Atlantic General Hospital was recently ranked forty-sixth out of 46 hospitals in the state of Maryland on the MHACs scale. This is one time that being at the bottom is positive and, for patients in Worcester County and the surrounding area, it’s a very good thing indeed. Just what is an MHAC?
It stands for Maryland Hospital Acquired Conditions and this particular ranking, announced this month by the Healthcare Service Cost Review Commission (HSCRC), is given to the hospital in the state with the lowest percentage of healthcare costs associated with medical conditions that develop after a patient is admitted for care.
Each hospital in Maryland is assigned an estimated percentage of their annual revenue that is expected to come from caring for potentially preventable conditions (PPCs) – urinary tract infections or collapsed lungs, for instance. This figure is based upon the number of patients a given hospital sees each year and the complexity of the illnesses and injuries they treat.
“The MHAC scaling levels the playing field and lets each hospital know where it stands in the effectiveness of its quality initiatives compared to others in the state, apples to apples,” said Bob Yocubik, director of quality at Atlantic General Hospital.
The HSCRC, the state agency that governs the unique rate-setting structure that all Maryland hospitals follow, began calculating the MHAC scale for fiscal year 2009. They gave the healthcare organizations a year, and then, began linking hospital rates in fiscal year 2011 to performance during the previous fiscal year.
Atlantic General’s operating revenue associated with treating PPCs was actually 3.87 percent lower than expected by the HSCRC. Being ranked forty-sixth will result in $438,422 in additional revenue for the hospital during the following fiscal year.
The 66 hospital acquired conditions tracked range from urinary tract infections to more serious blood stream infections to falls-related injuries and decubitis ulcers (bed sores). For a full listing of the PPCs tracked, visit http://www.hscrc.state.md.us/init_qi_MHAC.cfm.
The reduction in potentially preventable complications shown on paper may be due, in part, to more accurate medical coding to ensure that conditions that are present upon patient admission are actually captured, but it is also because of the intense focus on improving the quality of care patients receive.
It is estimated that healthcare costs for treatment of hospital associated infections alone average $33 billion annually in the U.S., according to the Agency of Healthcare Research and Quality. Atlantic General is among hospitals across the state and nation that are undertaking numerous quality initiatives to reduce costs and improve the effectiveness and safety of the care they provide for patients.
But continuous quality improvement efforts aren’t a new focus for AGH, and they will always remain at the forefront of hospital operations. Among some of the initiatives they have undertaken:
• December 2004: Atlantic General Hospital joined the national 100,000 Lives Campaign through the Institute for Healthcare Improvement to save lives through the prevention of ventilator-associated pneumonia (VAP). The campaign lasted 18 months, but Atlantic General Hospital has continued to use the best practices developed through the initiative and has had zero VAPS since January 2008.
• February 2006, Atlantic General Hospital’s surgical services department initiated the Surgical Care Improvement Project (SCIP) through a collaborative with the Delmarva Foundation. The department has continued to drive surgical infection rates below the national average.
• November 2007: Atlantic General Hospital joined the Maryland Patient Safety Center’s MRSA Prevention Initiative, a five-month program that helps participating hospitals, rehabilitation centers, and dialysis centers identify and successfully implement new practices to reduce the spread of MRSA. Results?
• October 2010: Atlantic General Hospital entered into a two-year collaborative with the Maryland Patient Safety Center, the Maryland Hospital Association and the Delmarva Foundation to develop best practices to reduce central line-associated blood stream infections (CLABSIs) in their ICU. The ICU has had zero such infections for the last 15 months.
About Atlantic General Hospital
Atlantic General Hospital has been providing quality health care to the residents of Worcester, Wicomico, Somerset (Md.) and Sussex (Del.) Counties since May 1993. Built by the commitment and generosity of a dedicated community, the hospital’s state-of-the-art facility in Berlin, Md. combines old-fashioned personal attention with the latest in technology and services. Atlantic General Health System, its network of more than 25 primary care provider and specialist offices, care for residents and visitors throughout the region. For more information about Atlantic General Hospital, visit www.atlanticgeneral.org.
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