Becker's Hospital Review

45 FINANCE CMO / CARE DELIVERY Study: Quality Improvement Initiatives Reduce Readmissions, But May Not Save Money By Brian Zimmerman W hile quality improvement initiatives to reduce read- missions at various health systems have proved successful, these interventions may not always result in fiscal savings, according to a study published in JAMA Internal Medicine. For the study, researchers conducted a review of 50 quality improvement studies, involving data on more than 16,700 patients. Analysis revealed quality improvement initiatives re- sulted in a 12.1 percent average reduc- tion in readmissions for heart failure patients and a 6.3 percent readmission reduction among older adults with various health conditions. While researchers determined the av- erage net savings for health systems per heart failure patient was approximate- ly $972, they attributed an average net loss of $169 per person treated for other health issues. Net costs varied so widely across the studies that researchers could not conclusively determine whether or not the initiatives were collective- ly cost-saving. However, interventions designed to engage the patient and caregiver proved to be the most fiscally beneficial. "Hospitalization is very expensive, so avoiding even a few readmissions should have saved a lot of money," said Terry Nuckols, MD, an assistant clinical professor with Cedars-Sinai Medical Center in Los Angeles and the study's lead author. "Our findings suggest that there is no guarantee of net cost savings once the implementation costs associat- ed with efforts to prevent readmissions are considered." n CMS Won't Update Hospital Overall Star Ratings in July By Heather Punke C MS will not update its Overall Hos- pital Quality Star Ratings in July, despite previous announcements it would do so, AHA News reports. The previously scheduled update will not occur because of data issues with three measures: • Central line-associated bloodstream infections • Clostridium difficile infections • PSI-90 When CMS updates Hospital Compare data in July, it will supress CLABSI data and C. diff measures for hospitals with in- correct data. The PSI-90 measure will not be refreshed, according to AHA News coverage of a QualityNet notice sent May 31. CMS' Overall Hospital Quality Star Rating program has had a rocky past. Original- ly scheduled to launch in April 2016, the agency delayed the launch to July 2016, just one day before the scores were sup- posed to go live in April. Several professional organizations have taken issue with the ratings, including the American Hospital Association, Ameri- ca's Essential Hospitals and the Federa- tion of American Hospitals. For instance, Rick Pollack, president and CEO of AHA, called the ratings "confusing" in 2016 and said the "ratings scheme unfairly penaliz- es teaching hospitals and those serving higher numbers of the poor." Further, the agency originally planned to update hospitals' star ratings each quar- ter. However, when CMS released the De- cember 2016 update, it also announced the star ratings would only be updated twice in 2017: in July and December. Now, CMS anticipates it will update the star ratings in October instead of July, per the AHA News report. Hospitals can start previewing the October ratings in July. n To Up Patient Compliance With Hand Hygiene, Consider Ease of Use By Heather Punke H and hygiene is an important aspect of infection prevention in any care setting, and patients are no exception. However, ease of use and accessibility to some hand hygiene products may preclude patients from properly cleaning their hands. In a study in the American Journal of Infection Control, researchers tested three hand sanitizer products — a pushdown pump bottle, a pocket-sized bottle with a reclosable lid and hand wipes — with 88 hospital patients and long-term care facility residents. Nearly all participants (86 of 88, or 97.7 percent) preferred the pump bottle, and the remaining two preferred the small bottle with the reclosable lid. Eight patients were unable to open the small bottle's lid, however. Additionally, none of the participants preferred the wipes — comments revealed concerns about where to dispose of the used wipes and lack of moisture in the wipes. Researchers also compared the time it took patients to access each type of product. The pushdown pump bottles took the least amount of time to access (0.45 seconds) compared with the smaller bottle (3.86 seconds) or wipes (5.66 seconds). "Feasibility of product use could be a deciding factor in engaging patients in their personal hand hygiene practice," the study authors wrote. The study concludes, "In efforts to increase patient engagement and self-manage- ment of patient hand hygiene, infection preventionists can use results of studies simi- lar to this to implement products that are patient-centered." n

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