Quality Quarterly

Anaphylactic Shock Highlights the Crisis in Medication Safety

Key Takeaways 

  • Cases of anaphylaxis have risen by 33% 
  • Anaphylaxis is especially dangerous in perioperative settings where sterile drapes hide visible skin reactions, and sedated patients cannot report their symptoms 
  • Chlorhexidine has emerged as an increasingly frequent trigger 

    • The Relationship Between Hospital Sepsis Bundle Compliance and Sepsis Mortality

    Key Points 

  • Statewide SEP-1 Sepsis Bundle compliance has increased over time. Sepsis mortality declined overall but spiked during the COVID-19 pandemic, indicating challenges in sustaining improvements. 
  • Higher hospital SEP-1 Sepsis Bundle compliance is associated with lower mortality rates, but the correlation weakened over time (from r = -.31 in 2017 to r = -.17 in 2022) and varied significantly by hospital characteristics such as ownership type and transfer volume. 
  • Investor-owned hospitals and those with smaller sample sizes exhibited weaker or negligible relationships between compliance and mortality, highlighting the role of contextual factors and the need for hospital-specific strategies. 

    • Ozempic and Wegovy: Are These Popular Diabetes and Weight Loss Drugs Associated with Increases in Serious Side Effects?

  • Prescriptions for semaglutide, marketed under the names Ozempic and Wegovy, surged almost 3,000% in the U.S. from 2018 to 2022. 
  • Encounters of gallbladder inflammation in California hospitals surged by 492% during the study period, potentially linked to the slowed digestion caused by long-term semaglutide use. 
  • Hospital encounters in California related to acute kidney injuries rose by 18% and cases of low blood sugar (hypoglycemia) increased by 27%, suggesting these may be emerging areas of concern for semaglutide users. 

    • End of 2024 HQIP Hospital Enrollment, Enhancements, and Utilization Trends 

    Key Takeaways 

  • 243 of 476 California hospitals have signed participation agreements for the Hospital Quality Improvement Platform (HQIP). 
  • The reports with the highest number of visits in Q3 2024 were: CMS Hospital Compare Measures over Time Quality Transparency Dashboard (308 visits), Sepsis Incidence, Case Mortality, & Length of Stay (216 visits), and Inland Empire Health Plan 2024 Pay for Performance Program (183 visits). 
  • New reports include Inpatient Psychiatric Readmission, Pediatric All-Cause Readmission, and Surgical Operative Procedures. Future updates will feature exportable equity reports for Assembly Bill (AB) 1204 compliance and procedure-specific readmission measures. 

    • HQI Supports Hospitals in Their Quest for Patient Safety Excellence

    We here at HQI are excited about the year ahead and continuing the collaborative work of enhancing patient safety and fostering a culture of excellence within hospitals. Our role is to support our members’ efforts toward providing the safest and highest quality care possible through education and the sharing of information and resources.

    Menopause and Misdiagnosis: A Call for Patient-Centered Safety 

    Key Takeaways:  

  • Patients experiencing menopause are at risk for misdiagnosis-related harm. 
  • Patient harm is primarily due to the complexity of symptoms and the stigma that often surrounds discussions of menopause. 
  • Effective and equitable menopause care is an integral part of becoming an age-friendly health system and advancing patient safety. 

    • HQI Examines Prevalence of Behavioral Health Conditions Among California Hospital Encounters 

    Key Takeaways: 

  • Mental health and substance use conditions were found to be more prevalent among inpatient than emergency department (ED) encounters. 
  • Depression and anxiety disorders were found to be the most prevalent mental health diagnoses among both inpatient and ED encounters. 
  • Using both the primary and secondary diagnoses results in a greater prevalence of mental health and substance use disorders. 

    • HQIP Hospital Enrollment & Enhancements

    Key Takeaways: 

  • More than half of all California hospitals now participate in Hospital Quality Improvement Platform (HQIP). Fifty-eight hospitals enrolled in just the last quarter. 
  • Several new reports have been added to HQIP, including sepsis readmissions and missed sepsis opportunities. 
  • HQI is working to help hospitals meet the upcoming Department of Health Care Access and Information (HCAI) Hospital/System Equity Reporting requirements by making a “report in a box” for their use.