DVT and Hospitals
Nearly 50% of all DVT cases happen after a patient is discharged – triggering hospital readmissions. Because DVT is preventable, costs associated with these “never events” are not reimbursed by the Centers for Medicare & Medicaid Services (CMS). Hospital reputations are damaged as well, through social media and public reporting of never events mandated by several states. According to the National Quality Forum (NQF), the risk of never events such as DVTs is significantly influenced by a hospital’s policies and procedures. Policies that promote continued DVT prevention after discharge – when risk is highest – are key.
The Affordable Care Act added to the Social Security Act establishing the Hospital Readmissions Reduction Program, which requires CMS to reduce payments to IPPS hospitals with excess readmissions.
Because DVT/PE complications are serious and preventable, the NQF has designated DVT and PE after total knee replacement or hip replacement surgery to be a serious, reportable never event.
The Joint Commission Perspectives on Patient Safety, June 2009, Volume 9, Issue “Preventing ‘Never Events’ Complications Following Total Knee or Hip Replacement Surgeries”
Never events are being publicly reported to increase accountability and improve care. Health care facilities are accountable for correcting systematic problems that contribute to never events, with some states mandating performance of a root cause analysis and reporting its results.
The NQF defines never events as errors in medical care that are of concern to both the public and health care professionals and providers, clearly identifiable and measurable (and thus feasible to include in a reporting system), and of a nature such that the risk of occurrence is significantly influenced by the policies and procedures of the health care organization.