Becker's Clinical Quality & Infection Control

38 QUALITY IMPROVEMENT & MEASUREMENT 5,800+ patient deaths tied to hospital overcrowding during COVID-19 surges, study suggests By Erica Carbajal C OVID-19 case surges at the most-strained hospitals in spring and summer 2020 may have led to nearly 6,000 inpatient deaths, according to research published July 6 in the Annals of Internal Medicine. Using a national database, researchers from the Na- tional Institutes of Health Clinical Center evaluated whether there was a link between hospitals' sever- ity-weighted COVID-19 caseload and COVID-19 mortality risk. e study included 144,116 adult COVID-19 inpatients at 558 U.S. hospitals who were admitted from March to August 2020. A total of 35,883 (24.9 percent) of patients were admitted to an intensive care unit, 19,583 (13.6 percent) required ventilation, and 25,344 (17.6 percent) died. Death rates decreased over time across all surge index levels. Of the total number of patients, 78,144 (54.2 percent) were admitted to hospitals in the top surge index decile, with hospital overcrowding potentially linked to 5,868 (23.2 percent) of inpatient COVID-19 deaths, findings showed. Researchers considered hospitals without surges as those under the 50th surge index percentile. e risk-adjusted odds ratio for COVID-19 death for hospitals in the 50th to 75th percentile was 1.11, compared to those not experiencing surges. As the percentiles rose, so did the adjusted risk, reaching 2.00 for hospitals in the top percentile. Overall, the association was stronger in June to August compared to March to May. In April, the Northeast saw the highest number of hospitals overwhelmed with COVID-19 surges, and in July, many hospitals in the South and West experienced overcrowding. "Despite improvements in COVID-19 survival between March and August 2020, surges in hospital COVID-19 caseload remained detrimental to survival and potentially eroded benefits gained from emerging treatments," researchers said. "Bolstering preventive measures and supporting surging hospitals will save many lives." n Florida hospital loses organ meant for biopsy, patient says By Erica Carbajal A patient who had his gallbladder removed at Boca Raton (Fla.) Regional Hospital, part of Baptist Health, says the hospital lost the organ, Boca News Now reported July 21. Josh Weiser, a 36-year-old Boca Raton resident, has a history of benign tumors in his leg. On July 8, Mr. Weiser had his gallbladder removed due to a suspicious polyp on the organ. The next day, he received a call from the hospital's risk management department. "They told me they lost my gallbladder," Mr. Weiser told the news outlet, "and I can't have pathology because they lost the organ." The hospital employee who called to inform Mr. Weiser about the incident called it a "human error," he said. A spokesperson for the hospital told the news outlet he could not discuss the incident "due to laws protecting patient privacy." "We are not able to comment on patient care matters," Michael Maucker, a hospital spokesperson, told Boca News Now. Mr. Weiser has filed a grievance with the state's agency for healthcare administration. n How Penn Medicine is promoting surgical equity By Mackenzie Bean P enn Medicine is seeking to connect patients who typically rely on the emergency room for elective procedures with surgical care via its Center for Surgical Health, the Phila- delphia-based system said July 26. "Many uninsured patients from marginalized groups — partic- ularly immigrant communities in Philadelphia — use the ER for their surgical needs, regardless of the condition, which can lead to costly care and worse outcomes," Jon Morris, MD, director of the center and a professor of surgery at University of Pennsylva- nia's Perelman School of Medicine, said in a news release. The center includes a program to help patients navigate their surgical care, along with research, policy and medical education arms focused on expanding this model beyond Philadelphia. Penn Medicine had treated 154 patients at the center this year, as of July 26. The health system said it's on track to treat 175 by the end of 2021 and expects this number to grow in subse- quent years as the center expands. n

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