Validation of Failure to Rescue complications through medical record review: the impact of "Present on Admission" and patient outcomes

2.50
Hdl Handle:
http://hdl.handle.net/10755/159791
Type:
Presentation
Title:
Validation of Failure to Rescue complications through medical record review: the impact of "Present on Admission" and patient outcomes
Abstract:
Validation of Failure to Rescue complications through medical record review: the impact of "Present on Admission" and patient outcomes
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Talsma, AkkeNeel, PhD, RN
P.I. Institution Name:University of Michigan
Title:School of Nursing
Contact Address:400 North Ingalls, Rm. 4154, Ann Arbor, MI, 48109-5462, USA
Contact Telephone:734-763-5199
The Failure to Rescue (FTR) measure has gained major attention, especially since the National Quality Forum endorsed this nursing sensitive measure. Recently, the Centers for Medicare and Medicaid Services (CMS) identified Failure to rescue as a potential measure for the Inpatient Prospective Payment System (IPPS), which may result in reduced reimbursements if cases expired due to a complication included in the FTR measure. The FTR measure, based on administrative (billing) data, captures cases that expired due to: acute renal failure, PE/DVT, pneumonia, sepsis, cardiac arrest/shock, or GI hemorrhage. The denominator includes cases with a FTR complication, the numerator reflects mortality of the included cases. Failure to rescue is linked with nursing staffing ratios. The study aims to validate the FTR complications through medical record review, to determine FTR complications present on admission (POA), and the distribution of FTR complications. A random sample of n=235 cases was drawn from a seven-hospital study for medical record review. The FTR Validation Tool was developed to validate of the FTR complications, determine POA status, and assess the distribution and mortality of FTR complications. Findings show the FTR complication distribution ranged from 15% (sepsis) to 19% (GI hemorrhage). The sepsis (83%) complication was most often confirmed in the medical record vs. GI hemorrhage (31%). PE/DVT (32%) showed the highest POA status whereas GI hemorrhage (11%) was least likely identified as POA. For this study, 23% of all FTR complications were identified as POA. The mortality of patients with a FTR complication present on admission was 5.6% vs. 30.6% for cases without the FTR complication identified as POA. Understanding of the population that is included in the Failure to rescue measure will be beneficial in devising appropriate admission screening approaches to identify and treat such patients upon the point of entry into the health system.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleValidation of Failure to Rescue complications through medical record review: the impact of "Present on Admission" and patient outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159791-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Validation of Failure to Rescue complications through medical record review: the impact of &quot;Present on Admission&quot; and patient outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Talsma, AkkeNeel, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Michigan</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">School of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">400 North Ingalls, Rm. 4154, Ann Arbor, MI, 48109-5462, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">734-763-5199</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">antalsma@umich.edu</td></tr><tr><td colspan="2" class="item-abstract">The Failure to Rescue (FTR) measure has gained major attention, especially since the National Quality Forum endorsed this nursing sensitive measure. Recently, the Centers for Medicare and Medicaid Services (CMS) identified Failure to rescue as a potential measure for the Inpatient Prospective Payment System (IPPS), which may result in reduced reimbursements if cases expired due to a complication included in the FTR measure. The FTR measure, based on administrative (billing) data, captures cases that expired due to: acute renal failure, PE/DVT, pneumonia, sepsis, cardiac arrest/shock, or GI hemorrhage. The denominator includes cases with a FTR complication, the numerator reflects mortality of the included cases. Failure to rescue is linked with nursing staffing ratios. The study aims to validate the FTR complications through medical record review, to determine FTR complications present on admission (POA), and the distribution of FTR complications. A random sample of n=235 cases was drawn from a seven-hospital study for medical record review. The FTR Validation Tool was developed to validate of the FTR complications, determine POA status, and assess the distribution and mortality of FTR complications. Findings show the FTR complication distribution ranged from 15% (sepsis) to 19% (GI hemorrhage). The sepsis (83%) complication was most often confirmed in the medical record vs. GI hemorrhage (31%). PE/DVT (32%) showed the highest POA status whereas GI hemorrhage (11%) was least likely identified as POA. For this study, 23% of all FTR complications were identified as POA. The mortality of patients with a FTR complication present on admission was 5.6% vs. 30.6% for cases without the FTR complication identified as POA. Understanding of the population that is included in the Failure to rescue measure will be beneficial in devising appropriate admission screening approaches to identify and treat such patients upon the point of entry into the health system.</td></tr></table>en_GB
dc.date.available2011-10-26T22:20:16Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:20:16Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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