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Does Patient Safety Pay? Evaluating the Association Between Surgical Care Improvement Project Performance and Hospital Profitability

Beauvais, Brad, PhD, FACHE; Richter, Jason P., PhD, FACHE; Kim, Forest S., PhD, FACHE; Sickels, Greg; Hook, Torry, RN; Kiley, Sean; Horal, Thomas

Journal of Healthcare Management: May-June 2019 - Volume 64 - Issue 3 - p 142–154
doi: 10.1097/JHM-D-17-00208

EXECUTIVE SUMMARY Financial issues are top concerns for hospital executives. Evolving reimbursement structures focused on value provide an incentive to fully understand how patient safety performance and financial outcomes are connected. To that end, this study examines the relationships between Surgical Care Improvement Project (SCIP) measurements and hospital financial performance.

Using multinomial logistic regression, we determined the association between hospital patient safety performances via analysis of eight prophylaxis data elements drawn from the archived Hospital Compare data. The measures are SCIP-Inf-1 (prophylactic antibiotic prophylaxis received within 1 hr prior to surgical incision), SCIP-Inf-2 (prophylactic antibiotic selection for surgical patients), SCIP-Inf-3 (prophylactic antibiotics discontinued within 24 hr after surgery end time), SCIP-Inf-4 (cardiac surgery patients with controlled 6 A.M. postoperative serum glucose management), SCIP-Inf-9 (urinary catheter removal postsurgery), SCIP-Inf-Card-2 (beta-blocker during the perioperative period), and SCIP-Inf-VTE-2 (venous thromboembolism prophylaxis). Data from the American Hospital Association provided two dimensions of organizational profitability: operating margin and net patient revenue. Our results indicate that improved hospital safety performance is associated with a relative risk of higher operating margin and net patient revenue, with some variation noted among the measures of patient safety. Our findings suggest that targeted improvement in patient safety performance, as evaluated in the Hospital Compare data, is associated with improved financial performance at the hospital level. Increased attention to safe care delivery may allow hospitals to generate additional patent care earnings, improve margins, and create capital to advance hospital financial position.

associate professor, Texas State University, San Marcos, Texas

squadron commander and medical group administrator, Aviano Air Base, Aviano, Italy

director, master of health administration program, University of the Incarnate Word, San Antonio, Texas

health safety work life regional practice manager, United States Coast Guard, Washington, DC

nurse methods analyst, Bassett Army Community Hospital, Fort Wainwright, Alaska

chief, program and budget, Brooke Army Medical Center, San Antonio

primary care service line chief, Carl R. Darnall Army Medical Center, Fort Hood, Texas

For more information regarding the concepts in this article, contact Dr. Beauvais at

The authors declare no conflicts of interest.

© 2019 Foundation of the American College of Healthcare Executives
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