October 2002 Bulletin

Board approves position statement, alliance with OSHA, Sign Your Site checklist

The AAOS Board of Directors met September 13-14, 2002 in Rosemont, Ill., and took the following actions:

Alliance with OSHA approved. Upon the recommendation of the Occupational Health Committee and the Council on Health Policy and Practice Management, a proposal from the Occupational Safety and Health Administration (OSHA) seeking an alliance with the AAOS in which the Academy would serve as a resource to the agency and as an educational vehicle on ergonomic matters was approved. The goal of the alliance is for both organizations to use their collective expertise to promote safe and healthful working conditions for industries and workers. The AAOS is the first organization that OSHA has approached to enter into such an agreement. Potential activities of the alliance include serving as a resource in developing programs to reduce and prevent exposure to ergonomic hazards; identifying ergonomic research needs; developing and disseminating ergonomic information at conferences, events or through print and electronic media; educating OSHA personnel on current research initiatives; and sharing data supporting solutions to ergonomic hazards developed by AAOS.

EMTALA position statement approved. The Patient Access to Emergency Care Task Force developed and the Board approved a Position Statement on Emergency Department On-Call Coverage. The American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons believe that there is a serious crisis resulting from EMTALA. Current interpretations of EMTALA by hospitals negatively affect patient access to quality care, foster a system of uncompensated care and place a tremendous burden on health care providers. Because many uninsured patients present to the emergency room with non-emergent conditions, Congress should clarify that EMTALA was enacted to ensure that all patients truly in need of emergency care receive such care. Simultaneously, it should grant physicians flexibility in the management of less urgent problems that present to emergency departments. The AAOS states that in providing emergency room coverage, hospitals should not impose an undue burden on orthopaedic surgeons and other physicians to provide this coverage. The AAOS also believes that hospitals and orthopaedic surgeons should negotiate an appropriate amount of on-call coverage that is not burdensome to either party. Further, hospitals should also compensate orthopaedic surgeons and other physicians for being on-call and that payment should reflect the work and liability risk associated with these services. For the full text of the statement visit the AAOS Web site at http://www.aaos.org and click on "Library and Archives," then on "Policies," then on "Position Statements." It is listed as document # 1157.

AAOS supports petition to the Consumer Products Safety Commission (CPSC) regarding ATVs. The AAOS was approached by the Consumer Federation of America, the U.S. Public Interest Research Group and Kids in Danger to join a petition to the CPSC opposing the use and sale of all three-wheel and four-wheel all-terrain vehicles (ATV) for use by children under age 16. It went beyond the AAOS Position Statement in also urging the CPSC to require manufacturers to offer refunds for ATVS previously purchased for children under 16. This petition was generally consistent with the existing AAOS Position Statement on ATVs, except for the refund demand, so the Board approved sending a letter to the CPSC supporting the petition, but without the reference to refunds.

IMCA Report on OA of the knee approved. Improving Musculoskeletal Care in America (IMCA) is a project of the AAOS consisting of a series of documents that contain state-of-the-art modules of information on specific musculoskeletal conditions. The purpose of this project is to improve musculoskeletal care in the U.S. and to establish AAOS as the definitive source of information on musculoskeletal conditions and health care.

These documents, or modules, are intended to serve as a foundation for additional programs and services to assist doctors and clinicians in helping patients manage their health and a general resource for policy makers of medical funding needs and priorities. Each module will contain sections on the state of the condition, burden/cost of the condition, evidence-based resources, research summary information, treatment options and AAOS resources. They are being developed through the Evidence- Based Practice Committee of the AAOS Council on Research.

Seven general musculoskeletal conditions that have been identified as placing the greatest burden on patients and society will be addressed by the IMCA project over a period of several years. Those topics include osteoarthritis, osteoporosis, rheumatoid arthritis, spinal conditions, soft tissue conditions and trauma and pediatric conditions. The Board approved dissemination of the first module–on osteoarthritis of the knee–upon recommendation of the Council on Research.

A plan for distribution of the new compendium on OA of the knee will be developed in the next few weeks and members will be notified about how they can obtain copies sometime after November 1, 2002.

Sign Your Site checklist approved. To supplement the Wrong Site Surgery Advisory Statement previously approved by the Board of Directors, and at the request of the Patient Safety Committee, the Professional Liability Committee created a Sign Your Site Surgery Checklist, which was approved by the Board of Directors. The checklist is intended to be posted in the OR as a reminder to surgical staff and/or be completed for each surgical patient. It is also meant to support a planned joint communications effort with the Joint Commission on AHO. The checklist for safety can be viewed on the AAOS Web site at http://www.aaos.org. Click on "Library and Archive," then click on "Policies," then "Advisory Statements." The checklist is part of the Advisory Statement entitled "Wrong Site Surgery" (Document #1015).

New Chair of Council on Health Policy and Practice appointed. Upon recommendation of the Committee on Committees, David Halsey, MD, was approved as the new chair of the Council on Health Policy. Dr. Halsey will replace the current chair Alan Morris, MD, whose appointment ends at the 2003 Annual Meeting.

Other activities highlighted. The Board also heard a detailed progress report by the Council on Communications, as well as inaugural reports from both the Patient Safety Committee and the Council on Academic Affairs. The Board conducted a strategic planning session to determine financial goals and objectives for the Academy over the next three years. It also set revenue targets and expenditure caps for the fiscal 2003 budget. A report on the results of this planning session appears on page 40 in this issue of the Bulletin.

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