Medical coding and quality improvement teams can effectively leverage data on risk factors that influence specific readmission and mortality measures to enhance healthcare outcomes. By ensuring accurate medical coding, these teams can identify discrepancies and opportunities for improvement, leading to more precise documentation and better resource allocation. Quality improvement teams can utilize this data to target interventions for high-risk patient cohorts, thereby reducing readmission rates and improving care quality. Collaboration between coding and quality teams, informed by comprehensive risk factor analysis, is crucial in driving operational efficiencies and enhancing patient care. This synergy not only supports financial performance through improved coding and reimbursement accuracy but also fosters a culture of continuous quality improvement within healthcare organizations.
Read moreDexur Overview and Demo Video: Healthcare’s Unified AI Quality, Safety, Risk & Incident Software
The video overviews Dexur, an AI-driven unified software for quality, safety, risk, and incident management, highlighting how it helps healthcare organizations save costs, improve efficiency, and enhance patient outcomes. It features Dexur's comprehensive capabilities, which include data ingestion, cross-program integration, AI Advisor Reports, predictive analytics, quality program management, and advanced simulations. It demonstrates Dexur's ability to streamline processes, provide actionable insights, and support decision-making across various healthcare programs.
Read more48% of SSI Colon Hospital Acquired infections are likely to occur within 10 days of Admission
Importance and Background on Surgical Site Infections in the Colon
Surgical Site Infections (SSI) following colon surgery present a significant challenge in healthcare. They adversely affect patient recovery and impact hospital quality metrics. These infections not only lead to longer hospital stays and increased costs but can also result in severe, life-threatening complications. Therefore, it is essential to focus on enhancing infection control measures and implementing robust post-surgical care protocols to effectively prevent and manage these infections.
Read moreThis white paper highlights how healthcare organizations can significantly reduce costs and enhance operational efficiency by consolidating multiple functions into a single platform with Dexur's AI Unified Quality and Risk Management software. Dexur offers an AI-powered unified system for managing quality, safety, risk, and incidents. By adopting Dexur's integrated software, healthcare providers can streamline their operations and achieve a higher standard of care at a reduced expense.
Read moreKey Pathogens Influencing CAUTI Infections in Hospitals
Catheter-associated Urinary Tract Infections (CAUTI) greatly influence both patient outcomes and the financial aspects of healthcare, with Dexur being a key contributor in data analytics to improve healthcare safety and quality. Leveraging hospital data reported to the CDC's NHSN, Dexur identifies key pathogens contributing to CAUTI, highlighting the top five: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus faecalis, and Proteus mirabilis. Each of these pathogens poses distinct challenges in their treatment and prevention. Through Dexur's detailed analysis, the development of targeted infection control protocols is facilitated, and the process supports both Root Cause Analysis (RCA) and the implementation of Corrective and Preventive Actions (CAPA). Such a strategy is crucial for the effective management of CAUTI, with the ultimate goal of enhancing patient outcomes and the efficiency of healthcare services.
Read moreThe Texas Hospital Association (THA) has endorsed Dexur, an AI-driven unified Quality, Safety, Risk, and Incident Management software, to support its member hospitals. This partnership is highlighted by THA's Alex Huff and Dexur's CEO, Nik Rao, who emphasize the alignment of Dexur's advanced technological capabilities, including AI-driven analytics and comprehensive data management, with THA's goals for enhancing healthcare quality and efficiency. Dexur's platform will offer THA hospitals a suite of tools for detailed program-to-case analysis, predictive insights, and strategic planning aimed at improving patient care outcomes and operational performance at a dramatically cost-effective price.
Read moreA Significant Portion of Readmitted Patients Stay for only 1 or 2 Days
Readmissions are a critical quality metric for hospitals, significantly impacting financial and reputational outcomes under the Hospital Readmissions Reduction Program (HRRP) and the Centers for Medicare & Medicaid Services (CMS) Star Rating system. The HRRP imposes penalties on hospitals with higher-than-expected readmission rates for specific conditions, aiming to incentivize improvements in hospital discharge planning and post-discharge care. Similarly, the CMS Star Rating system evaluates hospitals on various performance measures, including readmission rates, to help consumers compare hospitals more easily. High readmission rates can lead to reduced Medicare payments and lower star ratings, which may influence patient choice and hospital revenue.
Read morePeer review is a critical component in the accreditation and quality assurance processes for healthcare organizations. The Joint Commission (TJC), the Centers for Medicare & Medicaid Services (CMS), Det Norske Veritas (DNV), and the National Committee for Quality Assurance (NCQA) each have specific expectations regarding peer review processes.
Read moreWebinar: Dexur Releases its Annual 2024 CMS Star Rating Predictions
Dexur makes its annual predictions on CMS Star Ratings before CMS Star Ratings are published in July of every year. In 2023, Dexur had a 98% accuracy rate in its annual prediction rate. To get an understanding of your Hospital’s increase in decrease of your Star Rating, you can search for your Hospital’s prediction via the Hospital Search Function or you can also go through any Hospital’s CMS Star Rating predictions direction by browsing through state pages. To get the actual Star Rating prediction and a glimpse of the key drivers of the performance, you can also reach out to Dexur by email dexur@dexur.com.
Read moreEmergency Departments Play a Critical Role In Managing Readmissions
Readmissions to hospitals, particularly within 30 days of discharge, serve as a critical measure for evaluating the quality and effectiveness of healthcare services. The Hospital Readmission Reduction Program (HRRP) and the Centers for Medicare & Medicaid Services (CMS) Star Rating system place significant emphasis on readmission rates as indicators of hospital performance. These measures directly impact hospitals' financial health through penalties and influence their reputation through public reporting.
Read moreWhy are Inpatient THA / TKA Readmissions and Complications Increasing?
Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) are critical measures in assessing the quality of care provided by healthcare facilities, particularly in the context of Medicare's value-based care models. These procedures are common among the elderly population, who are the primary beneficiaries of Medicare. The rates of 30-day readmission and complications after THA/TKA are significant indicators of the quality and effectiveness of perioperative care, postoperative management, and the overall health system's ability to provide coordinated care. These metrics directly impact various Centers for Medicare & Medicaid Services (CMS) Quality Programs, such as CMS Star Rating and the Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals with higher than expected readmission rates for certain conditions and procedures, including THA/TKA.
Read moreHow the SEP1 Chart Abstraction Measure can be Integrated into CMS Star Ratings and VBP
The SEP1 chart abstraction measure, a critical component in healthcare quality assessment, plays a pivotal role in evaluating the efficiency and effectiveness of sepsis management in healthcare facilities. Sepsis, a life-threatening response to infection leading to tissue damage, organ failure, and potentially death, requires timely and precise treatment. The SEP1 measure is designed to quantify the quality of this treatment by tracking various parameters, such as the timeliness of antibiotic administration and the completeness of sepsis care.
Read moreDexur Quality Measure Regulatory and Compliance Reporting
Dexur’s Quality Measure reporting includes Chart Abstraction Software, which eliminates repetitive data entry, centralizing these functions into a single, efficient platform. With the unified approach, the primary focus shifts from data entry to improving quality outcomes. The Dexur’s Quality Reporting Module's original basis came from acquiring IHA’s Chart Abstraction software. Senior Vice President of IHA, Matt Browning, commented on the acquisition: "Dexur stands out as the best AI-driven solution to scale quality and risk management for hospitals. In the healthcare sector, there's a repetitive cycle of managing quality events, risk/incident management, and evaluating performance in programs like CMS Star Ratings. Dexur's innovative platform is uniquely positioned to unify these activities, offering a modern and efficient approach to managing these critical healthcare functions."
Read moreWhat are the Top Pathogens Impacting CLABSI Infections in Hospitals
Central Line-Associated Bloodstream Infections (CLABSI) remain a significant challenge in healthcare settings, directly influencing patient outcomes and healthcare costs. CLABSI, a severe infection occurring in patients with central venous catheters, poses risks that extend beyond immediate health concerns, impacting hospital ratings and reimbursement rates.
Read moreDexur, a leading provider of AI-driven unified quality and safety, risk, and incident management software, will acquire the Comparative Outcome Profile (COP) chart abstraction software from the Indiana Hospital Association (IHA). This strategic move aims to bolster Dexur's capabilities in offering comprehensive, AI-powered solutions to healthcare organizations.
Read moreMedical coding plays a crucial role in determining risk-adjusted rates, directly influencing a hospital's performance in quality programs like CMS Star Ratings, HRRP, and VBP. Risk adjustment is essential for equitable evaluations, especially in treating complex patient cases. Detailed coding impacts these risk-adjusted metrics, as seen in a case study of Acme Hospital, where coding accuracy significantly affects quality measures and assessments. A comparative analysis of Acme and Vibrant Hospitals further highlights the importance of precise coding practices in reflecting patient care complexity and ensuring fair evaluations in healthcare quality programs.
Read moreCritical Access Hospitals (CAHs) are essential to the healthcare infrastructure, particularly in rural and remote areas. They often serve as the primary, and sometimes only, source of healthcare for their communities. One of the key performance indicators for these hospitals is the management of Chronic Obstructive Pulmonary Disease (COPD) mortality. This measure not only reflects the quality of care provided but also significantly influences the CMS Star Rating's mortality domain.
Read moreHow Saving One AMI Mortality Per Year Can Help a Typical Hospital Move To the Top Percentile
Hospitals across the United States, from rural facilities in rural areas to large-scale Acute Care centers in urban areas, are continually striving to enhance the quality of their services. A key focus for these hospitals is to reduce mortality from AMI (Acute Myocardial Infarction), an essential goal for improving their CMS Star ratings and benefiting from the Value-based Purchasing (VBP) program. This objective is a significant indicator of care quality and heavily influences the mortality group within the CMS Star rating system.
Read moreHow Rural Hospitals Can Leverage Telehealth to Improve Mortality Measures Impacting CMS Star Ratings
For rural hospitals mortality measure group weightings could range from 22%-39% and therefore have a significance on CMS Star Ratings. Specifically, measures related to heart failure, Acute Myocardial Infarction (AMI), Coronary Artery Bypass Grafting (CABG), Chronic Obstructive Pulmonary Disease (COPD), and Pneumonia are integral to the mortality measure group in CMS Star Ratings. Addressing these specific conditions effectively can lead to improved outcomes, directly impacting a hospital's CMS Star Rating. Telehealth strategies emerge as innovative solutions to confront these challenges, offering rural hospitals a pathway to enhance patient outcomes in these critical areas and, subsequently, improve their CMS Star Ratings.
Read moreA Deep Dive into CMS's Excess Days in Acute Care (EDAC) Methodology
The Centers for Medicare & Medicaid Services (CMS) developed the Excess Days in Acute Care (EDAC) methodology as a critical tool for assessing and managing healthcare efficiency, particularly in relation to post-discharge care. This methodology is a significant element in the CMS Star Rating system, especially in the Readmission Group, which carries a substantial weight of 22%. By evaluating excess days spent in acute care settings, EDAC offers insights into the effectiveness of hospital discharge planning and post-discharge care coordination.
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