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Failure to Rescue Measure: Validation of Community- and Hospital-Acquired Complications

Talsma, AkkeNeel PhD, RN; Jones, Katherine PhD, RN; Liu, Guipeng MS; Campbell, Darrell A. MD

Journal of Nursing Administration: October 2010 - Volume 40 - Issue 10 - p 417-423
doi: 10.1097/NNA.0b013e3181f2eb5b

The inclusion of the failure to rescue (FTR) measure as one of the Centers for Medicare and Medicaid Services Inpatient Prospective Payment System measures has raised questions about the characteristics of FTR cases and their outcomes. In this study, we validated 75% of the identified FTR complications using medical record review (n = 461). Nearly half (49.5%) of the complications originated in the community and were present on admission. Acute renal failure, gastrointestinal hemorrhage, and sepsis most often originated in the community. Cardiac arrest/shock, pneumonia, and pulmonary embolism and deep vein thrombosis most often developed in the hospitals. These findings have important implications for practice as clinical leadership focuses on the prevention and aggressive management of complications to prevent death, increased length of stay, and possible reductions in Medicare diagnosis related groups' reimbursements.

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Authors' Affiliations: Assistant Professor of Nursing (Dr Talsma), Professor of Surgery, School of Medicine (Dr Campbell), University of Michigan, Ann Arbor; Professor of Nursing (Dr Jones), Case Western Reserve University, Cleveland, Ohio; Statistician (Ms Liu), University of Michigan Health System, Ann Arbor.

Corresponding author: Dr Talsma, University of Michigan, 400 N Ingalls, Ann Arbor, MI 48109 (

Funding: This study was supported by the BlueCross BlueShield of Michigan Foundation and Midwest Nursing Research Society Mentorship Program. The larger Failure to Rescue Study, from which the sample used was drawn, was funded by the University of Michigan Office of the Vice President for Research and the University of Michigan School of Nursing Grants and Research Office. Institutional review board approval was obtained from the University of Michigan Medical Review Board (HUM 0007000).

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© 2010 Lippincott Williams & Wilkins, Inc.