Statistical Results and Financial Assumptions
St. Anthony Medical Center has concerns about a few reported cases affecting the annual HAC rate and cost (hospital-acquired conditions). These are conditions that a patient develops while being treated for a different condition while admitted to the hospital. Each reported incident cost the hospital $5700 per penalty. The average HAC rate per 1,000 discharges is 117, which falls between a minimum reported of 106 and a maximum of 123 or more reported. Last year, the hospital averaged 10,000 discharges, so for every 1,000 discharges, reported incidents were 177.
That is over 1170 incidents for the year. The variables the hospital presented that could be affecting the HAC results are nurse staffing levels, skill mix, and ALOS (average Length of stay). In nursing staffing levels (nursing HPPD), the average working hours for nurses are 4 hours, with a min of 1.6 hours and a max of 6.7 hours. A 59% mix of the skill levels amongst registered and licensed practical nurses (LPNs). The Length of stay (ALOS) once the patient is admitted averages six days. The minimum Length of stay is four days, with a maximum of eight days. St. Anthony pays $2600 per inpatient day.
Recommendations
A few solutions can help St. Anthony Medical Center decrease its average HAC rate. After reviewing the statistical data, increasing the hours registered and the number of LPNs working will help reduce the HAC rate. The adjustments to consider are averaging the work hours between the registered nurses and the LPNs to meet an acceptable patient-to-nurse ratio. Help prevent burnout and prevent accidental incidents that can occur when there are nurse shortages and too many patients assigned to one nurse for an entire shift. Next, the average patient’s Length of stay should be decreased.
The average number of days is six, with a total cost per inpatient day of $2600. The decrease will help decrease the total amount the hospital pays for a total stay and prevent an average of 17% of the HAC rate. Last, continuous training for registered and licensed practical nurses should be considered. Training nurses to be aware of the common HAC incidents reported, how to prevent them, and how to seek help and find resources will help avoid accidental incidents and decrease the HAC rate.
