Failure to rescue measure: validation of community- and hospital-acquired complications

Area of Science:

• Healthcare Quality
• Patient Safety
• Hospital Administration

Background:

• The Centers for Medicare and Medicaid Services (CMS) incorporated the failure to rescue (FTR) measure into inpatient payment systems.
• This inclusion necessitates a deeper understanding of FTR cases and their origins.

Purpose of the Study:

• To validate identified FTR complications.
• To characterize the origins (community vs. hospital-acquired) of these complications.
• To inform clinical leadership and practice regarding complication management.

Main Methods:

• Medical record review of 461 identified FTR cases.
• Validation of 75% of identified FTR complications.
• Categorization of complication origins as community-acquired or hospital-acquired.

Main Results:

• Nearly half (49.5%) of FTR complications were present on admission (community-acquired).
• Acute renal failure, gastrointestinal hemorrhage, and sepsis were frequently community-acquired.
• Cardiac arrest/shock, pneumonia, and pulmonary embolism/deep vein thrombosis often developed during hospitalization.

Conclusions:

• A significant proportion of FTR complications are community-acquired, impacting patient outcomes and hospital finances.
• Targeted interventions for community-acquired complications are crucial.
• Focusing on prevention and aggressive management of all complications is vital to reduce mortality, length of stay, and potential reimbursement reductions.