Issue link: https://beckershealthcare.uberflip.com/i/1122871
71 QUALITY IMPROVEMENT & MEASUREMENT Leapfrog CEO: CMS' readmission reduction program is imperfect, but effective By Mackenzie Bean C ritics of CMS' Hospital Readmission Reduc- tion Program are oen quick to point out its flaws. However, the healthcare industry should work together to refine this program, rather than just "throw the baby out with the bath water," Leah Binder, president and CEO of e Leapfrog Group, wrote in an op-ed for Forbes. ree takeaways: 1. CMS rolled out the Hospital Readmission Reduction Program in 2012 to address high readmission rates, which cost the U.S. more than $41 billion annually. e program bases 3 percent of a hospital's total Medicare reimbursement on readmission rates. Last year, it saved Medicare more than $2 billion, according to the Medicare Payment Advisory Commission. 2. Ms. Binder cited several studies that identify "un- intended consequences" of the readmission reduc- tion program. For example, a 2018 study published in JAMA found the program's implementation was linked to a small — but statistically significant — increase in 30-day mortality rates among heart failure and pneumonia patients. "Commenters suggest these problems call into question the value of the entire program. But let's not throw the baby out with the bathwater," Ms. Binder wrote. "Other studies have found promising results without the disturbing uptick in mortality rates, so the jury is still out." 3. Ms. Binder said the most promising sign of the readmission reduction program's success is the innovation and leadership coming from hospitals nationwide. She pointed to Boston University Medi- cal Center, which lowered readmissions 30 percent by having nurse advocates conduct follow-up appointments at discharged patients' homes. "ere is a need for ongoing vigilance, flexibility and refinements of the readmissions reduction pro- gram. But we should never let the inevitable need for refinements send us backward to the nonsensi- cal policies of the old days," Ms. Binder concluded. "is is a policy that works, as long as we make it better together." n Patient gratitude can positively affect care team performance By Anuja Vaidya G ratitude from patients has a significantly positive effect on the performance of a medical team, according to a study pub- lished in Pediatrics. The study involved 43 neonatal intensive care unit teams, each comprising two physicians and two nurses. The teams were randomly assigned to one of four simulations: • Maternal gratitude, where the mother of a preterm infant ex- pressed gratitude to NICU teams • Expert gratitude, where a physician expert expressed gratitude to teams • Combined maternal and expert gratitude • Control Maternal gratitude positively affected teams' performances, and the enhancement in performance was mostly attributed to team informa- tion sharing. Forty percent of the variance in team information sharing among the four simulations was explained by maternal gratitude. Information sharing predicted team performance outcomes. "Patient-expressed gratitude significantly enhances medical team per- formance, with much of this effect explained by enhanced information sharing," study authors concluded. n 5 most challenging Joint Commission requirements for hospitals in 2018 By Mackenzie Bean T he Joint Commission listed the maintenance of fire protection systems as the requirement most often identified as "not com- pliant" during surveys and reviews at hospitals in 2018. Here are the five most challenging requirements for hospitals, based on noncompliance rate: 1. The hospital provides and maintains systems for extinguishing fires — 88.85 percent 2. The hospital manages risks associated with its utility systems — 78.68 percent 3. The hospital establishes and maintains a safe, functional environ- ment — 73.85 percent 4. The hospital provides and maintains building features to protect individuals from the hazards of fire and smoke — 72.90 percent 5. The hospital reduces the risk of infections associated with medical equipment, devices and supplies — 70.85 percent n