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

by webadmin on January 11, 2013

Cheryl Clark over at HealthLeaders Media has outlined the “Top 10 Quality Issues of 2013.” In our last post, we gave an overview of the first five of these 10 issues. Below are the final five, but we highly recommend that you read the entire article. It can be found here.

6.)  Quality scorecards

“Look for more flare-ups and controversy when the Leapfrog Group, Consumer Reports, U.S. News & World Report, and HealthGrades again issue report cards and rankings of various aspects of hospital and physician care,” Clark warns.

Premier, Inc., “a healthcare performance-improvement alliance with 2,700 hospital participants,” is working on condensing all of these scorecards into “one easy-to-understand score.”

Clark writes, “Look for Premier to release a list of more than 130 PIC measures, or potential inpatient complications of patient care, conditions that weren’t there when the patient came through the door…”

7.) Hospital-acquired blood clots

It used to be that blood clots “were just unavoidable bad outcomes in acute care,” but with Medicare withdrawing payment for blood clot-associated issues that lead to extra care (i.e., pulmonary embolisms and deep-vein thrombosis) and with payers demanding greater accountability “for hospital venous thromboembolism prevention strategies” and with the medical-research community saying these clots can be prevented, hospital-acquired blood clots is set to become a hot-button topic in 2013, Clark asserts.

8.) Sepsis alerts in the emergency department

Clark expects CMS to issue “another quality checklist for doctors and nurses in the emergency room that will look for symptoms of sepsis, the body’s response to infections in the blood that is a frequent cause of preventable hospital death,” mainly because “symptoms are often overlooked until it’s too late.”

9.) Squeezing waste

This point mainly applies to those hospitals that are poorly performing in most, if not all, quality measures. What is your incentive for improvement?

As Clark succinctly puts it, “According to a chart presented at a recent Institute for Healthcare Improvement forum, a sample 500-bed hospital that is a poor performer in every respect could see reductions in payments as high as 2.8 percent starting this year, falling to 9.1 percent in 2015, 12.2 percent in 2015, 14.1 percent in 2016, 15.6 percent in 2017, 17 percent in 2018, and 18 percent in 2019. Repeat for emphasis: 18 percent by 2019.”

And these cuts will be comprehensive, including productivity cuts, wage-index cuts, geographic-variation cuts, etc.

10.) Blood management

Blood may not be at the top of your agenda for 2013, but Clark believes the cost of blood in acute-care settings is going to gain steam, especially since “blood transfusions in certain patients who are not actively bleeding may not only be unnecessary, but may be resulting in avoidable adverse reactions, longer lengths of stay, and poorer long-term patient outcomes.”

Targeting a patient’s length-of-stay is part of the budget-shrinking priorities in most hospitals, and blood transfusions may play a huge role in helping to reduce those stays.

What quality issues do you foresee in 2013? Do you agree with Clark’s list? Do you have any insight or thoughts that you would add?

-by Pete Fernbaugh

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