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38 QUALITY IMPROVEMENT & MEASUREMENT IHI recognizes 162 health systems for age-friendly care By Mackenzie Bean T he Institute for Healthcare Improvement recognized 162 hos- pitals, health systems and healthcare practices for providing "age-friendly" care. IHI partnered with The John A. Hartford Foundation, the American Hospital Asso- ciation and the Catholic Health Association of the United States for the initiative. Healthcare organizations were recognized based on their alignment to IHI's framework for age-friendly care, which entails the following four elements: • A focus on what matters to older adults and their health goals • Use of age-friendly medication, if needed • Efforts to prevent, treat or manage delirium, depression and dementia • Mobility to maintain function Of the 162 recognized organizations, 85 were deemed age-friendly health systems for their exceptional adherence to these elements. The remaining organizations, which received IHI's age-friendly health systems participant designation, are in the process of putting these elements into practice. IHI aims to have 1,000 hospitals adopt its age-friendly care framework by the end of 2020. n Infectious disease physicians can help cut candida bloodstream death risk by 20% By Anuja Vaidya W hen infectious disease spe- cialists help oversee the care of patients with bloodstream infections caused by the candida fungus, death rates can drop by up to 20 percent, according to a study pub- lished in Lancet Infectious Diseases. Researchers from Washington Uni- versity School of Medicine in St. Louis analyzed data from 1,691 patients with candida bloodstream infections. The patients were treated at Barnes-Jewish Hospital in St. Louis from 2002 to 2015. They found 45.9 percent of the physi- cians consulted with infectious disease specialists. About 28 percent of those who were treated with the help of an infectious disease specialist died, but that number jumped to 50.5 percent among patients who were not evaluat- ed by an infectious disease specialist. After correcting for risk factors, re- searchers found that consulting with an infectious disease specialist could re- sult in a 20 percent lower risk of death. Infectious disease specialists were more likely to prescribe antifungal medications, check for serious com- plications and remove central line catheters, all of which helped improve care for the patient. "Even uncomplicated versions of these [candida bloodstream] infections are actually quite dangerous and require a detailed and well-thought out ap- proach to make sure that people do well. Infectious disease doctors are the ones who have the expertise to best treat these infections," said Andrej Spec, MD, senior study author, associ- ate director of the university's infec- tious diseases clinical research unit and director of the university's invasive fungal infections clinic. n Hospitals that report more measures have lower star ratings, study finds By Gabrielle Masson C MS' Overall Star Ratings methodology does not account for differences in the type and volume of quality measures hospitals share with the agency, which may offer an inaccu- rate analysis of quality performance, according to a study published in Health Affairs. CMS requires hospitals to have a minimum number of patient cases to report data for a star ratings measure. As a result, hospitals that treat a larger volume and mix of cases oen report more measures than hospitals treating a smaller patient pool. Despite this variation, CMS rates all hospitals on the same one to five star scale, regardless of the type or number of measures reported. For the study, researchers analyzed data on 3,692 hospitals from the December 2017 star ratings update. Researchers sorted hospitals into three groups based on similarities with the type and volume of measures reported. Group one reported an average of 43 mea- sures, group two reported 36 measures and group three reported just 22 measures. Researchers found hospitals in the third group oen had higher star ratings, while hospi- tals in the first group had lower scores. "Patients, referring providers, payers and other stakeholders who use the ratings in their decision-making can be misled if they assume that higher hospital quality is correlated with a higher star rating," the researchers said. ey warned against lumping hospitals together for the analysis and instead suggested CMS assess hospitals in groups based on how they report on the quality measures. n