing down along his temples, soaking into his beard, pounding over his shoulders. He made no move to reach for soap or shampoo, unable to get that NICU mom out of his mind. Her name was Amelia, she was seventeen years old, and her family disowned her because of the baby girl she’d given birth to not quite twenty-four weeks along. And there was nothing he could do for her daughter. Nothing the hospital could do. The only thing he could do was look up at the clock, pronounce her daughter’s time of death and offer his condolences. And when he did, she just stared up at him for a long moment and then whispered, “Is that it?”

He’d nodded. “I’m so sorry.”

She’d bobbed her head, her bottom lip quivering, her eyes shimmering with unshed tears. Then she’d bowed her head and one of the NICU nurses eased an arm about her shoulders, while he filled out the paperwork. When he’d finished, Amelia was on the phone, not crying, but she sounded almost dazed and when he’d passed by, she reached out to catch his wrist and thanked him.

Thanked him.

He did nothing to be thanked for and yet—

She’d thanked him.

“Fuck.” He reached for the shampoo.

When he emerged, in a cloud of steam, he felt more like himself and when he came down into the kitchen and heard Flynn and Maura arguing over who was the better goalie, Richter or Lundvist, he chimed in with, “Shesterkin has them both beat,” as he crossed to the Keurig.

“That’s what I said,” Jake broke in. “And they ignored me.”

“Well, he doesn’t have a cup,” Flynn said.

“Neither does Hank and you’re throwing his name out regardless,” Frerin tugged open the drawer below the counter, where the K-Cups were kept, and took out a Folger’s Black Silk pod. “And why are you fighting about hockey anyway? Did I miss something last night?”

“No. Boston kicked the shit out of the Rangers.”

“Flynn, mouth.”

He shook his longish dark hair out of his eyes. “Sorry, Dad. How was your shift?”

“I don't want to talk about it.”

“Why? What happened?” This came from Maura, who set her spoon against the side of her bowl. “Did you lose someone, Dad?”

“Yeah. A micropreemie. But, I also saved a kid from anaphylaxis, so there’s that.”

“What’s anaphylaxis?” Jake asked.

“He was allergic to cashews and had trouble breathing. But, he got the ER in time and will go home with his parents later today.” Frerin took the cup from the tray on the Keurig and brought it up for a much needed sip. “Did you all get your homework done?”

“Yeah.” Maura sighed. “Flynn had to help me with my algebra homework. Why do I even have to learn this? When will I ever use it again?”

To Frerin’s surprise, Flynn nudged her shoulder with his. “You’ll get it. It’s just that Mrs. Henderson is old and a crappy teacher. Nobody who has her understands algebra because she’s a dinosaur who doesn’t remember how to teach it.”

“It’s still stupid. And I have a test on Monday. I’m never gonna pass it.”

“I’ll help you over the weekend. Bring your stuff when we go to Mom’s.”

Maura wrinkled her nose and Frerin braced himself as her blue eyes met his. “Do we have to go to Mom’s this weekend? We’re seeing her on Christmas, isn’t that enough? I can’t stand that stupid boyfriend of hers.”

“Yes, you do and no, it’s not. In that order.” Frerin lowered his cup. “And what’s wrong with him?”

She just shot him a look. “Are you serious, Dad?”

“Yeah. I’m dead serious.”

“Well, for starters, it’s just like the last time. He’s overly friendly, like he wants to prove he doesn’t hate us just for existing, but you just know he wishes Mom would just not want us to come over.” Maura flung herself against the back of her chair with enough force it rocked back slightly. “And he’s just so skeezy.”

That made Frerin straighten up. “Skeezy how?”

“He’s like a used car salesman,” Flynn broke in, “all big teeth, cheesy smile, and back slaps. I want to dick punch him. He’s just such an ass.”

Frerin bit back a smile. “Ignore him. Your mother is the one you’re there to see. And as long as he keeps his distance…”

“You know, Dad,” Maura grinned up at him, “you didn't tell us how your date went the other night and you were home by eleven. Was it that bad? Tell me it wasn’t that bad, please.”

“No,” he shook his head, moving to the table to sit across from them, “it wasn’t bad at all, but it also wasn't a date.”

“You went to dinner,” Jake told him pointedly. “Isn’t that a date?”

“We didn't go out to dinner. That’s this Sunday.”

“Mom’s gonna flip,” Maura chuckled. “She asks about you, you know.”

“Maur, don't even go there,” he told her softly, shaking his head. 

“I know, but she does. And are we going to get to meet this mystery woman?”

“In time, if things go well. But, I promise you, she is not a skeezy used car salesman type at all.” He glanced at the clock on the microwave. “You two should get going.”

“Yeah, I know,” Flynn signed as he shoved his chair away from the table and stood. “Dad, you cannot possibly do any worse than Mom has.”

“Well, that’s something.” Frerin grinned at his oldest. “Drive carefully and make sure Jake eats something besides Frosted Flakes for dinner tonight.”

“Dad, when do you go back on days?”

He looked over at Jake. “Not until after the New Year. It’s only a few more weeks.”

“I hate when you work nights.”

“Yeah, I’m not too crazy about it, either, but that’s being a grownup, bud. You sometimes have to work the overnight shift when you don't want to.”

“Just think,” Maura rose from her chair and deposited her cereal bowl and spoon in the dishwasher, “in a few years, you’ll be able to throw parties when Dad’s working graveyard.”

Jake’s eyes lit, but before he could say anything, Frerin broke in, “I’ll hire a night nanny for you if that’s a possibility.”

“You never let us have any fun.” Maura slung her backpack over her left shoulder. 

“I know. Mean Dad strikes again. Have a good day, both of you and Flynn—”

“I know,” he sighed, “I’ll drive carefully.”

“Humor your old man, okay?”

The two of them thudded out of the kitchen and a moment later, the front door slammed. Jake sighed softly, setting his spoon down. “I really do hate when you work nights.”

“I know. I really don't like it, either, but sometimes, I have to work the shifts no one else can. That’s what being the boss means.”

“I thought it meant telling everyone what to do.”

“Well, there’s that, but it’s also picking up the slack when no one else can, either. And right now, my department is understaffed.”

“Where are all the doctors?”

“That, Jake, is a good question. Budget cuts make hiring staff and keeping staff more difficult when private hospitals don't have that problem and can lure good doctors away.”

“Why don't you do that? Aren’t you a good doctor?”

Frerin grinned. “I hope I am, but I’m happy where I am. I like where I am.”

“Mom used to get mad when you did the overnights. Is that why she left?”

Frerin sighed. Jake didn't know and he wasn't about to tell him the real reason why he and Toni were divorcing. “No, it’s a lot more complicated than that. Your mother and I just can’t live together any more.”

Jake sighed softly. “I hate that.”

“Yeah, I know.” Frerin reached out to rumple his thick auburn hair. “But sometimes, life throws crappy stuff at you. This is one of those times.”

Jake looked up at him. “But, if Mom said she was sorry—”

“We’ve had this discussion,” Frerin broke in gently, “and that’s not going to happen, Jake. Like I’ve said, the day will come when you will understand and you’ll realize we did the right thing. It’s better for you and Maura and Flynn.”

“It doesn’t seem like it.”

“I know it doesn’t seem like it now, but it will.”

“One day, right?”

Frerin nodded. “One day, I promise.” He glanced up at the clock. “We should get you off to school, buddy. Go get your stuff.”

Jake slid down from his chair and strode out of the kitchen to head up to his room. As his footfalls sounded overhead, Frerin sank back in his chair and sighed. One day. 

It couldn't come soon enough.

[janeblr]

Ewwww. It’s obviously an inherent hazard of reading house fanfiction that most authors have no knowledge of the healthcare industry, medicine, etc but seeing someone write JCO instead of JCAHO made me recoil in disgust

[fauvester]

these are my star trek doctor ocs emtala jcaho (pronounced jay-ko) and ama n'jem

[theoxenfree]

sigh, so I fucked up at work last night on something (if your work specifies wearing eye protection for anything. just do it. I'm a prime example of why those policies exist lmao) and I'm teetering on whether to say something or "lmao I'm probably fine let's wait and see".

if I knew what the consequences would be for something like that e.g. a slap on the wrist and being written up vs suspension and JCAHO investigation (very unlikely but JCAHO likes to hover around us) I'm like just let me get sick lmao

ahhhh to do the right thing for myself ethically , or boldly assume I'm invincible and avoid punishment

[awsomebloggersblog]

Job Opening For Certified Nursing Assistant (CNA) - Per Diem Intuitive Health Services Job title: Certified Nursing Assistant (CNA) - Per Diem Job description: OverviewOchsner Rehabilitation Hospital*A joint venture with Select Medical & Ochsner Health*New Orleans, LACertified Nursing Assistant (CNA) - Per DiemDays or NightsShift Hours: 5:45 am to 6:15 pm or 5:45 pm to 6:15 amBenefits of becoming a nursing assistant with us: Flexible scheduling with rotating weekends Manageable caseloads A high percentage of patients being discharged home Team-oriented and family-like culture A network of over 50K employees nationwide with advancement and relocation opportunities ResponsibilitiesCertified Nursing Assistants work collaboratively with our nursing and therapy teams and assist patients in their rehabilitation process. They are obtaining vital signs, help the patient with daily activities, promptly answering call lights, reporting any issues or progress observed, and reinforcing rehab techniques as assigned by the therapy team.QualificationsMinimum Qualifications Education: High School diploma or equivalent required. Certification as a Nursing Assistant required based on state JCAHO requirements Preferred Experience BLS preferred Hospital experience preferred Additional Data**Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer. Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law. Apply for the job Certified Nursing Assistant (CNA) - Per Diem At Intuitive Health Services, our goal is to make healthcare better for everyone. We help hospitals, clinics, and other healthcare places find the right doctors, nurses, and other healthcare workers. For over 15 years, we have been doing this important job. We work with places like state hospitals and correctional facilities to make sure they have the best people to take care of patients. We don’t just connect people with jobs; we also support them throughout their journey. We help with things like improving resumes, preparing for interviews, and finding the job that fits best. We work in over 50 different locations and have over 900 professionals who trust us to help them. If you are looking for a job in healthcare, we are here to guide you. If you are a healthcare facility needing to hire someone, we can find the best person for you. Our team is always ready to help, and we believe that by working together, we can make healthcare stronger and better for everyone. If you need to contact us, you can find us at: Address: 520 West Lacey Blvd, Hanford, CA 93230 Email: jobs@intuitivehealthservices.com Phone:+1 (805) 703-3729 We’re here to help you with all your healthcare staffing needs! https://intuitivehealthservices.com/register

[solutionscounselingenter]

All In Solutions Counseling Center Cherry Hill

All In Solutions Counseling Center Cherry Hill

All In Solutions Counseling Center is a drug and alcohol addiction treatment center located in Cherry Hill, New Jersey. JCAHO accredited, All In Solutions has maintained the highest standard of care for more than a decade. Our individualized inpatient and outpatient addiction treatment programs offer holistic, evidence-based, faith-based, and even medication-assisted treatment therapies.

The experienced staff at our alcohol and drug rehab provide quality care that addresses the mental health that underlies addiction. Our treatment center provides a family environment where we truly care about clients and they care about one another. The quality addiction treatment that we provide is covered by most private health insurance providers.

All In Solutions Alcohol & Drug Rehab in Cherry Hill, New Jersey

Welcome to All In Solutions, where we strive to provide more than just the most comprehensive addiction treatment programs in New Jersey; we aim to cultivate a family of recovery, growth, and support. We offer inpatient, outpatient, and medication-assisted treatment plans.

Our clinical team focuses on providing clients with the education, techniques, and support needed to sustain long term recovery. Our group curriculum utilizes proven, evidence based and cognitive behavioral techniques, delivered in a setting that promotes healing, openness, and personal growth.

Addiction Treatment Center Cherry Hill  

Located in Cherry Hill, NJ, our JCAHO-accredited treatment facility is conveniently near Philadelphia, PA and Trenton, NJ in the heart of Camden County. Just miles from several Jefferson Health and Virtua Hospital locations, All In Solutions is a proud leader in New Jersey behavioral healthcare. 

Why Choose All In Solutions?

In over 11 years in business, countless patients have placed their trust in the experience and expertise of All In Solutions Counseling Center Cherry Hill.

Experienced Addiction Experts

Over 11 years experience helping addicts and alcoholics recover.

More than 3000 alumni living happy healthy sober lives.

Detox Cherry Hill

Hundreds of 5-star reviews from satisfied patients and family members.

Accredited by the Joint Commission for providing exemplary care.

National Association of Addiction Treatment Providers member.

contact us

All In Solutions Counseling Center Cherry Hill https://www.allinsolutions.com/locations/cherry-hill-nj/ ​​​ADDRESS: 1930 Marlton Pike East Building T Building S Cherry Hill, NJ 08003, United States PHONE:(856) 336-5806

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[lnlconsulting2]

The Vital Role of a Certified Home Health Care Consultant: Ensuring Quality Care and Accreditation

As a certified home health care consultant, I play a pivotal role in ensuring that home health care agencies provide high-quality care to their patients while adhering to industry standards and regulations. In an ever-evolving healthcare landscape, these consultants serve as invaluable resources, bridging the gap between regulatory requirements and the practical implementation of best practices.

Our expertise lies in navigating the intricate web of accreditation processes, quality assurance measures, and compliance protocols. We work closely with home health care agencies to assess their current operations, identify areas for improvement, and develop tailored strategies to enhance the overall quality of care.

By leveraging our extensive knowledge and experience, we empower agencies to achieve their goals, maintain accreditation, and ultimately, deliver exceptional care to their patients.

The importance of quality care in home health care agencies

Quality care is the cornerstone of any successful home health care agency. It not only ensures the well-being of patients but also contributes to the agency's reputation, patient satisfaction, and long-term sustainability. However, maintaining high standards of care can be a daunting task, especially in the face of ever-changing regulations and industry best practices.

Home health care agencies must navigate a complex web of guidelines, policies, and protocols to ensure compliance and deliver consistent, high-quality care. Failure to adhere to these standards can result in regulatory penalties, loss of accreditation, and, most importantly, compromised patient outcomes.

By prioritizing quality care, home health care agencies can:

Enhance patient satisfaction and trust

Improve clinical outcomes and patient safety

Foster a culture of continuous improvement

Maintain accreditation and regulatory compliance

Strengthen their reputation and competitive edge

In an industry where patient well-being is paramount, the importance of quality care cannot be overstated. It is a fundamental responsibility that home health care agencies must embrace wholeheartedly.

Understanding the accreditation process for home health care agencies

Accreditation is a crucial aspect of the home health care industry, serving as a benchmark for quality care and operational excellence. The accreditation process is a rigorous evaluation conducted by recognized accrediting bodies, such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or the Accreditation Commission for Health Care (ACHC).

During the accreditation process, home health care agencies undergo a comprehensive review of their policies, procedures, and practices. Accrediting bodies assess various aspects, including:

Patient care processes and clinical outcomes

Infection control and safety protocols

Staff qualifications and training

Organizational structure and leadership

Quality improvement initiatives

Compliance with regulatory requirements

Achieving and maintaining accreditation is a significant undertaking that requires meticulous preparation, documentation, and adherence to stringent standards. Home health care agencies must consistently demonstrate their commitment to providing safe, effective, and patient-centered care.

The accreditation process not only validates an agency's commitment to quality but also instills confidence in patients, families, and healthcare partners. It serves as a seal of approval, indicating that the agency meets or exceeds industry standards and is dedicated to continuous improvement.

How a certified home health care consultant can help with accreditation preparation

Navigating the intricate accreditation process can be a daunting task for home health care agencies, especially when balancing the demands of day-to-day operations and patient care. This is where the expertise of a certified home health care consultant becomes invaluable.

As a seasoned professional in the field, I possess a deep understanding of the accreditation requirements and the nuances of the process. My role as a consultant is to guide agencies through every step, ensuring a smooth and successful accreditation journey.

Here are some of the ways I can assist with accreditation preparation:

Conducting comprehensive assessments: I begin by thoroughly evaluating the agency's current policies, procedures, and practices. This assessment identifies areas of strength and opportunities for improvement, allowing for a tailored approach to accreditation preparation.

Developing an accreditation roadmap: Based on the assessment findings, I create a detailed roadmap that outlines the specific steps and timelines for achieving accreditation. This roadmap serves as a blueprint, ensuring that no aspect of the process is overlooked.

Implementing best practices: Drawing from my extensive industry knowledge and experience, I provide guidance on implementing best practices in various areas, such as patient care, documentation, staff training, and quality improvement initiatives.

Mock surveys and readiness assessments: To prepare agencies for the actual accreditation survey, I conduct mock surveys and readiness assessments. These simulations help identify any remaining gaps and provide opportunities for staff training and process refinement.

Documentation review and preparation: Accurate and comprehensive documentation is crucial for accreditation success. I review and assist in the preparation of necessary documentation, ensuring compliance with accreditation standards and regulatory requirements.

Ongoing support and guidance: Throughout the accreditation process, I remain a dedicated partner, providing ongoing support, guidance, and expertise to address any challenges or concerns that may arise.

By leveraging the specialized knowledge and experience of a certified home health care consultant, agencies can navigate the accreditation process with confidence, minimizing stress and maximizing their chances of success.

Roles and responsibilities of a certified home health care consultant

As a certified home health care consultant, my roles and responsibilities extend beyond merely assisting with accreditation preparation. I am a trusted advisor, a problem-solver, and a catalyst for continuous improvement within the home health care industry.

Regulatory compliance expert: Staying up-to-date with the ever-changing regulatory landscape is a critical aspect of my role. I ensure that home health care agencies are aware of and compliant with all relevant federal, state, and local regulations, guidelines, and industry standards.

Quality assurance and performance improvement: I work closely with agencies to develop and implement comprehensive quality assurance and performance improvement programs. These programs are designed to identify areas for improvement, implement corrective actions, and foster a culture of continuous quality enhancement.

Staff training and development: Providing high-quality care relies heavily on a skilled and knowledgeable workforce. I collaborate with agencies to develop and deliver customized training programs for staff members, ensuring they are equipped with the latest knowledge, skills, and best practices in home health care.

Risk management and patient safety: Patient safety is of utmost importance in the home health care setting. I assist agencies in identifying and mitigating potential risks, implementing effective safety protocols, and fostering a culture of patient-centered care.

Operational efficiency and process optimization: By conducting comprehensive operational assessments, I identify opportunities for streamlining processes, enhancing efficiency, and optimizing resource utilization within home health care agencies.

Strategic planning and growth: As a strategic partner, I help agencies develop long-term plans for growth and expansion while maintaining a strong focus on quality care and regulatory compliance.

Accreditation and certification guidance: While accreditation preparation is a core responsibility, I also provide guidance and support for various other certifications and accreditations relevant to the home health care industry.

Advocacy and industry representation: I actively participate in industry forums, associations, and advocacy groups, ensuring that the voices and concerns of home health care agencies are represented and addressed at a broader level.

By assuming these diverse roles and responsibilities, I strive to be a trusted partner, empowering home health care agencies to achieve excellence in patient care, operational efficiency, and regulatory compliance.

Benefits of hiring a certified home health care consultant

Partnering with a certified home health care consultant offers numerous benefits that can significantly impact the success and sustainability of a home health care agency. Here are some of the key advantages:

Expertise and industry knowledge: Certified consultants bring a wealth of expertise and industry knowledge to the table. We possess a deep understanding of regulations, accreditation standards, best practices, and the latest trends in home health care. This expertise ensures that agencies receive guidance rooted in real-world experience and proven strategies.

Objectivity and fresh perspectives: As independent consultants, we offer an objective and unbiased perspective on an agency's operations. We can identify areas for improvement that may be overlooked by those immersed in day-to-day operations, providing fresh insights and innovative solutions.

Time and resource efficiency: Preparing for accreditation and implementing quality improvement initiatives can be time-consuming and resource-intensive for home health care agencies. By partnering with a consultant, agencies can leverage our expertise and streamline these processes, freeing up valuable time and resources to focus on patient care.

Regulatory compliance and risk mitigation: Navigating the complex web of regulations and accreditation standards can be challenging. Certified consultants ensure that agencies remain compliant, mitigating the risks of regulatory penalties, loss of accreditation, and potential legal issues.

Staff training and development: We provide comprehensive staff training and development programs tailored to the specific needs of each agency. This investment in human capital ensures that staff members are equipped with the knowledge and skills necessary to deliver high-quality care and maintain compliance.

Continuous improvement and quality assurance: Our role extends beyond accreditation preparation. We collaborate with agencies to implement robust quality assurance and performance improvement programs, fostering a culture of continuous improvement and excellence in patient care.

Cost-effectiveness: While hiring a consultant may seem like an additional expense, the long-term benefits and cost savings associated with successful accreditation, improved operational efficiency, and risk mitigation often outweigh the initial investment.

Competitive advantage: By partnering with a certified consultant, home health care agencies gain a competitive edge in the marketplace. They demonstrate a commitment to quality, compliance, and excellence, which can enhance their reputation and attract more patients and healthcare partners.

Investing in the expertise of a certified home health care consultant is a strategic decision that can propel agencies towards success, ensuring they provide exceptional care while navigating the complexities of the industry.

Key considerations when choosing a certified home health care consultant

Selecting the right certified home health care consultant is crucial for achieving desired outcomes and fostering a successful partnership. Here are some key considerations to keep in mind:

Credentials and certifications: Ensure that the consultant holds relevant certifications and credentials from recognized industry bodies. These credentials validate their expertise and demonstrate a commitment to ongoing professional development.

Industry experience: Look for consultants with extensive experience in the home health care industry. Seasoned professionals bring invaluable insights, best practices, and a deep understanding of the unique challenges faced by agencies.

Specialization and focus areas: Different consultants may specialize in specific areas, such as accreditation preparation, quality assurance, staff training, or regulatory compliance. Align your agency's needs with the consultant's areas of expertise for optimal results.

Reputation and track record: Research the consultant's reputation within the industry. Seek references from previous clients and inquire about their experiences, successes, and the consultant's ability to deliver tangible results.

Communication and collaboration skills: Effective communication and collaboration are essential for a productive consultant-agency relationship. Evaluate the consultant's ability to actively listen, understand your agency's unique needs, and work collaboratively with your team.

Customized approach: Avoid a one-size-fits-all approach. Look for consultants who tailor their services and strategies to your agency's specific goals, challenges, and organizational culture.

Availability and responsiveness: Consider the consultant's availability and responsiveness. Ensure they can dedicate the necessary time and resources to your agency's needs, promptly addressing any concerns or inquiries that may arise.

Cost and value alignment: While cost is a consideration, it should not be the sole deciding factor. Evaluate the consultant's proposed services and fees in relation to the potential value they can bring to your agency, both in terms of operational improvements and long-term sustainability.

By carefully considering these factors and conducting thorough due diligence, you can increase the likelihood of finding a certified home health care consultant who aligns with your agency's values, goals, and vision for quality care.

Resources and training for aspiring certified home health care consultants

As the demand for certified home health care consultants continues to grow, aspiring professionals may seek resources and training opportunities to embark on this rewarding career path. Here are some valuable resources and training options to consider:

Professional Associations and Organizations:

National Association for Home Care & Hospice (NAHC)

Home Care Association of America (HCAOA)

National Private Duty Association (NPDA)

These organizations offer educational programs, certifications, and networking opportunities for home health care professionals, including consultants.

Accrediting Bodies:

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

Accreditation Commission for Health Care (ACHC)

Community Health Accreditation Partner (CHAP)

Many accrediting bodies provide training and resources specifically focused on accreditation preparation and compliance for home health care agencies.

Online Courses and Certifications:

Home Care Consultant Certification (HCC) from the National Association for Home Care & Hospice (NAHC)

Certified Home Health Consultant (CHHC) from the National Association of Certified Home Health Consultants (NACHC)

Online courses and webinars offered by universities and professional training providers

These courses and certifications provide comprehensive training in areas such as regulatory compliance, quality assurance, accreditation preparation, and industry best practices.

Mentorship and Internship Opportunities:

Seek mentorship opportunities with experienced certified home health care consultants

Explore internship programs offered by home health care agencies or consulting firms

Hands-on experience and guidance from seasoned professionals can be invaluable in developing the necessary skills and knowledge.

Continuing Education and Professional Development:

Attend industry conferences, seminars, and workshops

Participate in webinars and online forums

Stay updated on industry publications and research

Continuous learning and professional development are essential for staying current with the latest trends, regulations, and best practices in the home health care industry.

By leveraging these resources and training opportunities, aspiring certified home health care consultants can acquire the necessary knowledge, skills, and credentials to excel in this rewarding field and make a lasting impact on the quality of care provided to patients.

Conclusion: 

In the dynamic and ever-evolving landscape of home health care, the role of a certified consultant is invaluable. We serve as trusted advisors, guiding agencies through the complexities of accreditation preparation, regulatory compliance, and quality assurance initiatives.

Navigating the complexities of healthcare accreditation can be daunting. An accreditation preparation consultant offers invaluable expertise, guiding your agency through assessments, policy development, and staff training. With their support, you can meet stringent standards and achieve accreditation, enhancing your reputation and ensuring high-quality care for your patients.

[pnovick]

SUPERVISOR LAB (CHEMISTRY) - 3152308

**Job ID: 3152308** **Laboratory Services Supervisor** **Industry:** Healthcare / Health Services **Job Category:** Medical / Health - Lab Our client, a leading healthcare provider with numerous Award-Winning Clients nationwide, is currently seeking a dynamic individual to fill the role of Laboratory Services Supervisor. **Responsibilities:** As the Supervisor of Laboratory Services, you will be at the helm of overseeing daily operations. This includes ensuring optimal staffing across various shifts, monitoring turnaround times, and effectively resolving concerns raised by healthcare providers and patients. You will play a pivotal role as a liaison and resource for central receiving staff, offering support in troubleshooting activities related to inpatient specimen collection and processing. - Oversee day-to-day operations of Laboratory Services. - Monitor and adjust staffing levels across shifts to meet operational demands. - Address and resolve concerns raised by healthcare providers and patients. - Act as a liaison and resource for central receiving staff in troubleshooting activities. - Manage and ensure the availability of essential supplies and consumables for Laboratory Services. - Evaluate and implement new procedures, technology, and safety measures to enhance laboratory performance. - Collaboratively design and implement technical orientation programs for Inpatient staff. - Coordinate ongoing education programs to support the professional development of staff. - Collaborate with the Laboratory Services management team to prepare work schedules. - Handle payroll functions for Laboratory Services staff. - Ensure adherence to federal and regulatory agency standards, including CLIA and JCAHO. - Work with the laboratory management team to collect quality assurance data and identify improvement opportunities. **Qualifications:** **Education Requirements:** - Bachelor’s Degree in Clinical/Medical Laboratory Science – OR – Bachelor’s in a related field AND completion of a Clinical/Medical Laboratory Science program. **Certification and Licensure:** - ASCP Registration. **Required Skills:** - Strong collaborative skills. - Excellent communication skills. - Exceptional interpersonal skills. If you are a qualified candidate passionate about maintaining high laboratory standards and enhancing operational efficiency, we invite you to apply for this exciting opportunity. Join our client's team, recognized for excellence in healthcare services. **Job ID: 3152308 ** Read the full article

[floridaprelaw-blog]

Big Tobacco

By Theodros Fekade, University of Miami Class of 2024

September 25, 2023

In the early 1900s, the popularity of cigarette smoking saw a significant surge due to the invention of automated cigarette rolling machines and a myriad of tactical marketing campaigns by prominent tobacco corporations. Since the early 20th century, Big Tobacco has consistently maintained an indelible imprint within the psyche of consumers. By the 1940s, the prevalence of smoking within the population had reached a staggering 49%, which is attributable to the glamorization of cigarettes by the silver screen and aggressive marketing that targeted all social classes. (Cheng & Kenkel, 2010) Despite an abundance of unambiguous medical reports linking cigarette smoking to lung cancer, the acclaim for and pervasive consumption of cigarettes persisted at unfathomable proportions. Correspondingly, in 1964, the U.S. Surgeon General’s Advisory Committee published a conclusive report that definitively proclaimed that “the death rate for smokers was 70% higher than the death rate of non-smokers,” with the main causes of death for smokers being “lung cancer, bronchitis/emphysema, larynx cancer,” and a plethora of other life-threatening “circulatory diseases.” (U.S. Department of Health, Education, and Welfare, 1964) Although the U.S. Surgeon General’s Advisory Committee issued a credible warning, there was only a marginal drop in the population of cigarette smokers to 40% as smoking continued in hospitals, school buildings, and aboard airplanes. (Cummings & Proctor, 2015) Since the 1970s, a plethora of states have effectively employed a form of banning smoking, while the federal government has prohibited smoking in all federal buildings through President Clinton’s executive order. In a parallel manner, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) elevated its accreditation standards for hospitals to require the prohibition of smoking by the end of 1993. (Longo, et al., 1998)

Amidst growing public awareness of the pernicious effects of cigarettes, the United States House of Representatives conducted a hearing on the regulation of tobacco products in 1994. During the congressional committee hearing, the CEO of Philip Morris, USA, and other Big Tobacco executives testified under oath that “nicotine is not addictive.” (University of California, San Francisco, n.d.) In 1995, Phillip Morris created Project Sunrise, which had the aim of advancing the promotion of cigarettes while simultaneously invalidating the anti-tobacco movement and challenging the scientific consensus asserting the addictive nature of nicotine. Within the framework of Project Sunrise, Phillip Morris actively supported the “moderate” tobacco control proponents while presenting itself to the public as “responsible” in relation to its counterparts within the tobacco industry. (McDaniel, Smith, & Malone, 2006)

The repercussions of Project Sunrise had a profound influence on the initiation of the U.S. Supreme Court case Philip Morris USA v. Williams, where the estate of Jesse Williams, a man who passed away due to lung cancer, alleged that Philip Morris had orchestrated a deliberate campaign of misinformation regarding the hazards of smoking. In an Oregon trial court, a jury awarded the estate of Williams $821,485 in compensatory damages and an initial $79.5 million in punitive damages, but the trial judge reduced the punitive damages award to $32 million due to the excessive nature of the $79.5 million. Subsequently, the Oregon Court of Appeals reinstated the $79.5 million award, which the Oregon Supreme Court upheld based on the reprehensible actions of Philip Morris. The U.S. Supreme Court vacated the Oregon Supreme Court’s decision and remanded the case back to the Oregon Supreme Court because the Due Process Clause of the Fourteenth Amendment “forbids” states from utilizing punitive damages as a means of punishing “a defendant for injury that it inflicts upon nonparties.” The U.S. Supreme Court ruled that a jury is not allowed to “go further than” using the evidence of injury to nonparties to determine “reprehensibility” of conduct by punishing “a defendant directly on account of harms” that have been inflicted on non-parties. (Philip Morris USA v. Williams, 2007)

Philip Morris USA v. Williams established a pivotal precedent for Big Tobacco and for the jurisprudence of punitive damages. For the jurisprudence of punitive damages, Philip Morris USA v. Williams provided a discernible standard for guiding how punitive damages can be imposed on a defendant. In the context of Big Tobacco, Philip Morris USA v. Williams prompted Philip Morris to cautiously assess the credible threat of similar cases that could emerge across multiple jurisdictions.

Society has since observed the decline of traditional cigarette consumption while witnessing the burgeoning growth of the e-cigarette market. In response to the industry shift, Philip Morris made a strategic purchase of a 35% stake in the biggest e-cigarette company, Juul Labs Inc. Juul Labs Inc. agreed to pay $462 million to settle the accusations that the corporation promoted addictive nicotine products to children through recruiting social media influencers, purchasing ad space across youth-focused websites, and an extensive array of other marketing tactics. (Kaplan, 2021) While state attorney generals and other prosecutors have cultivated significant strides in addressing the harmful consequences of Big Tobacco, the public must acknowledge the proliferation of the e-cigarette market as a threat to society’s viability while advocating for more legislation to prevent avoidable deaths from smoking, similar to Jesse Williams.

______________________________________

Cheng, K.-W., & Kenkel, D. S. (2010). U.S. Cigarette Demand: 1944–2004. Bethesda: National Library of Medicine.

Cummings, K. M., & Proctor, R. N. (2015). The Changing Public Image of Smoking in the United States: 1964–2014. Bethesda: National Library of Medicine.

Kaplan, S. (2021, May 25). Juul Bought Ads Appearing on Cartoon Network and Other Youth Sites, Suit Claims. Retrieved from The New York Times: https://www.nytimes.com/2020/02/12/health/juul-vaping-lawsuit.html

Longo, D. R., Feldman, M. M., Kruse, R. L., Brownson, R. C., Petroski, G. F., & Hewett, J. E. (1998). Implementing smoking bans in American hospitals: results of a national survey. Columbia: University of Missouri-Columbia School of Medicine.

McDaniel, P. A., Smith, E. A., & Malone, R. E. (2006). Philip Morris's Project Sunrise: weakening tobacco control by working with it. Bethesda : National Library of Medicine .

Philip Morris USA v. Williams, 05-1256 (The Supreme Court of the United States February 20, 2007).

U.S. Department of Health, Education, and Welfare. (1964). Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. Washington, D.C.: U.S. Department of Health, Education, and Welfare.

University of California, San Francisco. (n.d.). Tobacco CEO's Statement to Congress 1994 News Clip "Nicotine is not addictive.". Retrieved from University of California, San Francisco Academic Senate: https://senate.ucsf.edu/tobacco-ceo-statement-to-congress

[wdeft]

I have had cases like the one below with both anonymous and signed reports removed from medical charts. In one case, a doctor met me in a restaurant across the street from the hospital and delivered to me his copy of a report that had been removed from the patient’s chart. I have also been involved in cases challenging peer review privileges asserted by Hospitals. I have even secured a court order compelling a Hospital to produce JCAHO sentinel event reports. These are extraordinarily difficult issues to litigate – factually and legally. They require patience, resources, experience, and – most importantly – persistence.

[tacahealthcare21]

Arthroscopic knee surgery

Hey are you looking for the arthroscopic knee surgery? If yes then end your search with TACA Healthcare. TACA Healthcare provides a comprehensive range of services to meet the needs of patients. The practice also has a strong focus on community outreach and involvement, sponsoring events and donating to non-profit organizations. TACA Healthcare is accredited by the Joint Commission on Accreditation of Healthcare Organization (JCAHO). This accreditation demonstrates the commitment to quality care that TACA Healthcare strives to provide. The practice is also recognized for its quality care standards, providing its patients with safe and effective treatments. TACA Healthcare is driven by a strong commitment to provide its patients with an approachable and patient-centric environment. The medical professionals at TACA Healthcare are dedicated to creating a supportive and compassionate environment for their patients. They are committed to providing the highest quality of care and are passionate about creating a positive experience for their patients. TACA Healthcare is an active member of the community, sponsoring events and donating to non-profit organizations. The practice is dedicated to giving back to the community, helping those in need and advocating for the health and wellbeing of the community. TACA Healthcare provides its patients with access to affordable healthcare services. The practice offers a variety of quality care services, from primary care to specialty care and behavioral health services. The practice also provides unparalleled patient care, ensuring that the patients’ needs are met and that the experience is positive and supportive.

[swifttaylormsm]

The Advantages of Hiring an Accreditation Consultant in New Jersey

Accreditation is a crucial aspect of the healthcare industry, ensuring that healthcare providers meet the highest standards of quality and safety. Navigating the accreditation process can be complex and time-consuming, especially with the ever-changing state and federal regulations.

 In New Jersey, healthcare companies seeking accreditation can greatly benefit from the expertise and guidance of an Accreditation Consultant. This article explores the advantages of hiring such a consultant and how MSM Accreditation Services can assist healthcare providers in New Jersey with their accreditation journey.

Understanding the Importance of Accreditation

Accreditation plays a pivotal role in the healthcare sector. It signifies that a healthcare organization has met rigorous standards and is committed to delivering quality care. Accreditation also enhances an organization's reputation, increases patient confidence, and fosters positive relationships with insurers and regulators. However, achieving accreditation involves meeting strict requirements, which can be challenging without the right guidance.

The Role of Accreditation Consultants

Accreditation Consultants are experienced professionals who possess in-depth knowledge of various accreditation processes and regulations. They provide expert guidance and support to healthcare organizations throughout the accreditation journey. From the initial assessment to the final review, these consultants ensure that the organization is well-prepared and compliant with all relevant standards.

Customized Accreditation Planning

One of the primary advantages of hiring an Accreditation Consultant is the development of a tailored accreditation plan. Each healthcare organization has unique strengths and areas for improvement.

Accreditation Consultants from MSM Accreditation Services can identify these specific needs and design a comprehensive plan to address them effectively. This personalized approach streamlines the accreditation process and increases the chances of successful accreditation.

Expert Knowledge of Accreditation Standards

Accreditation standards set forth by organizations like ACHC, CHAP, JCAHO, NCQA, AMAP, and AAHC/URAC can be intricate and subject to updates. Accreditation Consultants at MSM Accreditation Services have undergone extensive training and possess up-to-date knowledge of these standards. They stay informed about any changes, ensuring that the healthcare provider is well-prepared for compliance during the accreditation process.

Efficient Documentation and Process Management

The accreditation process requires thorough documentation of policies, procedures, and quality improvement initiatives. It can be overwhelming for healthcare providers to organize and manage all the necessary paperwork. Accreditation Consultants assist in developing clear and concise documentation that meets the standards of accrediting bodies. This efficiency saves time and reduces the risk of errors during the review process.

Preparing for Accreditation Surveys

Accreditation surveys are comprehensive evaluations of a healthcare organization's operations and compliance with standards. These surveys can be daunting without adequate preparation. MSM Accreditation Services offers mock surveys to help healthcare providers in New Jersey simulate the accreditation process. Consultants assess the organization's readiness, identify potential weaknesses, and provide valuable feedback for improvement.

Addressing Deficiencies and Implementing Improvements

If deficiencies are identified during the accreditation process, they must be addressed promptly to achieve accreditation. Accreditation Consultants play a pivotal role in assisting healthcare organizations in New Jersey with implementing necessary improvements. They offer guidance and recommendations to rectify deficiencies efficiently, ensuring that the organization is ready for reevaluation.

Continued Support and Compliance Maintenance

Accreditation is not a one-time achievement; it requires ongoing commitment to compliance and quality improvement. Accreditation Consultants provide continued support to healthcare organizations to maintain accreditation status. They offer guidance on maintaining compliance, tracking performance metrics, and implementing continuous quality improvement initiatives.

Cost-Effectiveness and Time Efficiency

While some healthcare organizations may be hesitant to invest in accreditation consulting services, the long-term benefits outweigh the initial costs. Accreditation Consultants from MSM Accreditation Services streamline the accreditation process, saving valuable time and resources. They have the expertise to identify areas that require improvement, which prevents unnecessary delays and costly mistakes during the accreditation journey.

 By efficiently managing the process, these consultants help healthcare providers achieve accreditation faster, enabling them to focus on their core responsibilities - providing high-quality patient care.

Comprehensive Gap Analysis

An essential step in the accreditation process is conducting a thorough gap analysis to identify areas where a healthcare organization falls short of the required standards. MSM Accreditation Services' consultants perform comprehensive gap analyses, evaluating current practices, policies, and procedures against the specific standards set by accrediting bodies. This analysis provides a clear roadmap for addressing deficiencies, implementing improvements, and ultimately meeting the accreditation requirements.

Expert Training and Education

Accreditation Consultants not only guide healthcare organizations through the accreditation process but also provide valuable training and education to staff members.

They ensure that the entire team understands the importance of accreditation and their roles in achieving and maintaining compliance. MSM Accreditation Services' consultants offer workshops, seminars, and webinars on relevant topics, equipping the organization with the knowledge and skills needed to sustain quality improvement initiatives beyond the accreditation process.

Increased Staff Engagement and Empowerment

Involving staff in the accreditation process fosters a sense of ownership and engagement among healthcare professionals. Accreditation Consultants facilitate collaborative efforts between management and employees, encouraging open communication and a culture of continuous improvement. When staff members actively participate in the process, they become advocates for quality care and compliance, further enhancing the organization's overall performance.

Access to Best Practices and Industry Insights

MSM Accreditation Services' consultants have extensive experience working with various healthcare companies and accrediting bodies. This exposure provides them with valuable insights into industry best practices and emerging trends. By leveraging this knowledge, consultants can help healthcare organizations adopt innovative approaches to care delivery, patient safety, and quality management. Staying updated on industry trends ensures that the organization remains ahead of the curve and maintains a competitive edge in the healthcare landscape.

Stress Reduction and Confidence Building

Navigating the accreditation process can be stressful, especially for healthcare organizations that are unfamiliar with the intricacies of various accreditation standards. Hiring an Accreditation Consultant alleviates this stress and instills confidence in the organization's ability to achieve accreditation successfully. Consultants act as trusted partners, guiding the organization at every stage and providing reassurance that the organization is on the right track to meet the required standards.

Support during Post-Accreditation

Once the healthcare organization obtains accreditation, the journey does not end. Staying compliant and continuously improving are ongoing responsibilities. Accreditation Consultants from MSM Accreditation Services continue to support the organization even after accreditation is achieved. They help establish monitoring and tracking systems to ensure ongoing compliance with standards, conduct periodic reviews to identify opportunities for improvement, and facilitate re accreditation processes when necessary.

Conclusion

Obtaining accreditation is a crucial step for healthcare providers in New Jersey to demonstrate their commitment to quality care and patient safety. Hiring an Accreditation Consultant from MSM Accreditation Services can offer numerous advantages, including customized planning, expert knowledge, efficient documentation management, and comprehensive survey preparation.

With the support of these consultants, healthcare organizations can navigate the accreditation process successfully and continue to deliver excellence in patient care.