Becker's Clinical Quality & Infection Control

20 QUALITY IMPROVEMENT & MEASUREMENT How pharmacists are slashing readmission rates at a Philadelphia hospital By Megan Knowles P harmacist interventions at Philadel- phia-based Einstein Medical Center cut the hospital's 30-day readmission rate by more than half for traditional Medicare patients, according to a study published in the American Journal of Health-System Pharmacy. To reduce the risk that patients will be read- mitted to the hospital, three pharmacists at Einstein were tasked with getting involved with patients early — reviewing their medications, adjusting dosages, providing counseling and arranging for follow-up home visits. e hospital research team tested this qual- ity-improvement initiative on 1,059 admis- sions of 667 Medicare patients to Einstein Medical Center from July 2012 through June 2013. e initiative cut the readmission rate by more than half for traditional Medicare patients — 9.8 percent compared to 20.4 percent for patients who did not receive the interventions. irty of the 305 patients in the group that went through the full pharmacy inter- vention had unplanned readmissions, as opposed to 110 readmissions for the 518 patients who received the usual standard of care at discharge. "We now have three pharmacists who do this in their day-to-day work," study author and Einstein's network pharmacy director Deborah Hauser told e Philadelphia Inquirer. Ms. Hauser began brainstorming ways pharmacists could help fight against readmissions in 2010. Pharmacists are helping to reduce read- mission rates at Philadelphia-based Penn Medicine as well. "Pharmacists who work on inpatient units and in outpatient clinics, for example, conduct medication teaching for patients with diseases such as cancer, multiple sclerosis and rheumatoid arthritis, and a concierge service at several hospitals delivers patients new prescriptions prior to discharge," Richard Demers, chief ad- ministrative officer for Penn's ambulatory pharmacy services, told the Inquirer. n Fewer medical mistakes saved hospitals $2.9B from 2014 to 2016 By Alia Paavola T he rate of hospital-acquired conditions, including infections, injuries from falls and harm from medica- tion errors, fell 8 percent from 2014 to 2016, saving the industry $2.9 billion and preventing about 8,000 deaths, according to preliminary data from the Agency for Healthcare Research and Quality. The data, released June 5, shows there were about 2.69 million hospital-acquired conditions among all inpatients 18 years and older in 2016, down from 2.92 million hospital-acquired con- ditions from the same group in 2014. The preliminary patient safety data for 2014 through 2016 continues the downward trend. This trend was previously reported in data from 2010 to 2014 where hospital-acquired conditions dropped 17 percent. Overall, based on the hospital-acquired condition reductions seen in 2015 and 2016, in comparison to 2014, the agency estimates there have been 350,000 fewer medical mistakes — leading to $2.9 billion in cost savings and preventing 8,000 inpatient deaths. The decrease in hospital-acquired conditions is part of a nationwide effort by CMS, which has encouraged hospitals to improve infection control rates and mitigate any patient safety issues. CMS set a goal of reducing hospital-acquired conditions by 20 percent from 2014 to 2019, which would result in 1.8 million fewer hospital-acquired conditions, $19.1 billion in cost savings and 53,000 fewer deaths. n CMS unveils $25B quality improvement program By Megan Knowles C MS seeks to combine various Medicare quality improvement programs under a single contract worth up to $25 billion, the agency announced May 15. "CMS is making great strides in improving care for Medicare beneficiaries. However, much more work must be done to improve the quality and efficiency of the U.S. healthcare system," the agency said in the statement. Under a new initiative, called the "Network of Quality Improvement and Innovation Contractors," CMS aims to have an Indefinite Delivery/Indefinite Quantity con- tract to encourage quality improvement efforts across settings and programs in the healthcare spectrum. "The contract allows for the full spectrum of quality improvement work that is in operation under the cur- rent various networks," CMS said. This work includes efforts from the Quality Innovation Network-Quality Improvement Organizations, the End Stage Renal Dis- ease Network, hospital-focused large scale improve- ment work, clinician-focused technical assistance work, and additional quality improvement work. CMS anticipates giving out multiple IDIQ contract awards that will have a 10-year ordering period. n

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