Information Retention Assessment #3

The correct answer is Surgical Infection/GI complication/Failure to thrive-malnutrition. This is based on the Kassin study, which identified these three reasons as the most common for readmission postoperatively. Wound complications, urinary tract infections, and vascular complications were not mentioned as the top reasons for readmission in the study. Similarly, GI complications and pain were mentioned but were not among the top three reasons.

The study conducted by Kassin does not look at mortality rates.

In the Kassin study, it was found that a patient who experienced one or more complications after surgery was more than four times likely to be readmitted. This suggests that postoperative complications significantly increase the risk of readmission.

The approximate increased hospital costs associated with a patient who has one or more complications versus a patient with no complications is $18,000.

The study conducted by Kassin and Boltz showed that an increase in complication rates leads to an increase in length of stay (LOS). This implies that when patients experience more complications during their hospitalization, their stay is prolonged. This finding suggests the importance of preventing and managing complications effectively to optimize patient outcomes and reduce healthcare costs.

The potential limitation of NSQIP is that it does not collect information on all possible complications. This means that there may be complications that are not captured or included in the data collected by the program. Therefore, the program may not provide a comprehensive understanding of all the potential complications that could occur in surgical care.

The Centers for Medicare and Medicaid Services (CMS) has decided to stop covering the additional expenses related to treating preventable errors, injuries, or infections that happen in hospitals. This means that hospitals will no longer be reimbursed for the costs associated with these preventable incidents. This decision by CMS aims to incentivize hospitals to improve patient safety and reduce preventable harm.

The direct link between payment and Fee For Service (FFS) is not a CMS payment and delivery reform because it does not involve any changes or reforms to the current payment system. Fee For Service is a traditional payment model where healthcare providers are paid for each individual service or procedure they perform, without considering the quality or value of the care provided. In contrast, the other options mentioned (value-based purchasing, ACOs, medical homes, bundled payments, greater care coordination, and primary care focus) are all examples of CMS payment and delivery reforms that aim to incentivize higher quality, more coordinated, and cost-effective care.

Hospital performance begins to impact its future payments approximately 4 years before a payment and delivery reform start date. This means that the performance of a hospital in terms of quality and efficiency will be taken into account several years in advance when determining its future payments. This allows for a long-term assessment of the hospital's performance and incentivizes continuous improvement over time.

In addition to the conditions being measured starting in 2013 (Acute Myocardial Infarction, Heart Failure, and Pneumonia), the conditions that will be measured under the Hospital Readmissions Reduction Program in 2015 are Total Hip Arthroplasty and Total Knee Arthroplasty. This means that the readmission rates for these two procedures will also be monitored and evaluated as part of the program.

The total performance score (TPS) for hospital performance on the value-based purchasing program is created using multiple evaluation criteria. These criteria include the process of care, patient experience, and patient outcomes. By considering these factors, the TPS provides a comprehensive assessment of a hospital's performance, taking into account the quality of care provided, the satisfaction of patients, and the overall outcomes achieved.

The Inpatient Quality Reporting (IQR) program serves as the basis for proposing measures for the Hospital Value-Based Purchasing (VBP) Program. The IQR program requires hospitals to report on a set of quality measures, which are then used to assess hospital performance and determine incentive payments in the VBP program. By participating in the IQR program and reporting on quality measures, hospitals can improve their performance and receive financial rewards through the VBP program.

In the Ghaferi study, 25% of patients who underwent general or vascular surgery had a surgical complication.

The correct answer is "Similar rates of post-op complications." This means that high mortality hospitals had similar rates of post-operative complications compared to other hospitals. This suggests that the high mortality hospitals did not have significantly higher or lower rates of post-operative complications, indicating that post-operative complications may not be the primary factor contributing to the higher mortality rates in these hospitals.

The question is asking about the patient population that CMS will begin monitoring in 2015. The correct answer is "Vascular surgery procedures." This means that CMS will start monitoring the outcomes and readmission rates of patients who undergo vascular surgery procedures. This is in line with the Hospital Readmissions Reduction Program's goal of reducing readmissions for specific conditions, including Acute Myocardial Infarction, Chronic Heart Failure, Pneumonia, and now Vascular surgery procedures.