Healthcare leaders respond to Premier's hospital-acquired conditions report

Editor's note:This article was updated to clarify that sepsis is among the hospital-acquired conditions tracked through CMS.

Healthcare leaders reacted to a Premier Inc. analysis that found Medicare does not monitor several common, costly hospital-acquired conditions and shared their strategies for overcoming this drawback in a conference call Thursday.

Sharon L. Powell, R.N., patient safety officer and director, performance improvement at Frederick (Maryland) Memorial Hospital, discussed why Frederick chose to address sepsis.

She described a patient who was admitted to the emergency department (ED) with a "seemingly mild" urinary tract infection; when her condition deteriorated and clinicians found she had sepsis, the ED admitted her to Frederick's intensive care unit. The patient recovered and was discharged from the hospital. "That case represented to us the potential for what could occur for patients who seem to be doing well but develop complications such as sepsis very quickly and, in many cases die," she said. 

To address such issues, Frederick developed a multidisciplinary task force to conduct a gap analysis, and identify and implement hospital-wide best practices. The task force developed strategies to address sepsis, such as increasing staff and physician education on early recognition and treatment, and establishing sepsis protocols for the ED. Since then, she said, "we've experienced significant improvement in our clinical outcomes," with mortality, lengths of stay and cost per sepsis patients all down.

"We believe that mortality is one of those big…measures that depict the quality of care," said Ramon V. Meguiar, M.D., senior vice president and chief medical officer of Memorial University Medical Center in Savannah, Georgia, "and it has led us to expend a large amount of effort in identifying patients and conditions with increased risk of mortality."

In working to reduce sepsis mortality, Meguiar said, "what we found … was that collaborative work with our entire team of providers was absolutely essential." Early identification and implementation of evidence-based care were both essential in addressing sepsis mortality, he said. We worked closely with our critical care physicians and nurses as well as our emergency department to identify patients with sepsis early and to implement evidence-based care."

To learn more:
- read the Premier, Inc. whitepaper (.pdf)