Becker's Hospital Review

64 CARE DELIVERY These 7 Surgical Procedures Account for Most Complications, Deaths and Costs By Brian Zimmerman J ust seven procedures account for roughly 80 percent of all admissions, deaths, complications and costs attributable to emergency general surgery across the nation, according to a study published in JAMA Surgery. EGS includes surgical care for the most acutely ill, highest risk and highest cost general surgery patients. For the study, researchers identified 421,476 operative EGS patients, which were weighted to represent 2.1 million patients over the four-year study period. The analysis displayed an overall mortality rate of 1.2 percent and a complication rate of 15 percent. The average cost per admission was $13,241. Researchers then ranked the procedures for overall contribution to EGS mortality and morbidity. Seven procedures accounted for 80 percent of surgeries, 80 percent of patient fatalities, 79 percent of complications and 80 percent of national inpatient costs. e seven procedures are: • Partial colectomy • Small-bowel resection • Cholecystectomy • Operative management of peptic ulcer disease • Removal of peritoneal adhesions • Appendectomy • Laparotomy e authors conclude, "National quality benchmarks and cost reduction efforts should focus on these common, complicated and costly EGS procedures." n 'A' Grades Up, 'F' Grades Down in Leapfrog Hospital Safety Scores: 5 Things to Know By Heather Punke T he Leapfrog Group released its spring 2016 Hospital Safety Score update Monday, assigning A through F letter grades to 2,571 hospitals in the U.S. Here are five things to know about the spring update to Leapfrog's safety scores. 1. Leapfrog releases safety score updates twice a year, but this spring's scores included new factors, including patient satisfaction outcomes like nurse communication, doctor communication and communication about discharge, as well as infection measures for Clostridium difficile and methicillin-resistant Staphylococcus aureus. 2. The breakdown of grades earned by the 2,571 scored hospitals is as follows: • 798 earned an A (up from 773 in the fall) • 639 earned a B (down from 724 in the fall) • 957 earned a C (up from 866 in the fall) • 162 earned a D (up from 133 in the fall) • 15 earned an F (down from 34 in the fall) 3. Of the 798 hospitals that earned A's this spring, 153 have earned an A grade in each update for the last three years, becoming a distinct group of "Straight A" Leapfrog hospitals. 4. Vermont had the highest percentage of A hospitals this spring, as five of its six graded hospitals earned the highest score. On the other hand, no hospitals in Alaska, Wyoming or the District of Columbia earned an A grade this spring. 5. According to Leapfrog data and analysis from John Hopkins Medicine's Armstrong Institute for Patient Safety and Quality, B, C, D and F hospitals have higher risk of avoidable death than their A counterparts. In fact, there is a 9 percent higher risk of avoidable death in B hospitals, 35 percent higher in C and 50 percent higher in D and F hospitals. Additionally, roughly 33,440 lives could be saved if all hospitals had the same performance as A hospitals. n Stanford Embeds Clinic in Luxury Apartment Building By Emily Rappleye S tanford (Calif.) Health Care teamed up with private real estate firm Irvine Company to open the San Francisco Bay Area's first express care clinic in an apartment community. The clinic, which opened in May and is open daily from 9 a.m. to 9 p.m., is housed in the River View Apartment Homes in San Jose, Calif., a luxury apartment community with 1,308 units. It has a staff of 10 primary care physicians and additional nurse practitioners and physician assistants, who will provide consumers with same- and next-day appointments for minor illnesses and injuries, as well as lab services and referrals. The goal of the partnership is to make care easily accessible and convenient for consumers. "Modern life is busy and hectic, and convenience and access is really important to people, so offering healthcare to people closer to where they live or work is part of our vision for the future," Sang-ick Chang, MD, associate dean for primary care at Stanford School of Medicine, said in a statement announcing the partnership. He added, "This new partnership will increase access to Stanford's world class faculty and cutting-edge treatments not only for River View residents, but for the entire San Jose community." Irvine Company has launched similar partnerships with San Diego-based Scripps Health and St. Joseph Hoag Health in Orange County, Calif. n

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