With three healthcare reform law financial penalties impacting quality of care starting or increasing this year, and numerous proposals and rules to add more components to each one, hospital and physician leaders may be forgiven if they're just a bit nervous about how 2014 will affect their operations.
There is no crystal ball. But these healthcare quality issues are certain to influence how hospitals and physicians deliver care in 2014.
1. Hospital-Acquired Acute Kidney Injury
While HA-AKI is not yet part of any federal payment or penalty program, it is being increasingly recognized as a common type of patient harm that is, at least in many cases, preventable through better management and diligence.
Kidney injury affects between 7% and 18% of all hospital inpatients, and when hospital-acquired, is often the result of contrast agents used in cardiovascular procedures, or as a complication of nephrotoxic medications, according to a paper published last May in International Kidney, a journal of the by the International Society of Nephrology.
Such complications may be avoided, however, by using less contrast or less toxic medications, and being more aware of patients' renal health status before intervening with drugs or procedures.
The LEAPT (Leading Edge Advanced Practice Topics) program, part of Partnership for Patients, which is the Centers for Medicare & Medicaid Services' effort to push hospitals to reduce complications, has established "Hospital-Acquired Acute Renal Failure" as third on the list of avoidable harm initiatives, behind severe sepsis and prevention of Clostridium difficile infections.