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Quality Efforts Showing Results at BRMC and OGH

Posted on: 12/18/2015

 

Quality Efforts Showing Results at BRMC and OGH

The Centers for Medicare and Medicaid Services (CMS) recently announced that for fiscal year 2016, 758 hospitals were penalized under the Hospital-Acquired Condition (HAC) reduction program, costing them $364 million in reimbursement penalties. They will have their reimbursement from CMS reduced by 1 percent for all Medicare discharges between October 1, 2015, and September 30, 2016.

Olean General Hospital (OGH) and Bradford Regional Medical Center (BRMC), member hospitals of Upper Allegheny Health System, are not among the penalized hospitals.  For the second year, since the inception of the program, both hospitals earned scores well below the threshold for incurring a penalty from Medicare. Hospitals with a total HAC score greater than 6.75 for fiscal year 2016 had their payments reduced. Olean General Hospital had a HAC score of 5.75.  Bradford Regional Medical Center earned score of 4.12.  The result is a reimbursement penalty avoidance of $70,000 at BRMC and $140,000 at OGH.

The HAC program was created under the Patient Protection and Affordable Care Act and was effective beginning fiscal year 2015, which started with discharges on October 1, 2014. It looks at four quality measures examining such areas as urinary, catheter, surgical site and bloodstream infections, pressure ulcer care, postoperative hip fractures, sepsis, accidental punctures and lacerations. 

Under the program, hospitals that are paid under the Inpatient Prospective Payment System are measured on HAC measures. The bottom 25 percent of hospitals could be subject to payment reduction.   “The HAC results are obviously encouraging to us since they have an impact on reimbursement, but more importantly it is one more indicator of our success in assuring a safe environment for our patients”,” said Timothy J. Finan, president and CEO of Upper Allegheny Health System.  “We have been taking an aggressive approach to reducing infections, patient harm events and utilizing technology to improve patient safety and quality,” Finan said. 

Finan noted that recently Olean General Hospital earned a grade of “A” in patient safety from the Leapfrog Group, one of nation’s most noted independent hospital rating organizations.  Early this year Bradford Regional Medical Center was recognized by the Hospital and Healthcare Association of Pennsylvania with the “Safety Across the Board “ Award for its efforts in reducing preventable harm.

“When patients come to us for care, they want to get appropriate medical care and then be discharged safely home,” Finan said. “They don’t bargain for an infection, a medication error, a fall or some other problem while they are with us.”

Finan said both hospitals have been driving the quality and safety agenda very hard over the past several years and believes those cumulative efforts are getting results.  “It’s a combination of factors. Both hospitals have introduced aggressive initiatives surrounding infection control and harm prevention, including more effective communication in clinical areas and intense efforts around hand hygiene. Additionally, our employees are very involved in leading these efforts Finan said.

Gail Bagazzoli, Vice President for Quality at UAHS said a “Stop the Line” program has been introduced, which empowers anyone to stop a procedure or an action which they perceive could be harmful to a patient.  “We’ve introduced Safety Champions at both hospitals with nearly 150 employees trained and designated to observe and report on safety around the hospitals,” he said. “We encourage patients and their families to take an active role, ask questions and express concerns to staff through the Patient Speak Up initiative,” she said.

William Mills, MD, Senior Vice President, Quality and Professional Affairs at UAHS, said the introduction of Computerized Physician Order Entry has been a factor in avoiding medical errors.   “Last year OGH was in the top 10% of hospitals nationally for achieving 100% compliance in 63 of 65 core safety and quality measure routinely reported to Medicare,” Dr. Mills said.

He noted that Olean General is the only hospital in the region with intensivists to manage its Intensive Care Unit,. Intensivists are physician specialists in intensive and critical care. They are on site at Olean General 24/7/365.  He said the clinical literature notes that ICU’s directed by intensivists experience a 40% reduction in ICU mortality.  Dr. Mills also noted that Bradford Regional Medical Center recently introduced a hospitalist program.  A hospitalist is a physician who specializes in the practice of acute care medicine with a sole focus on hospitalized patients.    BRMC now provides hospitalist services 24 hours a day, seven days a week and joins the majority of hospitals in the region offering this service. “The 24/7 presence of hospitalists on patient care units significantly enhances patient care and safety,” he noted. 

Bagazzoli said the latest weapon in reducing infections at BRMC and OGH is the acquisition of new germ killing Clorox UV light towers that kills surface germs and bacteria by exposing them to intense UV light.  “This technology was just rolled out at both our hospitals and we are the only hospitals in the region to have it.” 

The Clorox Optimum-UV System is a six foot high mobile light tower, which is placed in an unoccupied room and bathes surface areas with intense ultraviolet light for several minutes to inactivate pathogens on surface areas. The intense ultraviolet light damages the DNA of micro-organisms, neutralizing them. Bagazzoli said the technology is designed to supplement, not replace, manual surface disinfection in the hospital. The Clorox system is known to reduce the risk of surface infection by up to 20%.  At OGH the system was purchased by hospital employees through donations to the Olean General Hospital Foundation.

“Raising the bar on quality and safety is not one effort. It is many efforts with people working together on multiple programs to ensure patients have a safe experience whenever they entrust themselves to our care,” Finan said. 

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