Benchmarking statewide trauma mortality using Agency for Healthcare Research and Quality's patient safety indicators

Ang, Darwin; McKenney, Mark; Norwood, Scott H.; Kurek, Stanley; Kimbrell, Brian; Liu, Huazhi; Ziglar, Michele; Hurst, James Willard

doi:10.1016/j.jss.2015.05.053

Cited by 19 publications

(12 citation statements)

References 16 publications

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“…[19] The adverse effect of PSI on patient outcomes has been well documented. [21, 32, 33] In addition to the ethical obligation for physicians to provide high quality care for their patients, physician and hospital reimbursement is increasingly tied to care quality. Rajaram et al used CMS, Center for Disease Control (CDC), and Medicare data to show that 721 hospitals (22% of all participating hospitals) were financially penalized for substandard quality of care in the first year (fiscal year 2015) of the CMS HAC Reduction Program.…”

Section: Discussionmentioning

confidence: 99%

Insurance status and reportable quality metrics in the cervical spine fusion population

et al. 2017

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BACKGROUND CONTEXT The incidence of adverse care quality events among patients undergoing cervical fusion surgery is unknown using the definition of care quality employed by the Centers for Medicare and Medicaid Services (CMS). The effect of insurance status on the incidence of these adverse quality events is also unknown. PURPOSE This study determined the incidence of hospital acquired conditions (HAC) and patient safety indicators (PSI) in cervical spine fusion patients and analyzed the association between primary payer status and these adverse events. STUDY DESIGN Retrospective cohort design PATIENT SAMPLE All patients in the Nationwide Inpatient Sample (NIS) aged eighteen and older that underwent cervical spine fusion from 1998–2011 were included. OUTCOME MEASURES Incidence of HAC and PSI from 1998–2011. METHODS We queried the NIS for all hospitalizations that included a cervical fusion during the inpatient episode from 1998–2011. All comparisons were made between privately insured patients and Medicaid/self-pay patients because Medicare enrollment is confounded with age. Incidence of non-traumatic HAC and PSI were determined using publicly available lists of ICD-9-CM diagnosis codes. We built logistic regression models to determine the effect of primary payer status on PSI and non-traumatic HAC. RESULTS We identified 419,424 hospitalizations with cervical fusion performed during an inpatient episode. The estimated national incidences of non-traumatic HAC and PSI were 0.35% and 1.6%, respectively. After adjusting for patient demographics and hospital characteristics, Medicaid/self-pay patients had significantly greater odds of experiencing one or more HAC (OR 1.51 95% CI 1.23–1.84) or PSI (OR 1.52 95% CI 1.37–1.70) relative to the privately-insured cohort. CONCLUSION Among patients undergoing inpatient cervical fusion, primary payer status predicts PSI and HAC (both indicators of adverse healthcare quality used to determine hospital reimbursement by CMS). As the U.S. healthcare system transitions to a value-based payment model, the cause of these disparities must be studied to improve the quality of care delivered to vulnerable patient populations.

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Section: Discussionmentioning

confidence: 99%

Insurance status and reportable quality metrics in the cervical spine fusion population

et al. 2017

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“…Prior studies have demonstrated a relationship between increased PSI incidence and worse patient outcomes. [14,24,33] In addition to the obligation faced by physicians to provide high quality care to their patients, provisions in the ACA have begun to link reimbursement with quantifiable quality metrics such as PSI. [16] Rajaram et al utilized data from the CMS, Center for Disease Control, and Medicare to demonstrate that 721 hospitals were financially penalized by CMS for substandard quality of care in 2015.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Reportable Quality Metrics by Insurance Status in the Primary Spine Neoplasm Population

et al. 2016

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STUDY DESIGN-Retrospective cohort study.BACKGROUND CONTEXT-CMS defines "adverse quality events" as the incidence of certain complications such as post-surgical hematoma and/or iatrogenic pneumothorax during an inpatient stay. Patient safety indicators (PSI) are a means to measure the incidence of these adverse events. When these occur, reimbursement to the hospital decreases. The incidence of adverse quality events among patients hospitalized for primary spinal neoplasms is unknown. Similarly, it is unclear what the impact of insurance status is on adverse care quality among this patient population.

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“…Главная роль при внедрении индустриальной модели управления качеством в медицинской организации принадлежит высшему руководству -главному врачу, так как он демонстрирует лидерство и приверженность системе управления качеством, формирует стратегию развития и ценности, вдохновляет сотрудников добиваться поставленных целей в области качества. В настоящее время индустриальная модель управления остается наиболее современной и распространенной в мировом сообществе [16,18].…”

Section: понятие «качество» в здравоохраненииunclassified

“…TQM контролирует все процессы преобразования организации, чтобы лучше удовлетворять потребности клиентов наиболее экономичным способом (Andersen HV, et al, 2004). Три принципа, которые характеризуют TQM, -это ориентация на клиента, постоянное совершенствование и тимбилдинг (работа в команде) [18][19][20][21].…”

Section: подходы к управлению качествомunclassified

International practices of quality management in healthcare (a review)

Ginnyatulina¹

2019

Science and Innovations in Medicine

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An analysis of international publications revealed a growing interest in all aspects of quality in medical care, especially in the definition of the concept of quality in healthcare. In the world community, the following approaches to quality management are widely used: the Total Quality Control (TQC); Total Quality Management (TQM), which includes Quality Assurance and Quality Improvement; Continuous Quality Improvement (CQI); Lean management, including Hoshin Kanri's policy and PDCA's Deming - Shuhart Cycle (Plan-Do-Check-Act). Practical implementation of the principles of General Quality Management (TQM) and Continuous Quality Improvement (CQI) is based on the models of business improvement in quality management: the EFQM (European Foundation for Quality Management) model, the MBQA (Malcolm Baldrige Quality Award) model and the Chronic Care Model. In management ofmedical organizations, the International standards for services perfection are more often used, which use the experience of quality assurance, as well as the international systems and standards: JCI, ISO 9001, IWA1, ISO 15189, ISO 14000, OHSAS 18001. The ISO interstate standards represent the international consensus of world practice in quality management. Nowadays, medical organizations use the following standards: SRPS ISO 9001: 2015, SRPS EN 15224: 2017, SRPS EN ISO 15189: 2014, SRPS EN ISO 13485: 2017, IWA 1: 2005. In the period of globalization of the world economy and healthcare, the best international practices should form the basis for improving domestic health care in medical care quality management.

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Benchmarking statewide trauma mortality using Agency for Healthcare Research and Quality's patient safety indicators

Cited by 19 publications

References 16 publications

Insurance status and reportable quality metrics in the cervical spine fusion population

Insurance status and reportable quality metrics in the cervical spine fusion population

Disparities in Reportable Quality Metrics by Insurance Status in the Primary Spine Neoplasm Population

International practices of quality management in healthcare (a review)

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