Reducing hospital inpatient complications: A four year experience

Abstract

This study described the use of administrative data and a computer software algorithm, Potentially Preventable Complications, to support reduction of inpatient hospital complications. The study was carried out between 2008 and2012 inSt. Joseph’s Hospital Health Center in Syracuse, New York. The hospital generates approximately 23,000 inpatient discharges annually. The study employed summary tables for individual inpatient complications and patient specific spreadsheets to evaluate and follow adverse outcomes. The spreadsheets were employed by hospital staff to determine whether patient medical records confirm each complication identified by the software. This process resulted in improvement of the accuracy of administrative data describing inpatient complications. The administrative data and the software were also used in conjunction with medical records to Identify patients who received program interventions and still experienced inpatient complications. This process enabled hospital staff to ensure that interventions were being provided and evaluate their effecttiveness. The study demonstrated that, at the aggregate level, the inpatient complication rate per 1000 discharges declined by 33.4 percent, from 56.11 to 37.37 between 2008 and 2011. The principal drivers of this decline were high volume complications such as pneumonia, where the rate declined by 45.7 percent and urinary tract infection where the rate declined by 23.7 percent. The project provided a means of communicating and managing outcomes data that could be implemented and understood by a wide range of health care providers.