Issue link: https://beckershealthcare.uberflip.com/i/1122871
74 QUALITY IMPROVEMENT & MEASUREMENT Colorado 2nd state to enact law on surgical smoke in OR By Mackenzie Bean C olorado is the second state in the U.S. to adopt a surgical smoke evacuation law to pro- tect perioperative nurses and surgical team members. Three things to know: 1. Democratic Gov. Jared Polis signed a bill into law March 28 that requires healthcare facilities to use a smoke evacuation system for relevant surgical procedures. 2. The Association of periOperative Reg- istered Nurses worked with the Colorado Nurses Association and the Colorado Hospital Association to lobby for the law's passage. 3. Rhode Island became the first state to implement such a law in June 2018. n CMS star ratings don't account for surgical volumes, study finds By Mackenzie Bean C MS does not adequately assess the effect of surgery volume when cal- culating its Overall Hospital Quality Star Ratings, according to a study published in JBJS Open Access. CMS excludes some quality measures for hospitals that perform fewer than 25 sur- gical procedures over a three-year period. Researchers from the Hospital for Special Surgery in New York City hypothesized that exclusion could alter hospitals' ratings, since they're graded relative to one another. For the study, researchers assessed four measures CMS excludes from star ratings calculations for low-volume hospitals: • Complication rate for coronary artery bypass graing • Readmission rate for coronary artery bypass graing • Mortality rate for total joint arthroplasty • Readmission rate for total joint arthroplasty Researchers calculated estimated values for the above measures for low-volume hospi- tals. ey then repeated CMS' star ratings calculations using these estimated measures to identify which hospitals had the same, better or worse ratings. When researchers input estimated measures for total joint arthroplasty complications, more than one-third of hospitals had a dif- ferent — and oen lower — rating. Ratings were unchanged when incorporating the other three measures into calculations. "e CMS star ratings do not fully repre- sent the risks of undergoing procedures at low-volume hospitals, potentially misrep- resent quality across facilities, and hence are of uncertain utility to consumers," the researchers concluded. n Hospital-associated sepsis on decline, but treatment costs climb by $1.5B By Morgan Haefner W hile hospitals are doing a better job of preventing and treating sepsis, patients who develop the infection are becoming sicker. As a result, the average cost of treating sepsis has grown more than 20 percent since 2015, according to an analysis from healthcare consultant Premier. For its analysis, Premier examined discharge data from 871 hospitals representing 1.8 million cases. Premier found hospital-associated sep- sis as a percentage of all sepsis cases fell by 15 percent from fall 2015 to fall 2018. The analysis also found mortality rates for all sepsis patients decreased 8 percent. Readmission rates dropped 7 percent. Still, while hospitals saw improvement in these quality metrics, Premier found patients who developed sepsis were 10 percent more likely to develop septic shock. From fall 2015 to fall 2018, the average cost per hospital-associated sepsis case grew 20 percent to about $70,000 — or seven times more than the average hospital stay for all other conditions. As a result, hospitals spent an additional $1.5 billion on treating patients with hospital-associated sepsis in 2018. "While significant progress has been made, there is opportunity to reex- amine protocols for patients who develop sepsis after being admitted for another medical reason, as this suggests a complication of care," Made- leine Biondolillo, MD, vice president of quality innovation at Premier, said in a prepared news release. n