HACs

Hospital-acquired conditions, abbreviated HACs, are medical problems that arise during a hospital stay and were not present on admission. They are used as a measure of patient safety and quality of care, and they can lead to longer hospital stays, additional treatments, worse outcomes, and higher costs.

HACs cover a range of conditions, including unintended retention of a foreign object after surgery, certain infections such as catheter-associated infections and some surgical-site infections, severe pressure ulcers (stage III or IV), falls and trauma, and certain adverse drug events. The exact categories and definitions can vary by country and payer, but the underlying principle is conditions not present on admission that develop during hospitalization.

Hospitals identify HACs by reviewing clinical data and using present-on-admission indicators in patient records to distinguish conditions present at admission from those that developed during the stay. Data on HACs are used for quality reporting and benchmarking, and in some systems they also influence payment policies and reimbursement decisions.

In the United States, the Centers for Medicare & Medicaid Services has implemented a no-payment policy for many HACs, meaning that Medicare will not reimburse hospital costs for these conditions when they arise during a hospital stay and were not present on admission. The policy is intended to incentivize prevention and safety improvements and has influenced practice patterns and hospital reporting in other payers as well.

Prevention focuses on safe clinical practices, including infection-control measures, surgical safety checklists, careful device and catheter management, skin integrity programs to prevent pressure ulcers, medication safety processes, and fostering a patient-safety culture that emphasizes reporting and learning from near-misses.

Beyond healthcare, HACs can refer to other fields, but this article concentrates on hospital-acquired conditions.