Thursday, January 12, 2017

As patient-safety penalties hit hospitals, expert wonders why they aren't improving more; could be eliminated by Obamacare repeal

This is the third year federal government will apply penalties to hospitals that fall short of patient safety standards, leading one Consumers Union leader to wonder why hospitals aren't working harder to eliminate the infections and complications that are causing them to loose money, Trudy Liberman writes in her column for the Rural Health News Service.

“What I am most frustrated about is the lack of urgency in the country and at the agencies for eliminating these infections," Lisa McGiffert, head of the Consumers Union Safe Patient Project, told Liberman. "They are aware of them, but there’s not a sense of urgency to stop them."

"The penalties, along with the entire program to eliminate hospital-acquired conditions, were authorized under the Affordable Care Act," Liberman writes. "They could be in jeopardy if the law is repealed. Some hospitals probably would be happy if they disappeared."

Penalties are levied against hospitals that have a high number of patients with avoidable infections and complications, including blood clots, urinary-tract and surgical-site infections, bed sores and falls. And this year, infections related to antibiotic-resistant infections, like methicillin-resistant Staphylococcus aureus (MRSA) and C. difficile, have been added to the list.

"The federal Agency for Healthcare Research and Quality says there were 3.8 million hospital injuries last year. That translates to 115 injuries per 1,000 patient stays," and "antibiotic-resistant bacteria infect some two million people annually. One quarter of a million cases occur in hospitals," Liberman notes.

Medicare will impose a 1 percent cut in payment to 769 U.S. hospitals who fell short of these patient safety standards in the fiscal year that ended Sept. 30. Eleven Kentucky hospitals were on the list, two more than last year, but five Kentucky hospitals that were penalized last year are not on this year's list.

Since the inception of the penalty program, Lieberman reports, 241 hospitals have been punished in all three years, but 347 that were penalized last year are not on the "bad-guy list."

Critical-access hospitals (by definition, rural) and specialized hospitals that treat psychiatric patients, veterans and children are exempt from the penalties.

"Larger teaching hospitals could lose as much as $1 million or more," Lieberman writes. McGiffert told her that the penalties have gotten the attention of hospital CEOs.

McGiffert said that as recently as 12 years ago, hospitals said infections were not preventable, but, “Now, most people in health care believe most infections are.” She also noted that government agencies have only recently started reporting hospital mistakes and other data to help patients.

McGiffert said patients should use the data to decide where they go for care when they have a choice. She suggested that they look for improvements from one year to the next, which could indicate that that particular hospital' emphasis on patient safety. She also encouraged patients to ask questions if the numbers show a hospital isn't performing as well as it has in the past.

Click here and follow the prompts to learn about Kentucky hospitals. You can compare three at a time. Click on the tab for "complications" to learn more about surgical complications and healthcare-associated infections in each of the facilities.

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