A Katrina Daydream

Just after Katrina hit, I heard a commentator say of New Orleans that before the week was over, there would be thousands of horror stories and thousands of heroes. As we watched the misery in the Superdome alongside the miraculous rooftop rescues from that flooded city, his prediction came true.

Response to the hurricane’s devastation was immediate from both private and corporate citizens, including the many heroes who came forward from this industry. Too bad the same can’t be said about the chaos in New Orleans after the storm. At every level of government, it seems, there was shameful dysfunction that resulted in unnecessary loss of life.

But amid the imploring appeals from victims and the urgent calls for DME and other supplies across the region, our staff heard from one Gulf Coast provider not about what went wrong, but about what went right.

With power out at five of its Mississippi branches and its Gulfport location severely damaged after the storm made landfall on Monday morning, Southern Pharmaceutical Corp. was fully operational — even in Gulfport — by Tuesday. In fact, the company ended up taking care of other providers’ patients, servicing RedCross/FEMA shelters throughout the area and even providing oxygen tanks for fire departments.

How did they do it? The answer, they say, lies in being properly prepared. For SPC, that preparation began two years ago when the company decided to take part in a beta test for a joint audit by the Accreditation Commission for Health Care coupled with certification to ISO 9001:2000. Company officials say their emergency precautions were a direct result of business and operational improvements made to get ready for that first-of-its-kind audit. If you thought ISO standards were only for manufacturers, you’ll think differently after reading SPC’s story on page 26.

As writer James Faucett and I were discussing the confusion in New Orleans versus Southern Pharmaceutical’s well-run response in Gulfport, he remarked that it seemed the government would be a prime candidate for ISO training.

Wow, what a concept! Imagine how different the situation in New Orleans might have been had its government been organized, or if FEMA had been faster.

Imagine if that tough process improvement standard were applied to other government agencies — umm, say CMS:

No more meetings without all the facts. (The agency held a special forum last month to hear comments about its interim final rule for power mobility, but the DMERCs didn’t release the draft of their local coverage determination until the next day.)

No more changing horses in mid-stream. (On Sept. 14, CMS upped the number of new power mobility billing codes from 49 to 63 and changed its mind about product testing requirements — after manufacturers had scrambled to meet a Sept. 1 testing deadline.)

No more impossible timelines. (The agency has said providers must gather medical necessity documentation from physicians to support power mobility claims. But it hasn’t educated the docs about their new responsibility, and the requirement is set to take effect Oct. 25 — that’s this year, on the same day the comment period for the new rule ends.)

Imagine how much easier it would be for you to plan for your business and serve your patients if — like the companies that operate to the ISO standard — CMS did things in a logical way. Quite a daydream.

Our hearts are with those affected by Hurricanes Katrina and Rita. To donate to the Red Cross Disaster Relief fund, visit www.redcross.org or call 800/HELP-NOW.