The Silent Epidemic in Hospitals:  Unveiling the Hidden Costs of Adverse Events

Introduction

There is an ever present pressure on hospital executives to improve efficiency, enhance patient care, and ultimately, boost the bottom line.  But a persistent challenge lurks beneath the surface, a silent epidemic costing hospitals billions of dollars every year: adverse events.

These events, including hospital-acquired conditions (HACs), medical errors, and preventable complications, represent a significant drain on hospital resources. While efforts to improve patient safety have made strides, progress has stalled and in many areas reversed since the COVID exodus, with the impact of these events remaining a critical concern.

The True Cost of Inaction:

The Agency for Healthcare Research and Quality (AHRQ) has been diligently researching the financial and human toll of adverse events. Their report, "Estimating the Additional Hospital Inpatient Cost and Mortality Associated With Selected Hospital-Acquired Conditions,"  reveals a sobering reality about the cost of adverse events pre-COVID that are likely to be higher now in a post-COVID world.

The report analyzed ten HACs commonly targeted for improvement, including:

1. Adverse Drug Events (ADEs):  These events, often linked to anticoagulants, opioids, and hypoglycemic agents, can lead to prolonged hospital stays and increased mortality.

2. Infections: Catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), surgical site infections (SSIs), ventilator-associated pneumonia (VAPs), and Clostridium difficile infections (CDIs) are costly to treat and can have severe consequences.

3. Falls: These preventable incidents, often leading to injuries and extended hospital stays, represent a significant financial burden.

4. Obstetric Adverse Events (OBAEs):  These events, impacting both mothers and infants, can include complications like eclampsia, infections, and hemorrhage.

5. Pressure Ulcers:  These painful skin lesions, often occurring due to prolonged bed rest,  result in prolonged hospital stays and increased medical costs.

6. Venous Thromboembolism (VTE):  This serious condition, including deep vein thrombosis and pulmonary embolism, can lead to disability and even death.

The report found that the average additional cost per HAC case ranged from $600 for OBAEs to $48,000 for CLABSIs. Additionally, the excess mortality associated with these HACs was significant, ranging from 5 deaths per 1,000 cases (falls) to 150 deaths per 1,000 cases (CLABSIs).

The Missing Link:  Structured Interdisciplinary Bedside Rounds (SIBRs)

 While hospitals are actively investing in technology and implementing best practices to reduce adverse events,  a critical component is often overlooked: structured interdisciplinary bedside rounds. SIBR rounds, involve a team of healthcare professionals gathering at the patient's bedside to discuss their care plan, which offers several advantages for teams:

1. Enhanced Communication:  SIBRs foster clear and concise communication between physicians, nurses, pharmacists, therapists, and other relevant professionals. This facilitates a shared understanding of the patient's situation, potential risks, and treatment goals.

2. Early Intervention:  By discussing potential complications and risks proactively, SIBRs enable early intervention and prevent escalation of adverse events. This can significantly reduce the length of stay, minimize costs, and ultimately improve patient outcomes.

3. Proactive Risk Assessment:  During SIBRs, the team can effectively assess a patient's risk for developing HACs and implement preventive measures. This proactive approach can reduce the incidence of these events and minimize their impact on the patient's care.

4. Improved Patient Engagement:  SIBRs empower patients to actively participate in their care decisions. This fosters greater understanding and adherence to treatment plans, leading to better outcomes.

The Financial Imperative for SIBRs

Investing in SIBRs is not only a matter of patient safety but also a strong financial decision. By proactively addressing potential risks and preventing complications, SIBRs can:

1. Reduce Length of Stay:  Early intervention and effective care coordination facilitated by SIBRs can lead to shorter hospital stays, translating to significant cost savings for hospitals.

2. Lower Treatment Costs:  Preventing complications through SIBRs can significantly reduce the need for expensive treatments, surgeries, and extended care.

3. Enhance Patient Satisfaction:  Improved communication and proactive care plans fostered by SIBRs can lead to greater patient satisfaction, enhancing the hospital's reputation and attracting more patients.

SIBR rounds: A Catalyst for Positive Change

Hospitals are constantly seeking new and innovative ways to improve efficiency and patient care. SIBRs represent a cost-effective solution with a proven track record of success.

By embracing structured interdisciplinary bedside rounds, hospital executives can:

1. Unlock Hidden Savings:  By reducing the incidence of adverse events, SIBRs can unlock significant cost savings for hospitals, allowing for reinvestment in other critical areas.

2. Improve Patient Safety:  SIBRs are a vital tool for enhancing patient safety and preventing preventable harm, leading to better patient outcomes.

3. ·Enhance Reputation:  Hospitals that prioritize patient safety and implement evidence-based practices like SIBRs gain a competitive edge and attract more patients seeking high-quality care.

The silent epidemic of adverse events is a real and costly threat to hospitals.  By embracing structured interdisciplinary bedside rounds, hospital executives can combat this epidemic, improve patient safety, and ultimately, strengthen their bottom line. 

How can you not embrace SIBR rounds as the solution to many of your hospital’s problems?