ROI from Hospital-Acquired Pressure Injury Surveillance
Direct Costs of Hospital-Acquired Pressure Injuries
A pressure injury is a localized injury to the skin or underlying tissue.1 When these conditions are acquired in an inpatient setting, or not documented as “present upon admission” within 24 hours, they can cause a hospital to incur significant penalties under the Centers for Medicare and Medicaid Services (CMS) Hospital-Acquired Condition (HAC) program.2 Hospital-acquired pressure injuries (HAPI’s) are a substantial burden on U.S. hospitals.3 Through deploying Tissue Analytics’ wound surveillance software, hospitals across the country have demonstrated clear reductions in the financial burdens of pressure injuries.
Because CMS consider HAPIs as “never events” under the Hospital-Acquired Condition program, CMS does not reimburse costs accrued to treat stage 3 and stage 4 pressure injuries.4 Thus, hospitals must pay between $5,900 and $14,840 for a stage 3, and between $18,730 and $21,410 for a stage 4.5 All hospitals with a total score in the bottom quartile of the US face reduced payments by 1% of the total hospital claims to CMS.6 In fact, HAPIs play an outsized impact on the PSI-90 composite score, accounting for over 30% of the “harm rate”, 8% of the “volume rate”, and 13% of the “component rate” of the score.7
Pressure Injury Reduction with Tissue Analytics
Sarasota Memorial Hospital is the only hospital in Florida to have consistently earned the federal CMS’ highest 5-star rating for overall quality and safety since the rating system launched in 2016. In an effort to reduce pressure injuries, Sarasota Memorial Hospital deployed a pressure injury prevention program alongside Tissue Analytics. Accordingly, their monthly PSI-03 scores reduced by 50%. From April to July 2019, their average PSI-03 score was .94.
Sarasota Memorial Hospital’s Inpatient Rehabilitation Facility also reduced their pressure injury rate after deploying Tissue Analytics as a photographic wound surveillance system. This deployment provides a clearer picture of Tissue Analytics’ impact on pressure injuries since a pressure injury prevention program was not deployed simultaneously. The Inpatient Rehab is rated on the number of hospital-acquired pressure injuries of stage 2, 3, and 4.
“We’ve been able to improve all of our pressure injuries to the point where we went June, July and August with none worsening or created. That’s the best we’ve ever been as an inpatient rehab,” said Nicole McClain, Clinical Manager of Inpatient Rehabilitation.
More than 17,000 lawsuits arise due to pressure injuries annually, and the average settlement in a pressure injury malpractice suit is $250,000.8 With over 2.5 million patients affected by pressure injuries yearly, health systems are increasingly burdened by malpractice lawsuits.9 In a study of pressure injury liability in long-term care facilities, 87% of residents received liability against the facility.10 In performing a risk assessment where the severity of a hazard is multiplied by the likelihood of occurrence, the average HAPI (.87 x $250,000) costs the hospital $217,500 in litigation settlement.11 After deploying Tissue Analytics as a global surveillance tool for pressure injury prevention, Bayfront Health avoided two HAPI lawsuits. According to a risk assessment, the estimated litigation costs of these suits would be $435,000.
Anna Marie Michel, Bayfront Health’s wound care nurse
Tissue Analytics is at the core of our pressure ulcer prevention program.
Return on Time Saved with Patients
Tissue Analytics makes wound care teams more efficient, saving significant time during the documentation process. For example, through Intermountain Healthcare, Tissue Analytics tested its software at the McKay-Dee Hospital in Provo, Utah, which performs approximately 730 wound evaluations per month. While manual charting of wounds took nurses 2 minutes and 25 seconds per wound, nurses were able to chart wound evaluations with Tissue Analytics in 35 seconds each. This resulted in a time savings of 76%, so that each nurse could save an average of over 22 hours of charting time per month.
The New Standard for Wound Care
In addition to helping hospitals reduce HAPIs and improve the efficiency of wound care teams, Tissue Analytics brings additional benefits to hospitals, such as improving care coordination by making wound images instantly available in the hospital information system and improving the documentation and billing for debridement procedures. These benefits can have a significant impact on the operations and effectiveness of would care organizations and are a major reason why AI-powered digital imaging is transforming wound care workflows within hospitals and becoming the new standard for wound care imaging.
1 Rondinelli J, Zuniga S, Kipnis P, Kawar LN, Liu V, Escobar GJ. Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System. Nurs Res. 2018;67(1):16–25. doi:10.1097/NNR.0000000000000258
2 Hospital-Acquired Conditions. Centers for Medicare and Medicaid Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Hospital-Acquired_Conditions.html
3 Are We Ready for This Change? Preventing Pressure Ulcers in Hospitals: A Toolkit for Improving Quality of Care. April 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/
4 Are We Ready for This Change? Preventing Pressure Ulcers in Hospitals: A Toolkit for Improving Quality of Care. April 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/
5 The Financial Impact of Pressure Ulcers. Leaf Healthcare. 2016. http://www.leafhealthcare.com/pdfs/LH_WP_FinancialOverview_ 1563AB_101316.pdf
6 Hospital-Acquired Conditions. Centers for Medicare and Medicaid Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Hospital-Acquired_Conditions.html
7 United States, Congress, “Patient Safety and Adverse Events Composite Technical Specifications.” Patient Safety and Adverse Events Composite Technical Specifications, Agency for Healthcare Research and Quality, 2019. https://www.qualityindicators.ahrq.gov/Downloads/Modules/PSI/V2019/TechSpecs/PSI 90 Patient Safety and Adverse Events Composite.pdf.
8 The Financial Impact of Pressure Ulcers. Leaf Healthcare. 2016. http://www.leafhealthcare.com/pdfs/LH_WP_FinancialOverview_ 1563AB_101316.pdf
9 Are We Ready for This Change? Preventing Pressure Ulcers in Hospitals: A Toolkit for Improving Quality of Care. April 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/
10 Yunghan, Au, and Sheila Wang. “Financial and Clinical Risk Evaluation of Pressure Injuries in US Hospitals: A Business Case for Initiating Quality Improvement.” Wounds Research, vol. 31, no. 5, May 2019, https://www.woundsresearch.com/article/financial-and-clinical-risk-evaluation-pressure-injuries-us-hospitals-business-case.
11 Risk Assessment Guidance. University of Bath. thesubath.com/pageassets/health-and-safety/Risk-Assessment-Guidance.pdf