The Baucus Plan: Improving Value By Reforming The Health Care Delivery System It's nice that Senator Baucus wants to improve value, or get more bang for the buck by reforming the "health care delivery system.
" However, the term itself is an oxymoron because the word system denotes organization with one mind and purpose.
The ironic truth is that not only is there no "system" as such, but the deadly mistakes are systematic in that they occur repeatedly in every hospital across America.
Aside from killing 23 people every hour by negligence, hospitals do not do anything systematically.
Each facility can create its own policy, which is often in direct violation of fire codes and health department regulations.
There are no codified ethical standards for implementing hospital management policy.
Thus, you can't reform the "health care delivery system" because it does not exist.
Therefore, congress needs to create a real health care delivery system that by law would require hospital management personnel and health care professionals to conform to certain standards of ethics and human decency, which should include, but is not limited to, the following:

1. State Licensing of all hospital administrative personnel;
2. All equipment must be in good working order;
3. Buildings must conform to fire and safety codes;
4. All professional personnel files must be in compliance at all times;
5. Safe nurse-to-patient ratios must be established by federal statute;
6. All units must conform to safe staffing ratios;
7. Every patient unit in the emergency department must have a cardiac monitor, oxygen delivery system and suction in good working order;
8. All supplies required for nursing care must be on hand;
9. All architectural designs for any new construction or renovation of any hospital or nursing facility must have Registered Nurse approval;
10. All staffing coordinators must submit a staffing schedule two months in advance and report any shortfalls to the health department or other regulating authority and the hospital must submit a plan for obtaining the required number of nursing staff;
11. All hospital administrators must put their emergency departments on diversion when all inpatient beds are occupied;
12. It must be forbidden for hospitals to house patients in the emergency department for more than four hours after admission while waiting for an available bed;
13. Nurses must immediately report adverse changes in clinical condition to the attending physician.
    
14. Nurses must provide risk assessment for falling;
15. Nurses must provide risk assessment for bedsores;
16. Hospital management must inform the family members or significant others when the patient is at risk for falls or bedsores and present the plan of care for prevention;
17. Patients or their advocates must have the right to appeal if they are not satisfied with the plan for prevention of falls and bedsores;
18. There must be a law to forbid drawing more blood for testing than is required to actually perform the test;
19. Hospital management must have adequate personnel for sitting with patients to prevent falling and other traumatic injuries;
20. Nurse must turn all patients at risk for bedsores every two hours and the hospital must provide a specialty bed.
    
21. Nurse must respond at least by intercom system to a patient's call for help within three minutes.
    
22. All patients must be within earshot of a nurse's station (place where nurses sit down to write their notes, make phone calls and review charts) and all patient units must be video monitored.
    
23. All personnel must wash hands with antiseptic soap before any hands on patient contact;
24. All isolation protocols must be adhered to.
    

In conclusion, we can see clearly that Senator Baucus and his Congressional colleagues either do not know what is really going on in health care or don't want to know.
In any event they can't reform what doesn't exist.
They have to build a system of health care from the ground up by imposing the above standards and making hospital managers personally accountable for violations.
The bad practices alluded to above are wantonly dangerous and commonplace.