Failure to rescue measure: validation of community- and hospital-acquired complications.
The inclusion of the failure to rescue (FTR) measure as one of the Centers for Medicare and Medicaid Services Inpatient Prospective Payment System measures has raised questions about the characteristics of FTR cases and their outcomes. In this study, we validated 75% of the identified FTR complications using medical record review (n = 461). Nearly half (49.5%) of the complications originated in the community and were present on admission. Acute renal failure, gastrointestinal hemorrhage, and sepsis most often originated in the community. Cardiac arrest/shock, pneumonia, and pulmonary embolism and deep vein thrombosis most often developed in the hospitals. These findings have important implications for practice as clinical leadership focuses on the prevention and aggressive management of complications to prevent death, increased length of stay, and possible reductions in Medicare diagnosis related groups' reimbursements.
Talsma
AkkeNeel
A
University of Michigan, Ann Arbor, MI 48109, USA. antalsma@umich.edu
Jones
Katherine
K
Liu
Guipeng
G
Campbell
Darrell A
DA
D000368:Aged; D000465:Algorithms; D003428:Cross Infection / Q000191:economics / Q000517:prevention & control; D003625:Data Collection / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007049:Iatrogenic Disease / Q000191:economics / Q000517:prevention & control; D007902:Length of Stay; D008297:Male; D008484:Medicaid / Q000191:economics; D019300:Medical Errors / Q000191:economics / Q000517:prevention & control; D006278:Medicare / Q000191:economics; D008824:Michigan; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011445:Prospective Payment System / Q000191:economics; D019984:Quality Indicators, Health Care / Q000191:economics; D012052:Reimbursement, Incentive; D014481:United States