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This October, about a quarter of the nation’s hospitals will experience a 1 percent cut in their Medicare/Medicaid reimbursements as a penalty for unacceptably high rates of hospital-acquired conditions.

King’s Daughters Medical Center’ tentative HAC score of 2.675 puts it in the best one-third of hospitals nationwide, said Angie Graham, KDMC director of Quality Management.

The HAC score is a composite of patient safety, central line bloodstream infections and catheter-associated urinary tract infections rates. A lower score is better; hospitals with scores of seven or above are at risk for the payment reduction.

Patient Safety

The patient safety score includes performance from July 1, 2011 through June 30, 2013, on eight indicators of preventable harm. It is 35 percent of the overall HAC score and includes:  

  • Pressure ulcers
  • Collapsed lungs following surgery
  • Central line-related bloodstream infections
  • Broken hips from falls after surgery
  • Blood clots in the lung or legs following surgery
  • Bloodstream infections
  • Wounds that split open after surgery
  • Accidental cuts/tears in surgery

“In 2012, we implemented a Zero Defects campaign, with the goal of reducing preventable harm by 50 percent,” Graham noted. “We exceeded the goal – reducing these events by nearly 53 percent.”

The Zero Defects campaign continues to this day, with an emphasis on completing and sharing fall risk assessments, following universal protocols and working diligently with Surgical Services team members to drive out surgical site infections, she said.

Infection Rates

The remaining 65 percent of the HAC score is based on central line associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) rates for 2012 and 2013. The table below shows King’s Daughters performance on these two measures from Oct. 1, 2013 to date.

Indicator

KDMC Rate

U.S. Average Rate

CLABSI

0.4

1.01

CAUTI

0.6

1.09

“Our medical staff and team members are diligent in providing evidence-based care,” Graham said.  “These results show that the focus we’ve applied to these issues and the steps we’ve taken to drive out error and reduce harm are working,” she said.

Beginning in October 2015, CMS rates of surgical site infection in colon surgery and abdominal hysterectomy will be included in HAC calculations. In October 2016, MRSA and C-Diff rates will also be included, Graham noted.

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