Since four years have passed since data collection ended, might hospitals have begun to launch more aggressive efforts to prevent post-discharge surgical complications? Hawn says she doesn't think so.
"Hospitals now have 95%, 96%, and 97% adherence to these process measures, or even higher. And yet surgical patients are still getting VTEs and infections, and still being readmitted," she says.
A Tough Task
Hawn says it's crucial for hospitals to be more diligent about preventing these surgical complications. But that's a labor-intensive task. Patients who develop these complications may not be readmitted to the same hospital where they had the surgery. Hospitals usually learn how many of their patients get readmitted, but Hawn says most hospitals do not have a system to track the reasons why. Was it due to a fall, or something related to the surgery? There's often no way a hospital can know without a huge amount of effort they don't have the resources to make.
Another problem with the system, she says, are the surgical care improvement project or SCIP process measures that are now included in Medicare's value-based purchasing program. These prompt hospitals to perform blood cultures and administer antibiotics to patients undergoing surgery to prevent infections or blood clots.