A Breakdown of 2013 Hospital Quality Issues (Part 1 of 2)

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Cheryl Clark over at HealthLeaders Media conveniently outlines the “Top 10 Quality Issues of 2013.”

Below is an overview of the first five on her list, but we highly recommend that you read the entire article for a deeper understanding of the issues discussed. It can be found here.

1.) Cracking HACs

Beginning Oct. 1, 2014, hospital-acquired conditions (HACs) will be used as a measurement for Medicare payments. The problem is, CMS has yet to clearly define which HACs they’re referring to or what time period will be used to classify an HAC.

“But it may be assumed that performance during all or a portion of 2013 and 2014 could figure in the equation,” Clark points out. Medicaid patients could also be included in this system, she adds.

2.) More readmission penalty conditions and exclusions

“The PPACA specifies that effective Oct. 1, 2014, penalties for higher rates of 30-day readmissions may apply to four additional conditions that brought the patient to the hospital the first time,” Clark writes.

Currently, these penalties apply to patients with congestive heart failure, pneumonia, and heart attacks. Patients admitted for placement of a stent, a coronary artery bypass  graft procedure, vascular surgery, and chronic obstructive pulmonary disease will also be added, with hip and knee-replacement procedures to be added shortly.

3.) Health insurance exchanges must be accredited

This applies to “all health-insurance plans that operate within state or federal health-insurance exchanges…” Satisfying clinical quality measures and patient-experience scores will go a long way in determining an HIE’s accreditation.

4.) Compounding conundrum

“With 39 people dead and 656 patients sickened so far from meningitis due to fungus-infected steroid injections supplied by the New England Compounding Center in Framingham, Mass., hospitals and physicians that have relied on compounding sources should be giving their supply chain a very tough look,” Clark writes.

Also, the CDC is recommending that “clinicians…be on the lookout for patients with any symptoms near the site of their injection.”

5.) Patient experience survey expanding

CMS’ 27- Hospital Consumer Assessment of Healthcare Providers and Systems survey will possibly have five more questions added to the inpatient quality reporting lineup.

They are as follows: 1.) During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my healthcare needs would be when I left; 2.) When I left the hospital, I had a good understanding of the things I was responsible for in managing my health; 3.) When I left the hospital, I clearly understood the purpose for taking each of my medications; 4.) During this hospital stay, were you admitted to this hospital through the Emergency Room?; and 5.) In general, how would you rate your overall mental or emotional health?

In our next post, we’ll look at Clark’s final five quality issues for 2013. In the meantime, what are your thoughts on the matters presented above?

-by Pete Fernbaugh

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