Surgical Site infections (SSIs) occur in 2% to 5% of surgery patients. This category of infection comprises approximately 22% of all healthcare-associated infections and has a 3% mortality. Patients with SSIs require significant care and average 7 to 10 days of increased length of hospital stay. The cost of providing care for a single SSI ranges from $3,000 to $29,000. The total cost of care for SSIs is estimated at $10 billion dollars per year. There are of course additional expenditures for outpatient care, readmissions, and care of long-term disabilities.
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Catheter-associated urinary tract infections are the fourth most common HAI. They comprise over 12% of all acquired infections in acute care hospitals. 93,300 of these UTIs are estimated to be acquired in hospitals each year, with an estimated death toll of 13,000 patients.
The CDC defines a Central Line-Associated Bloodstream Infection as: “A laboratory-confirmed bloodstream infection (LCBI) where central line (CL) or umbilical catheter (UC) was in place for more than 2 calendar days on the date of event, with day of device placement being Day 1 and the line was in place on the date of event or the day before.” In other words, the patient must have had the device in place for at least 2 days and the diagnosis must be made while the device is still indwelling or was indwelling on the day before.
Patient experience is an area of healthcare that has a significant impact not only on an organization’s reimbursement, but also on a hospital’s professional liability (HPL) and exposure to litigation. As a result of recent regulatory changes from the Affordable Care Act, it appears that hospitals have become even more judicious in their allocation of resources to various internal initiatives. With this in mind, let’s explore recent evidence that supports a rational, targeted approach for impacting HCAHPS that should lead to an improvement in reimbursement and reduction in liability.
Patient experience has emerged as one of the most important aspects of medical training in today’s healthcare environment. Patients are not only demanding satisfaction in their experience, they are researching hospital and provider satisfaction ratings to make sure others have had a positive experience prior to seeking medical care themselves.
“It’s all about communication!” The world of medicine has changed by leaps and bounds over recent decades. Computers are part of our daily lives, and technological advances have significantly improved our ability to diagnose and treat diseases that were once thought incurable. Despite this incredible progress, healthcare providers continue to commit far too many medical errors. And unfortunately, many of these mistakes are simply caused by “poor communication.”
Preventable hospital readmissions cost taxpayers billions of dollars each year. As we move further into the age of healthcare reform, practitioners will feel rising pressure to reduce costs and decrease unnecessary and preventable re-hospitalizations. Providers cannot and should not avoid the readmission of patients when medical or surgical situations require inpatient care. However, a fair percentage of unintended readmissions can and will be reduced by implementation of initiatives that not only improve quality, but support patients as they transition through the care continuum.
It is certainly a good idea to avoid readmissions that are deemed unnecessary. However, from the vantage point of risk and patient safety, the sword of readmissions reduction has another sharp and dangerous edge. Plain and simple, along with sensible system solutions, there will be irrational but powerful pressures exerted on the gatekeepers of inpatient admission to send sick patients home rather than readmit them.
The patient satisfaction survey, HCAHPS, reflects patients’ perspectives of their hospital experience. The survey results are used to compare hospitals to each other using measures that are significant to healthcare consumers. HCAHPS scores are used by CMS to determine a slice of reimbursement to hospitals, making up 25% of a hospital’s Total Performance Score in the Hospital Value-Based Purchasing program for 2016.