218252 Role of States to Track and Report Hospital-Acquired Conditions (HACs)

Monday, November 8, 2010

Nathan West, MPA , Health Care Quality and Outcomes, RTI International, Durham, NC
Terry Eng, MS , Social Policy, Health, and Economics Research, RTI International, Waltham, MA
Brieanne Lyda-McDonald, MSPH , Health Care Quality and Outcomes, RTI International, Research Triangle Park, NC
Nancy McCall, ScD , Social Policy, Health and Economics Research, RTI International, Washington, DC
Medical errors and other serious adverse events rank as a leading cause of preventable death in the U.S. Many states mandate hospitals to report hospital-acquired conditions (HAC), such as the rate of foreign objects retained in the body after surgery or catheter-associated urinary tract infections. The focus of our research, which is one aspect of evaluating the Hospital-Acquired Conditions-Present on Admission (HAC-POA) Program, is on the 10 categories of HACs identified in the Inpatient Prospective Payment System (IPPS) Fiscal Year 2009 Final Rule, which the Centers for Medicare & Medicaid Services (CMS) has determined will no longer receive additional Medicare payment when one of these reasonably preventable conditions was not present on admission. Our preliminary findings have found that just over half the states have reporting systems authorized and operated by state governments to collect reports from hospitals about HACs, with the intent to improve patient safety. We distinguish between three distinct types of reporting systems: (1) those that focus on the collection of information of serious reportable events; (2) those that focus on the impact of HACs on clinical outcomes, i.e. morbidity and mortality; and (3) those that focus on hospital-acquired infections (HAI). We performed document reviews of state regulations and public reports, held telephone discussions with state personnel, and consulted the Centers for Disease Control and Prevention on their current initiative to implement HAI Prevention State Plans. States make use of these data collected from reporting systems in a variety of ways, including regulatory (mandatory) and quality improvement (voluntary) functions. Many states monitor HAC incidence and trends over time or share best practices in prevention across hospitals. In some cases, states hold facilities accountable through correction action. States are increasingly mandating public reporting of HACs as greater transparency is called on regarding hospital patient safety improvements or deficiencies.

Learning Areas:
Program planning
Public health administration or related administration

Learning Objectives:
Identify and describe state government efforts to track hospital-acquired conditions (HACs) with the intent to improve patient safety. A particular focus of our research explores the uses of the data collected from these efforts. These activities vary widely from quality improvement programs to dissemination of publicly-available information in efforts to promote change in the safety culture.

Keywords: Quality Improvement, Hospitals

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have more than 12 years experience as a Health Research Analyst at RTI International, working on numerous research projects evaluating health care delivery systems, Medicare demonstrations, and health care quality measurement.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.