OIG’s January 2025 Work Plan Update

The OIG only added one Work Plan item in January 2025, however, it is a significant item for compliance professionals to review. 

Patient Harm Events

Anyone involved in providing healthcare services should want to reduce patient harm events. Healthcare providers want to help not harm patients. 

Prior work performed by the OIG (https://oig.hhs.gov/oei/reports/OEI-06-18-00400.asp) identified, for a 2018 sample, that 25% of Medicare patients experienced patient harm during their hospital stays. OIG includes adverse events and temporary harm events in their definition of patient harm. 

A closer look at their report revealed that 12% of patients experienced adverse events that led to longer hospital stays, permanent harm, life-saving intervention, or death. In addition to the patients who experienced adverse events, 13% of patients experienced temporary harm events which required intervention but did not cause lasting harm, prolong hospital stays, or require life-sustaining measures.  

They classified the most common type of harm events in the following way: 

  • Harm events related to medication (43%)
  • Events related to patient care (23%), such as pressure injuries
  • Procedures and surgeries (22%)
  • Infections (11%)

Since the publication of this report, the OIG released in July 2023 two toolkits to assist providers with their efforts in reducing harm events. The two toolkits are: 

  1. Toolkit: Medical Record Review Methodology https://oig.hhs.gov/oei/reports/OEI-06-21-00030.pdf
  2. Toolkit: Clinical Guidance for Identifying Harm https://oig.hhs.gov/oei/reports/OEI-06-21-00031.pdf

In adding a Work Plan item on this topic, the OIG explained that hospitals collect information about patient harm events to meet Medicare requirements to measure, analyze, and track adverse patient harm events. Hospitals are also required to report certain types of harm events to meet CMS program and State legal requirements.  

In additional past work performed by the OIG, they found that hospitals reported few harm events to State reporting systems (https://oig.hhs.gov/documents/evaluation/2954/OEI-06-09-00092-Complete%20Report.pdf).  

With this newly added Work Plan item, the OIG plans to determine the extent to which hospitals reported harm events as required per CMS program and State requirements. The OIG will use the harm they identified in report OEI-06-18-00400 (https://oig.hhs.gov/oei/reports/OEI-06-18-00400.asp) as the basis for this review.  

The OIG also explained this newly announced work will be a supplemental product to their ongoing study that is examining hospital identification of patient harm events (OEI-06-18-00401) which was added to their work plan in May 2023 (https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000769.asp). 

 

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