Becker's Clinical Quality & Infection Control

37 QUALITY IMPROVEMENT & MEASUREMENT Readmission Penalties Have Not Harmed Patients, Study Finds By Brian Zimmerman E fforts to reduce readmissions for heart attack, heart failure and pneumonia were not associated with increased mortality rates after the ACA's passage, according to a study pub- lished in JAMA. After the ACA established financial penalties for hospitals with high readmission rates for common medical conditions, industry members wondered whether efforts to keep patients out of the hospital would result in increased mortality. To assess the possible correlation between efforts to reduce read- missions and patient mortality, researchers analyzed records of more than 5 million Medicare fee-for-service hospitalizations for heart attack, heart failure and pneumonia from 2008 to 2014. Research- ers did not identify a negative correlation between 30-day patient mortality and 30-day readmission, but rather a small positive correla- tion, suggesting efforts to decrease readmission may also decrease patient mortality. "Our study validates that the national focus on readmissions im- proved outcomes without causing unintended harm," said Harlan Krumholz, MD, a cardiologist and healthcare researcher with Yale School of Medicine in New Haven, Conn. "Thousands and thou- sands of readmissions are being avoided every year without any evidence of people being harmed — that is a victory of improving the quality of care." n Press Ganey Releases 1st Quality Indicator to Measure Assaults on Nurses By Brian Zimmerman T he performance analytics provider Press Ganey created the first quality indicator to measure assaults on nursing personnel. The indicator is a part of the company's National Database of Nursing Quality Indicators, which aims to increase under- standing about workplace safety as as- saults against nurses are being reported at epidemic levels, according to Press Ganey. "To provide patient-centered care and be both engaged and resilient in their roles as caregivers, nurses must feel safe in their practice environment," said Christy Dempsey, MSN, Press Ganey CNO. "This indicator can help organizations prioritize workplace safety, and delivers insights needed to nurture a culture of nursing excellence." n AHA Asks CMS to Suspend Hospital Star Ratings By Molly Gamble I n a letter issued to CMS Administrator Seema Verma in June, the American Hospital Association urged the agency to suspend its "deeply flawed" overall star rat- ings program, which is less than 1 year old. CMS unveiled the Overall Hospital Quality Star Ratings on its Hospital Compare website in late July 2016. e AHA voiced concern about the star ratings immediately upon their release. In June, the advocacy group reaffirmed its opposition by calling on CMS to suspend the metric from Hospital Compare. "While we continue to be concerned that CMS's methodology is flawed, our concern is amplified by the fact that further analysis performed since the star ratings were first released show that substantive errors were made in executing CMS's chosen method- ology," the AHA stated in the letter. "As a result, far too many hospitals have been in- correctly classified into star rating categories that are different than those that should have been assigned." e star rating system is updated quarterly and combines 64 public measures into a single, one-to-five star rating. CMS designed the consumer-friendly classification in hopes it would help families and patients compare hospitals in their area with greater ease. CMS was originally supposed to unveil the star ratings in April 2016, but delayed the release aer members of Congress voiced concern about methodology. Lawmakers were not alone in their hesitancy. Consumer groups — like AARP — hailed the ratings as a step forward for the public, but major hospital groups, academics and safety-net and teaching hospitals voiced con- cern. A Georgetown University economist found several shortcomings in the program, such as its failure to account for social determinants of health. AHA President and CEO Rick Pollack wrote last year that the association was concerned ratings unfairly penalized teaching hospitals and those serv- ing higher numbers of poor patients. Leaders with the Association of American Medical Colleges said patients would find the ratings confusing at best, misleading at worst. Earlier in June, CMS reported it would not update the star ratings in July due to data issues with three measures. It anticipates the next update in October. Here is the breakdown of how 3,499 star-rat- ed hospitals were classified as of April 28: Five stars: 188 hospitals Four stars: 1,178 hospitals ree stars: 1,493 hospitals Two stars: 563 hospitals One star: 77 hospitals e request to CMS is one of several AHA made, all in an attempt to reduce the number of regulatory burdens on hospitals. n

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