Jul 23 2012

OIG Issues Provider Podcast and Guidance on Adverse Events

Last week the U.S. Department of Health & Human Services Office of Inspector General (OIG) released a podcast for providers as well as supplemental resources outlining recent data and guidance on hospital adverse events.  The OIG’s focus on adverse events is a result of a report required by the Tax Relief and Health Care Act of 2006 that examined how Medicare beneficiaries were harmed as a result of medical care. The OIG’s podcast evidences its continued focus on adverse events in a hospital setting and its new focus on nursing home adverse events.

Ruth Ann Dorrill, Deputy Regional Inspector General for the Office of Evaluation and Inspections, defined adverse events as circumstances, preventable or non-preventable, during which Medicare patients are harmed as the result of medical care (e.g., never events, hospital-acquired conditions, infections, surgical complications, medication errors, allergic reactions, and injuries from falls).  Ms. Dorrill noted that the OIG’s reports were based on physician experts examining hospital medical records.  These reports identified that 1 in 7 hospitalized Medicare patients experienced an adverse event serious enough to prolong hospitalization, cause permanent bodily harm, require life-sustaining intervention, or result in death.  According to the OIG, each month an estimated 134,000 hospitalized Medicare patients experienced serious problems, and 15,000 died as a result of adverse events. Further, the OIG calculated the cost of adverse events to the Medicare program at approximately $4.4 billion.  The OIG repots that its studies indicate that 44% of these harmful events could have been prevented.

During the podcast, the OIG advised that hospitals should consider (1) changing systems to reduce the odds of human error and (2) adopting policies that will provide better care with less risk of harm.  According to the OIG, only 14% of adverse events are identified and reported. As a result, the OIG noted that provider awareness of adverse events as well as a willingness to change policies in order to increase prevention and compliance is the key to improvement.

The OIG also reported in its podcast that it will continue to focus its efforts on review of required patient safety standards, including enforcement of such standards.  Ms. Dorrill also explained that the OIG will be reviewing adverse events in the nursing home setting in the near future.  In addition to the OIG’s focus, Affordable Care Act quality standards require providers to continue to focus on reduction of adverse events and hospital-acquired conditions in order to remain fully eligible for Medicare reimbursement.