Hospitals are keenly aware that they risk attracting reimbursement penalties for every patient that contracts an infection while they’re hospitalized. A Premier analysis identified complications that could increase costs, lengths of stay and mortality. Although several of the conditions it identifies probably couldn’t be prevented by hospitals. But some hospitals have initiated programs to identify patients at risk for sepsis, respiratory failure and pneumonia and this research underscores the importance of doing that.
You can see additional slides from the report by clicking here.
Premier looked at 5.5 million patient records for fiscal year 2013 across 530 hospitals. It determined that 86 conditions were associated with nearly 50,000 potential deaths, $4.3 billion in costs and 1.7 million added hospital days. These conditions occurred in more than one million cases.
When Investment Rhymes with Canada
Canada has a proud history of achievement in the areas of science and technology, and the field of biomanufacturing and life sciences is no exception.
The hospital acquired conditions that ticked all the boxes — increasing length of stay, cost, and mortality rate are sepsis and pulmonary embolism. Sepsis occurred most frequently, representing 51,424 cases that were associated with 669 additional deaths, 2.34 additional inpatient days on average and increased costs of more than $330
million. Pulmonary embolism was also associated with 403 deaths, 2.67 additional inpatient days on average and more than $44 million in excess costs.
So what are hospitals supposed to do with that information? Premier listed three approaches they could take:
- Broadening hospital ability to identify, and then address, care processes that may lead to or contribute to complications.
- Better identifying which hospitals perform well on a broad range of measures — and which ones don’t — while reducing the arbitrary nature inherent in narrow measures.
- Helping hospitals evaluate the importance of a particular complication by quantifying the impact against other outcomes (mortality, length of stay and cost).
Post op respiratory failure is an example of a common complication associated with more than $940 million in excess costs. In a conference call by Premier Dr Ramon Meguiar, CMO of Memorial Medical University in Savannah, Georgia, highlighted a program it initiated to reduce post-op respiratory failure. one component involved identifying risk factors for post-op respiratory failure such as obstructive sleep apnea, snoring, and neck circumference. By doing that it saw a three fold decrease in post op respiratory failures between the first quarter of 2012 through the third quarter of 2013.
Frederick Memorial Hospital in Frederick, MD focused on reducing sepsis cases. On the conference call, Sharon Powell, the patient safety officer and an RN, shared some details of the program. It introduced an education program for staff and physicians to identify symptoms early on. A nurse screening tool was developed for triaging patients in the emergency department and inpatients upon admission. As a result, cases diminished by 40 percent.
