Eighteen Connecticut hospitals will lose 1 percent of their Medicare payments in 2016 as a penalty for comparatively high rates of avoidable infections and other complications, such as pressure sores and post-operative blood clots, according to new federal data. The Centers for Medicare & Medicaid Services (CMS) announced this month that 758 of the nation’s hospitals – about 23 percent of all eligible hospitals — would be penalized for patient safety lapses in the second year of the Hospital-Acquired Condition Reduction Program, which was mandated by federal health care reform. The penalties are based on rates of infections and other complications that occurred in hospitals between 2012 and 2014. The 18 hospitals in Connecticut include larger urban institutions, such as Yale-New Haven, Hartford and Bridgeport hospitals, and smaller hospitals, such as Manchester Memorial and Windham. They are among hospitals in the worst performing quartile nationally on patient-safety measures including the frequency of central-line and catheter-related infections, post-operative sepsis and accidental laceration.
Twenty-four of Connecticut’s 31 hospitals will face Medicare penalties in the fiscal year starting in October, in the second round of the federal government’s push to reduce the number of patients readmitted within a month of discharge, new data shows.
UConn’s John Dempsey Hospital has drastically reduced the frequency of “combination” CT scans of patients’ chests and abdomens, as federal regulators have clamped down on the practice, which carries a risk of excess radiation. New data provided by Dr. Douglas Fellows, chair of radiology at the UConn Health Center, shows that the hospital has reduced the rate of double scans of the chest to below 1 percent, and the rate of combination abdominal scans to 23 percent for Medicare patients, the population that federal regulators track. A 2011 story by C-HIT disclosed that Dempsey’s double-scan rate was the highest in the state and far exceeded the national average, with 48 percent of all patients who received chest scans subjected to combination scans—nearly 10 times the national average—and more than 72 percent who received abdominal scans getting double procedures. That data was from 2008. Fellows said the hospital has made a concerted effort in the last two years to crack down on double scans, by educating emergency department personnel, physicians in other parts of the hospital, and community doctors who order the scans.
As a practitioner at Yale-New Haven Hospital, Dr. Leora Horwitz has seen her share of patients who misunderstand medication changes made during their hospital stays. Just recently, one of her female patients, who was switched to a new beta blocker for high blood pressure during an inpatient stay, landed back in the hospital after discharge because she had taken both the new medication and her old beta blocker – a combination that lowered her heart rate and blood pressure to dangerous levels. “Every physician can tell you about these kinds of errors,” Horwitz said. “We do a relatively poor job of educating patients about their medications.”
As a researcher, Horwitz can now quantify those lapses. A recent study she led looked at 377 patients at Yale-New Haven Hospital, ages 64 and older, who had been admitted with heart failure, acute coronary syndrome or pneumonia, then discharged to home. Of that group, 307 patients – or 81 percent — either experienced a provider error in their discharge medications or had no understanding of at least one intended medication change.