Becker's Clinical Quality & Infection Control

18 PATIENT SAFETY & OUTCOMES The reporting practice that could lead to unreliable patient safety data By Erica Carbajal S ome hospitals may classify admissions in a way that exempts them from elective-based patient safety indicator scores, or PSIs, leading to less reliable patient safety data, according to a study published in the August issue of e Joint Commission Journal on Quality and Patient Safety. Hospitals classify admissions as elective or non-elective based on internal definitions. Researchers hypothesized these internal admission classification policies may lead to some hospitals being exempt from elective-based PSIs. Researchers from Chicago-based Rush University Medical center analyzed inpatient Medicare claims data from 3,484 hospitals during the PSI measurement period from 2015 to 2017. ey measured the average percentage of elective admissions, known as APE, across surgical diagnosis-related groups, or DRGs. Using multiple regression and machine learning, they compared this data to hospital characteristics, surgical claims volumes, and numbers and types of surgical DRGs. For 96 of the hospitals, researchers found exceptionally low APE could not be explained by surgical claims volume, surgical DRGs among claims or hospital characteristics. "ese outliers were disproportionately exempt from elective-based PSI scores," the study said. "Transparency into admission classification policies is needed to ensure fair and reliable use of PSIs when ranking hospitals and adjusting payments," researchers concluded. "Alternatively, PSIs may need modifications to rely on externally validated criteria." n Leapfrog recommends 29 measures to prevent diagnostic errors By Cailey Gleeson T he Leapfrog Group recommended 29 practices for hospitals to implement in order to prevent patient harm and death from diagnostic errors in a July 28 report. The report, "Recognizing Excellence in Diagnosis: Recommended Practices for Hospitals," is a culmination of a team of experts and stakeholders conducting a year- long effort to identify best practices in diagnostic quality and safety at hospitals. The report includes descriptions and resources to help hospitals implement each of the recommended practices, while also offering guidance to employers, purchasers and patient advocates. "Clinicians and hospital leaders tell us they know diagnostic errors are harming too many patients, but they are less clear on how to fix the problem," Leah Binder, president and CEO of Leapfrog, said in a July 28 news release. "Thanks to the incredible leadership of the multi- stakeholder group Leapfrog has convened, hospitals now have clarity on the steps to take. The faster hospitals act, the more lives they can save." This fall, Leapfrog is launching a pilot program to survey hospitals based on practices identified in this report, feedback from which will eventually be used for a new section in the Leapfrog Hospital Survey. n Brain fog may last for 2 years after COVID-19, study finds By Mackenzie Bean B rain fog and other neurological issues may linger for two years after a COVID-19 diagnosis, according to a study published Aug. 17 in The Lancet Psychiatry. Researchers at the University of Oxford in the U.K. analyzed health records from more than 1.4 million people, mostly from the U.S., who were diagnosed with COVID-19 between Jan. 20, 2020, and April 13, 2022. Researchers compared their outcomes to those of an equal number of patients with other respiratory infections. Risk for psychiatric disorders such as anxiety and depression initially jumped for adults with COVID-19 but fell to rates seen among the control group after two months. However, two years after their infection, people with COVID-19 still had an elevated risk of brain fog, dementia, psychotic disorders and epilepsy compared to the control group. "These findings are relevant for policymakers involved in anticipating and addressing the health burden of the pandemic, for researchers seeking to identify the mechanisms underpinning brain sequelae of COVID-19, and for patients and clinicians wishing to know the neurological and psychiatric risks following SARS-CoV-2 infections," researchers said. n

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