The Sts Adult Cardiac Surgery Database

Hospital readmissions are potentially harmful, costly and often times an avoidable event. Between the provisions set forth under the Affordable Care Act and the penalties authorized by the Centers of Medicare and Medicaid Services, hospitals are forced to shift their focus towards the development of strategies to reduce and prevent avoidable hospital readmissions related to heart failure. It is estimated that of the 6 million individuals within the United States diagnosed with heart failure, 1 million of them are hospitalized each year with a primary diagnosis of heart failure, accounting for $17 billion dollars of Medicare expenditures (Sales et al, 2013). What is worse is the death rate associated with heart failure each year, accounting

Cardiac diseases alone have been estimated, direct and indirect costs, for the overall American population are “approximately $165.4 billion for 2009” (CDC, 2013). A survey found that heart disease accounted for 4.2 million of the hospitalizations in 2006. In 62% of these cases were short stay hospitalizations and occurred amount peoples ages 65 and older. These hospitalization rates also vary by gender, racial, and ethnic groups.

Implementation of The Affordable Care Act has addressed some issues surrounding HAIs. For instance, section 3008 of ACA recognized the HAC or hospital acquired condition in the Reduction Program to further reduce HACs and improve patient quality. In this program, the ACA seeks to establish a monetary incentive through CMS that will encourage hospitals to reduce HAC or HAIs. Since most not for profit, public, and even large hospitals receive some form of funding through CMS from Medicare or Medicaid payments, this monetary incentive is one of the better incentives to have been recently proposed by the ACA regarding HAIs. Therefore, some of the strategies in managing and developing evidence-based practice relevant in handling

This article sought to find an appropriate model to predict the risk of unplanned heart failure readmissions. The primary outcome from chart reviews also included death of heart failure patients within 30 days of discharge. The study looked at Centers for Medicaid and Medicare Services (CMS) models and the LACE+ index, to mention two of many

An opportunity or metric for Memorial Herman Northeast to improve upon are Bloodstream infections after surgery and mortality rates.

3) On what basis could County argue that it is conforming with the criterion at 1715(3)? On what basis could the state agency argue that County's application in nonconforming with the criterion? In your opinion, which side has the more persuasive argument? Why?

In 2008, CMS implemented policy through the Affordable Care Act that links quality to payment in an effort to produce better patient outcomes and decrease healthcare expenditures. The CMS policy includes pay-for-performance incentives and non-payment for HACs and readmissions. The problem with this policy is that recent data suggests there are no significant changes in central catheter-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), or ventilator-associated pneumonia after the implementation of the policy. There is also the issue of unreliable reporting of HACs through the use of Medicare severity diagnosis related groups (MS-DRGs) and present on

According to the Centers for Disease Control and Prevention (CDC) there are an estimated 5.1 million adults suffering from heart failure (2013). As the prevalence of heart failure continues to rise, one out of every nine deaths occur as a result of this chronic condition. Studies conducted at Yale found in Medicare age patients with heart failure, there is a median 30-day mortality rate of 11.1% and 5-year rate of approximately 50% (Alspach, 2014). According to Desai & Stevenson (2012), rising costs of care are in direct correlation to the number of hospital admissions related to a primary diagnosis of heart failure especially among adults age 65 years or older. The national rate for readmissions within 30 days is approximately 24.7%, consequently having

Rising health care cost and stricter regulations for insurance reimbursement plans have pushed health care leaders to re-evaluate health care services. One focus is reducing hospital readmission rates for chronic disease process (Bos-Touwen et al, 2015). Congestive heart failure is one of the leading causes of hospital readmission (Cubbon et al, 2014). Fifteen million people worldwide have a diagnosis of CHF. In addition, 15-20% of those with the diagnosis of CHF are hospitalized yearly (Sahebi et al, 2015). In 2010, 40 billion dollars was spent on health care needs for CHF patients. Seventy percent of the resources were for hospital services (Siabani, Driscoll, Davidson, and Leeder, 2014). The need for streamline healthcare for CHF patients is imperative to improve overall patient outcomes and reduce the amount of hospital readmission rates.

With heart failure, increasing in incidence in the United States, hospital readmission rates are being scrutinized to save money, especially for Medicare beneficiaries. Over 5 million people in the United States are living with heart failure, defined as “a condition in which the heart cannot pump enough blood and oxygen to support other organs in the body” (CDC, 2013). Heart failure affects 2.4% of the United States population with nearly 12% of both women and men 80 years and older having heart failure (Heidenreich, P. A., Albert, N. M., Allen, L. C., Bluemke, D. A., Butler, J., Morrow, G. C., Ikonomidis, J. S., et al., 2013). Heidenreich et al (2013) project that by 2030, heart failure will affect over 8 million Americans, with 2 million of those being ages 80 years and older. Heart failure is one of three conditions to be included in the Centers for Medicare and Medicaid Services (CMS) reimbursements that hospitals are penalized for if the hospital experiences an excess amount of readmissions within 30 days of the initial hospitalization due to the disease.

This was a retrospective, descriptive, and correlational study. Data from the records of patients who had undergone a heart catheterization or PCI over the span of two years was retrieved from the Clinical Automated Office Solutions database. (Dumont, Keeling, Bourguignon,

As our population’s longevity continues to grow, patients undergoing heart surgery will become older and sicker (Ettema, 2014). The unhealthy lifestyle choices that are existing in our society propose a higher risk for patients who have cardiac surgery to develop post-operative complications. This paper will be examining one of the five core competencies in relation to a specific patient population, clinical concern, and evidence based practice proposal that will educate patients pre-operation on lifestyle changes that will help prevent post-operative sternal surgical site infections.

The purpose of this paper is to analyze if there is any improvement, post-operative complications, mortality and related factors of elderly undergoing cardiac surgery. The debate whether or not we are pushing the limits is still questionable because of the complications associated with these invasive surgeries and whether or not if it’s a money game. The growing numbers of the elderly patients enjoy a prescription drug benefit, access to artificial knee and hip surgery, and life-saving cardiovascular interventions that were undreamed of a half-century ago.

For the hospital, there is a lower risk than the reference population. The indicator measures in-hospital deaths per every 1000 hospital discharges with a principal diagnosis of acute myocardial infarction for patients above 18 year of age. This measure excludes all obstetric discharges and any transfers to other hospitals. The numerator is the number of deaths and the denominator is the number of discharges with a ICD-9 code for AMI.

It is reported that even small increase (0.3-0.5 mg/dl) in serum creatinine after cardiac surgery is associated with nearly three-fold increase in 30 day mortality, while a larger increase > 0.5 mg/dl is associated with more that 18-fold increase in 30 - day mortality(13). Patients in need for renal replacement therapy(RRT) have significantly longer in-hospital stay as well as increased