Becker's Hospital Review

33 QUALITY IMPROVEMENT & MEASUREMENT Federal quality programs penalize high-performing heart hospitals By Mackenzie Bean H ospitals recognized for high-quality cardiovascular care are more likely to be penalized under federal value-based programs, according to a study pub- lished in JAMA Cardiology. For the study, researchers analyzed data on nearly 6,000 hospitals participating in the Hospital Readmissions Reduc- tion Program and Hospital Value-Based Purchasing Program in fiscal year 2018. Eighty-five percent of hospitals recognized by the Ameri- can Heart Association and American College of Cardiology received financial penalties under the HRRP, compared to 79 percent of hospitals without recognition. Similar trends were seen with recognized hospitals under the VBP. These hospi- tals were also less likely to receive financial awards through this program. "These findings highlight the potential need to standardize mea- surement of cardiovascular care quality," researchers said. n Hundreds of donor organs lost, delayed in transit since 2014 By Mackenzie Bean N early 200 viable organ donations have been wasted due to commercial transit delays since 2014, accord- ing to a report from Kaiser Health News and Reveal from the Center for Investigative Reporting. For the report, KHN and Reveal analyzed data on more than 8,800 organ and tissue shipments from the United Network for Organ Sharing between 2014 and 2019. Four takeaways: 1. About 170 organs could not be used due to transportation issues during this period. Another 370 organs had delays of two hours or more, which UNOS qualifies as "near misses." 2. Many of these delays involved kidneys, which have a longer shelf life than other organs — like hearts — and are, therefore, transported commercially. 3. The U.S. lacks a comprehensive system to transport organs via commercial means, which may contribute to these delays, the report noted. In addition, no requirements exist to track organ shipments in real time. 4. The delays are concerning, KHN noted, considering nearly 113,000 Americans are currently waiting for an organ trans- plant nationwide. n EMR 'nudge' cuts unneeded C. diff tests, study finds By Anuja Vaidya A n EMR-based alert helped reduce unnecessary orders for testing for Clostridioides difficile in- fection in hospitals, according to a study pub- lished in Infection Control & Hospital Epidemiology. Researchers analyzed C. diff testing orders two years before and two years after the implementation of an EMR intervention. Orders for C. diff testing were considered inappropriate if the patient had received a laxative or stool softener in the previous 24 hours. The EMR intervention included an alert that defaulted to canceling a C. diff test order for patients whose medical records showed they had received a laxative or stool softener in the 24 hours prior. The study shows that of the 17,694 C. diff test orders, 7 percent were inappropriate. Monthly C. diff test orders decreased by 21 percent after the EMR alert was implemented. n Medicare spent $41M+ on sepsis in 2018, HHS says By Mackenzie Bean T he number of sepsis-related hospitalizations for Medicare patients has increased significantly since 2012, according to new HHS research published in Critical Care Medicine. Researchers analyzed data on more than 9.5 million hospitalizations among Medicare beneficiaries between 2012 and 2018. The research represents the largest Medicare-focused sepsis study ever published in the U.S. Four study findings: 1. Medicare enrollment rates increased 22 percent between 2012 and 2018, while sepsis-related hospi- talizations jumped 40 percent. 2. The average inpatient cost per stay among Medi- care patients decreased over the study time period. 3. However, the increase in sepsis cases caused an- nual Medicare spending on hospital admissions and subsequent skilled nursing care to jump from $27.7 billion in 2012 to $41.5 billion in 2018. 4. Researchers project the cost of sepsis care could surpass $62 billion in 2019 based on current trends. n

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