5 ways OIG checks hospital safety

New this year is quality reporting data
By Bernie Monegain
05:12 AM
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Doctors with protective gear

The Office of Inspector General in the Department of Health and Human Services is charged with overseeing the agency's programs to make sure they function efficiently and safely.

OIG recently released its work plan for 2016.

Here, among the vast responsibilities assigned to the office are five items OIG will check to ensure hospitals provide quality care and maintain safety:

1. CMS validation of hospital-submitted quality reporting data
This is new to OIG's checklist. OIG will determine the extent to which Centers for Medicare & Medicaid Services validated hospital inpatient quality reporting data. CMS uses these quality data for the hospital value-based purchasing program and the hospital acquired condition reduction program, so accuracy and completeness of the data is critical.

[See also: Do quality metrics hurt patient care?.]

2. Hospitals' contingency plans for protecting data in the EHR
OIG will determine the extent to which hospitals comply with contingency planning requirements of the Health Insurance Portability and Accountability Act. It will also compare hospitals' contingency plans with government- and industry-recommended practices. The HIPAA Security Rule requires hospitals and other entities to have a contingency plan that establishes policies and procedures for responding to an emergency or other occurrence that damages systems that contain protected health information.

3. Hospital preparedness and response to high-risk infectious diseases
OIG will describe hospitals' efforts to prepare for the possibility of public health emergencies resulting from infectious diseases. Several HHS agencies, including the Centers for Disease Control and Prevention, the Office of the Assistant Secretary for Preparedness and Response and CMS provide guidance and support on this score. Also, OIG will determine hospital use of HHS resources and identify lessons learned through recent experiences with pandemic or highly contagious diseases, such as Ebola.

4. Long-term-care hospitals – adverse events in post-acute care for Medicare beneficiaries
OIG will estimate the national incidence of adverse and temporary harm events for Medicare beneficiaries receiving care in long-term-care hospitals It will also identify factors contributing to these events, determine the extent to which the events were preventable, and estimate the associated costs to Medicare.

5. Inpatient rehabilitation facilities – adverse events for Medicare beneficiaries
Here, too, OIG will estimate the national incidence of adverse and temporary harm events for Medicare beneficiaries receiving post-acute care and identify factors contributing to these events as well as gauge to what extent the events were preventable, and also estimate the costs to Medicare.

[See also: NQF CEO urges better quality measures.]

Read the complete OIG work plan for 2016 here.