Becker's Clinical Quality & Infection Control

30 PATIENT SAFETY & OUTCOMES Rare COVID-19 complication may be underdiagnosed in adults By Mackenzie Bean M ultisystem inflammatory syndrome — a rare and severe COVID-19 complication first characterized in children — presents differently among adults and may be underdiagnosed as a result, according to a study published May 19 in JAMA Network Open. Researchers at Vanderbilt University Medical Center in Nashville, Tenn., ana- lyzed data on 15 hospitalized COVID-19 patients who met the working defi- nition for multisystem inflammatory syndrome in adults, or MIS-A, between March 1 and Sept. 30, 2020. Nine of 15 patients with MIS-A had acute COVID-19 symptoms. In most pediat- ric cases, children develop the complication after having a mild or asymptom- atic COVID-19 infection. "In adults, the overlapping symptoms of acute COVID-19 and MIS-A make dif- ferentiating the [two] diagnoses difficult," Eric Chow, MD, an infectious disease fellow in the department of medicine at the University of Washington in Seattle, said in an accompanying commentary also published in JAMA Network Open. Researchers found only three of the 15 patients were diagnosed with MIS-A, even though they all met the criteria for the condition. Three patients were pre- viously hospitalized for COVID-19 before being admitted for their MIS-A symp- toms, and the median period between hospitalizations was 23 days. The medi- an number of organs affected by the illness was four, with the gastrointestinal, hematologic and kidney systems being the most commonly affected. "These data suggest that, although uncommon, MIS-A has a more heteroge- neous clinical presentation than previously appreciated and is commonly un- derdiagnosed," researchers said. n Where are the 10 Leapfrog 'F' hospitals? By Kelly Gooch T he Leapfrog Group gave 10 hospitals failing grades in its spring 2021 Hospi- tal Safety Grades released April 29. e organization assigns letter grades bi- annually to hospitals based on their ability to protect patients from preventable errors, accidents, injuries and infections. In the latest update, grades were assigned to more than 2,700 general acute-care hospitals in the U.S. e data for this safety grades update are from immediately before the onset of the COVID-19 pandemic, Leapfrog said. Still, the organization said some measures used in this spring's update can be a proxy for the safety of care provided to coronavirus patients. Here are the 10 hospitals that received an "F" grade from Leapfrog: California Los Angeles Community Hospital Memorial Hospital of Gardena San Joaquin General Hospital (French Camp) Illinois St. Bernard Hospital (Chicago) Kansas Southwest Medical Center (Liberal) Missouri St. Alexius Hospital – Broadway Campus (St. Louis) New Mexico Rehoboth McKinley Christian Health Care Services (Gallup) New York New York Community Hospital (New York City) Oklahoma Comanche County Memorial Hospital (Lawton) Washington, D.C. United Medical Center n Joint Commission: 5 most challenging requirements for hospitals in 2020 By Gabrielle Masson T he Joint Commission has collected data on compliance with standards, Na- tional Patient Safety Goals, and Accreditation and Certification Participation Requirements to identify trends on challenging requirements. The Joint Commission identified the top five requirements most frequently found to be unmet during surveys and reviews from Jan. 1 through Dec. 31, 2020. Fewer surveys were conducted in 2020 because of the pandemic, ac- cording to The Joint Commission. The top five most challenging requirements for hospitals in 2020, as cited by The Joint Commission: 1. Reduce the risk for suicide. 2. The hospital reduces the risk of infections associated with medical equip- ment, devices and supplies. 3. The hospital implements its infection prevention and control plan. 4. The hospital safely administers medications. 5. The hospital manages risks associated with its utility systems. n

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