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Joint Commission releases analysis of eCQM data

The analysis found that missing data was the biggest cause of discrepancies. Some examples of missing data are:

•    Missing data on medication route
•    Use of wrong template ID
•    Diagnosis Active is missing, which puts the case in denominator

The Joint Commission also unveiled its Core Measure Solution Exchange®,which allows hospitals to share how they implemented the eCQMs. Users can post about the implementation issues they’ve had, challenges they’ve faced, and solutions they’ve come up with. They can learn from other facilities about the problems and solutions they came up with as well.

The Exchange is free and is part of your facility’s Joint Commission Connect extranet.

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AHRQ toolkit teaches how to face up to medical errors

Medical errors happen too often, and can cause irreversible and irreparable injury to patients when they do. While there is a myriad of ways to try and prevent errors from happening, every hospital needs to have policies in place for when they occur.

A common approach of responding to medical errors is to hide the details of them from patients, also known as the “deny-and-defend” strategy. Often this is done out of fear that a patient or their family will get angry and sue if they find out a mistake was made during their care. There’s also the possibility that the hospital would have to foot the bill for any follow-up care necessitated by the mistake, or waive a patient’s bills.

That said, studies have found that patients are more inclined to sue if they think their physician has been hiding something from them. Therefore, the Agency for Healthcare Research and Quality (AHRQ) published an online toolkit this May that suggests that physicians do the exact opposite. The toolkit,Communication and Optimal Resolution (CANDOR), emphasizes openness with patients and family when a mistake happens.

Some hospitals are now having physicians and medical students go through role-playing scenarios where they have to explain a mistake to a patient or their family. MedStar Health, a provider in Maryland and Washington, D.C., created a “Go Team” of physicians trained in disclosing medical errors that remains on standby to provide support to staff when they need to tell a patient about a mistake.

“We felt horrible that we couldn’t openly talk to patients and families … our attorneys would tell us we can’t do that because we’re going to give them all the information that will cause us to lose a lawsuit,” David Mayer, vice president of MedStar told Kaiser Health Media.  “There were no winners”

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CMS to save millions by increasing hospital readmission fines

CMS LogoWith spending on inpatient hospital services expected to increase by $746 million next year, CMS is in need of new ways to save and raise revenue. On August 2, the agency announced a change that will help ease some of its money woes.

At the beginning of the 2017 fiscal year in October, CMS will add new criteria to the Hospital Readmissions Reduction Program that’s expected to save CMS $538 million; $108 million over the previous fiscal year. The new criteria will increase the number of hospitals that are penalized for high readmission rates, as well as the amount for which they are penalized.

CMS has added coronary artery bypass grafts as a surgery for which hospitals can receive a readmission penalty, as well as alter how it calculates readmissions for pneumonia. Other readmission penalty procedures include heart failure, heart attacks, chronic obstructive pulmonary disease, and hip and knee replacements. It’s estimated that 2,588 hospitals will be fined next year due to the update, losing 0.73% of their Medicare payments on average. Only 49 hospitals are expected to receive the maximum penalty of 3% according toKaiser Health News.

Readmissions have been a major point of contention between hospital groups and CMS. Many argue that since CMS’ program doesn’t take socioeconomic factors into account, hospitals that serve poorer or sicker patients are disproportionately fined for high readmissions.

“We are disappointed CMS missed another opportunity to adjust for the social and economic challenges of vulnerable patients in its quality improvement and reporting programs,” said Beth Feldpush, senior vice president at America’s Essential Hospitals, in a statement. “The evidence is clear that these programs disproportionately penalize hospitals that serve disadvantaged patients and communities.”

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Study: 45% of ICU physicians suffering from severe burnout

Earlier this month, the Critical Care Societies Collaborative published a report simultaneously in the American Journal of Respiratory and Critical Care Medicine, Chest, the American Journal of Critical Care, Critical Care Medicine on the issue of burnout syndrome (BOS) in the ICU. The report defines BOS as when is when excessive and prolonged stress causes a state of emotional, mental, and physical exhaustion. Researchers found that 45% of critical care physicians and 25%-33% critical care nurses working in the U.S. are currently suffering from severe burnout.

“With more than 10,000 critical care physicians and 500,000 critical care nurses practicing in the United States, the effects of burnout syndrome in the ICU cannot be ignored,” says senior author Curt Sessler, MD. “We believe that protecting the mental and physical health of healthcare professionals who are at risk for burnout syndrome is vitally important for not only the professionals but for all stakeholders, including our patients.”

There are three main symptoms of BOS: exhaustion, depersonalization, and reduced personal accomplishment. There’s also a host of nonspecific symptoms such as the inability to feel happiness or contentment, and experiencing feelings of frustration, anger, fear, or anxiety.

To treat and prevent BOS, the study authors recommend: [more]