Feds Stop Reporting Leading Hospital Errors

The Centers for Medicare and Medicaid Services (CMS) has changed its reporting of hospital errors, making it harder for consumers to make informed choices about their care. This month, CMS stopped providing public data on eight avoidable “hospital acquired conditions” (HACs), including reports of when hospitals leave foreign objects in patients’ bodies. The change comes on the heels of CMS’s assurances last year that it would not make such a reporting change.

CMS will continue to report certain HACs such as MRSA and sepsis while removing others. According to a spokesperson for the National Quality Forum (NQF), a Washington, D.C.-based nonprofit that works to measure and improve the quality of healthcare, the additional HACs were abandoned because they weren’t “appropriate for comparing one hospital to another.”

But the government views HACs – including the eight HACs dropped from CMS’s data – as serious enough to affect payment; moving forward under the Affordable Care Act, the hospitals with the highest rates of HACs will receive an overall reduction in Medicare reimbursement.

Hospital-acquired conditions not eligible for Medicare reimbursement

Under the Deficit Reduction Act of 2005, CMS was required to identify hospital errors that are high cost or high volume, increase the cost of healthcare, and are reasonably preventable. The consequence to affected hospitals is that they are not reimbursed for the secondary, acquired HAC.

Some of the HACs identified by CMS include:

• Foreign object retained after surgery
• Blood incompatibility
• Falls and traumas including fracture, dislocations, and burns
• Catheter-related infections
• Conditions resulting from poor control of blood sugar, such as hypoglycemic coma and diabetic ketoacidosis
• Surgical site infections
• DVT and pulmonary embolism following total knee replacement or hip replacement

Hospital errors among top causes of medical malpractice

JAMA Internal Medicine recently published a study examining the five leading causes of medical malpractice lawsuits against hospitals. After studying over 30,000 medical malpractice cases filed over a 25-year span, the report concluded that the top cause was an inaccurate or missed diagnosis, followed by a breach of care. Holding third place was surgical errors, such as the types removed by CMS from its new reporting standard.

According to a study of 10 years’ worth of data by the Department of General Surgery, Carolinas Medical Group, in Charlotte, North Carolina, retained foreign objects are a preventable error with clear risk factors. More than half of the retained foreign objects in the study were sponges and analysis showed that patients were at a significantly higher risk to have surgical objects left behind in their bodies when they had multiple procedures performed at the same time and there was an incorrect instrument or sponge count. More than 2/3 of the patients studied required a second operation as a result of the foreign object left behind.

Retained foreign bodies are referred to in the medical field as “never events” since they are never supposed to happen. But studies show that they happen across the country more than a dozen times a day – for a total of nearly 6,000 incidents per year. These mistakes come with a price. According to CMS data, the average hospital stay involving a retained sponge or other surgical instrument costs more than $60,000 and results in a malpractice suit that costs the hospital between $100,000 and $200,000.