CMS’ Hospital-Acquired Conditions for the Neurohospitalist

Sand, Heather; Owen, Mary; Amin, Alpesh

doi:10.1177/1941874411426887

Cited by 7 publications

(5 citation statements)

References 34 publications

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“…Closed fracture of nasal bones 802. 1 Open fracture of nasal bones 802. 20 Closed fracture of unspecified site of mandible 802.…”

Section: 94mentioning

confidence: 99%

“…Crushing injury of unspecified site 940.0 Chemical burn of eyelids and periocular area 940. 1 Other burns of eyelids and periocular area 940. 2 Alkaline chemical burn of cornea and conjunctival sac 940.…”

Section: 21mentioning

confidence: 99%

“…The Centers for Medicare and Medicaid Services (CMS) evaluated these events in 2008 and decided that the increased charges associated with their treatment will no longer be reimbursed in the inpatient setting. [1][2][3] The never events that specifically affect vascular surgery patients include air embolism, catheter-based urinary tract infection (UTI), stage 3 and 4 pressure ulcers, falls/trauma, blood incompatibility, vascular catheter infection, complications with poor glucose control, foreign objects, and wrong-site surgery. 4,5 Reducing the occurrence of never events could potentially lower morbidity, mortality, and total charges.…”

mentioning

confidence: 99%

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Occurrence of “never events” after major open vascular surgery procedures

Shah

Farber

Kalish

et al. 2016

Journal of Vascular Surgery

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Never events after major vascular surgery are associated with a number of perioperative factors and are predictive of increased charges, LOS, and mortality. Falls and catheter-based UTIs have increased in frequency since the Centers for Medicare and Medicaid Services announced that it would no longer reimburse for these complications. This study establishes baseline never event rates in the vascular surgery patient population and identifies high-risk patients to target for quality improvement.

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“…Closed fracture of nasal bones 802. 1 Open fracture of nasal bones 802. 20 Closed fracture of unspecified site of mandible 802.…”

Section: 94mentioning

confidence: 99%

Section: 21mentioning

confidence: 99%

mentioning

confidence: 99%

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Occurrence of “never events” after major open vascular surgery procedures

Shah

Farber

Kalish

et al. 2016

Journal of Vascular Surgery

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“…We excluded another 337 articles after reviewing the full-text citations largely because they neither identified individual NEs nor specified an existing framework (47%), or because they were non-scholarly (eg, media releases; 30%). Thus, our analyses were based on 367 articles 3 4 7–11 18–377. A full list of these articles and the information we extracted from them are found in online supplemental tables 1 and 2.…”

Section: Resultsmentioning

confidence: 99%

Identifying a list of healthcare ‘never events’ to effect system change: a systematic review and narrative synthesis

et al. 2023

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BackgroundNever events (NEs) are patient safety incidents that are preventable and so serious they should never happen. To reduce NEs, several frameworks have been introduced over the past two decades; however, NEs and their harms continue to occur. These frameworks have varying events, terminology and preventability, which hinders collaboration. This systematic review aims to identify the most serious and preventable events for targeted improvement efforts by answering the following questions: Which patient safety events are most frequently classified as never events? Which ones are most commonly described as entirely preventable?MethodsFor this narrative synthesis systematic review we searched Medline, Embase, PsycINFO, Cochrane Central and CINAHL for articles published from 1 January 2001 to 27 October 2021. We included papers of any study design or article type (excluding press releases/announcements) that listed NEs or an existing NE framework.ResultsOur analyses included 367 reports identifying 125 unique NEs. Those most frequently reported were surgery on the wrong body part, wrong surgical procedure, unintentionally retained foreign objects and surgery on the wrong patient. Researchers classified 19.4% of NEs as ‘wholly preventable’. Those most included in this category were surgery on the wrong body part or patient, wrong surgical procedure, improper administration of a potassium-containing solution and wrong-route administration of medication (excluding chemotherapy).ConclusionsTo improve collaboration and facilitate learning from errors, we need a single list that focuses on the most preventable and serious NEs. Our review shows that surgery on the wrong body part or patient, or the wrong surgical procedure best meet these criteria.

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“…Prior studies have shown that inpatient falls are expensive, and the Centers for Medicare and Medicaid Services no longer reimburses for several complications related to inpatient falls, including intracranial injuries. 33 One retrospective cohort study by Fields et al of inpatient falls showed that the bulk of costs related to falls were due to widespread use of head CT. 34 This same study reported a 4.3% prevalence of a positive CT finding for inpatient falls, similar to the 3.6% prevalence in our study. Their study did not describe whether the CT findings led to a change in management or neurosurgical intervention.…”

Section: Discussionmentioning

confidence: 99%

The Applicability of New Orleans Criteria for Head Computed Tomography in Inpatient Falls With Injury

Yarlagadda

Joshi

Cerasale

et al. 2019

The Neurohospitalist

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Background: Inpatient falls are a patient safety concern. Limited data exist on the utility of head computed tomography (CT) for inpatient falls. The New Orleans Criteria (NOC) is a validated tool to determine the appropriateness of neuroimaging in the emergency department for falls with minor head injury. This study aimed to evaluate whether the NOC could be applied to inpatient falls. Methods: This retrospective cohort study assessed 1 year of inpatient falls with injury at 5 inpatient facilities. Records were reviewed for demographic data, fall circumstances, laboratory results, components of the NOC, and head CT results. Cohorts included positive NOC (≥1 NOC finding) and negative NOC. Sensitivity and specificity were calculated for the NOC alone, NOC plus coagulopathy, and NOC or coagulopathy for acute intracranial process. Results: Of 332 inpatient falls with injury, 188 (57%) received a head CT. Of the 250 (75.3%) NOC-positive cases, 159 (63.6%) received a head CT. Of all patients who received a head CT, 7 (2.1%) showed a significant acute intracranial process. The NOC was positive in 6 of the 7 cases (sensitivity 85.7% and specificity 23.8%); the other case had a significant coagulopathy. New Orleans Criteria or coagulopathy had 100% sensitivity and 23.4% specificity. Conclusions: Our findings show that use of the NOC to evaluate potential intracranial injury in inpatient falls is limited. Adding criteria to the NOC may improve its test characteristics, with a sensitivity of 100% for the NOC or coagulopathy, suggesting potential clinical utility.

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CMS’ Hospital-Acquired Conditions for the Neurohospitalist

Cited by 7 publications

References 34 publications

Occurrence of “never events” after major open vascular surgery procedures

Occurrence of “never events” after major open vascular surgery procedures

Identifying a list of healthcare ‘never events’ to effect system change: a systematic review and narrative synthesis

The Applicability of New Orleans Criteria for Head Computed Tomography in Inpatient Falls With Injury

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