Tracking the Sustainability of Improvements in Hospital Outcomes

Abstract

This study focused on tracking the sustainability of improvements in inpatient outcomes in the hospitals of Syracuse, New York. It involved evaluation of inpatient complications during a six-year period for two of the Syracuse hospitals and inpatient readmissions during a three-year period for three hospitals. The study employed the Potentially Preventable Complications and Potentially Preventable Readmissions software developed by 3M^TM Health Information Systems. The study demonstrated that two of the Syracuse hospitals produced reductions in aggregate complication rates between 2009 and 2012. This was followed by an increase in complications during 2013 and 2014. The decline in complications and the increase that followed were supported by developments in high volume complications and some lower volume complications. Hospital readmissions for adult medicine, the largest inpatient service, both increased and declined at the aggregate level and for individual hospitals during the three-year period. Hospital readmission rates for adult surgery declined, however, individual hospital rates increased and declined. The study identified sustained reductions in readmission rates for the combined hospitals for congestive heart failure and COPD during the three-year period. The study identified the challenges related to sustaining reductions in hospital outcomes over time. In the Syracuse hospitals, these challenges involved inpatient clinical management for complications and system-wide issues for readmissions.