Wound Care Articles and Insights
July 17, 2023

What is a HAPI and why are they bad for Hospitals?

Kallie Christensen

A Hospital Acquired Pressure Injury (HAPI) is a pressure injury that develops during a patient’s stay in a medical facility, or is not recorded during admission. A pressure injury is defined by the National Pressure Injury Coalition as, “localized damage to the skin and underlying soft tissue, usually over a bony prominence or related to a medical or other device.” Meaning, a HAPI is not only an injury formed on the backside of the body from the pressure of laying in one position for too long, but also any injury caused by medical devices, like breathing tubes or catheter lines. And even with the knowledge of the importance of pressure injury prevention, HAPIs affect more than 2.5 million Americans each year.  

HAPIs are not only detrimental to the health of the patient that develops the ulcer, but also to the hospital's financial system. Hospital’s are faced with a huge financial burden for each Stage 3 and 4 Pressure Injury developed under their care, since Medicare will not reimburse for the treatment of these wounds. An individual HAPI occurrence could cost the hospital up to $70,000 in total treatment, and annually can cost the nation up to 11 Billion Dollars. 

One might be asking, how can one pressure injury cost that much to treat? However, the total financial impact does not come from that one isolated wound. Aside from reimbursement penalties from Medicare and private insurers who have taken the same stance on HAPIs, since they are considered never events, there are 3 other major reasons the financial impact is severe: 

  1. Increased length of stay: Pressure injuries can prolong a patient's hospital stay as they require additional care and treatment. Hospitals need to allocate resources, including medical personnel, wound care supplies, and specialized equipment, to manage these injuries effectively. The longer a patient stays in the hospital, the higher the costs for the hospital. 
  1. Additional treatment costs: Treating pressure injuries involves various interventions such as wound dressings, specialized mattresses or cushions, topical treatments, and sometimes even surgical interventions. These treatments can be expensive, especially when they are required for an extended period. Hospitals bear the cost of these additional treatments, which can strain their financial resources.
  1. Legal implications: HAPIs can sometimes lead to medical malpractice lawsuits. If patients or their families believe that negligence or inadequate care by the hospital staff caused or worsened the pressure injury, they may pursue legal action. These lawsuits can result in significant financial settlements or judgments against the hospital, impacting their finances and reputation. 

Fact: HAPIs are the 2nd leading hospital lawsuit claim after wrongful death in the United States. 

Although, as stated above, each Pressure Injury can be prevented through effective and consistent prevention techniques. When hospitals implement a prevention strategy, they are not only helping save the patient from potential mortality, but also themselves financially. Wound Care Advantage has assisted clients reduce up to 50% of incidences and uncovered millions in savings. 

"By implementing evidence-based strategies and empowering our healthcare teams with specialized education, we've achieved significant improvements in patient outcomes in our HAPI prevention efforts. We achieved this in collaboration with Wound Care Advantage. With this data-driven approach to prevention, our hospital has effectively curbed HAPI rates, as we have witnessed a substantial reduction in incidences. These strategies and our partnership with Wound Care Advantage, has been pivotal in this endeavor and reaffirms our commitment to delivering high-quality care while ensuring the financial well-being of our institution."

Theresa Murphy, Chief Nursing Officer, USC-Keck Verdugo Hills Hospital

A 9-year retrospective case study evaluates the effectiveness of the approach and strategy taken with our client, USC-Keck Verdugo Hills Hospital. Our Case Study; Proactive Hospital Acquired Pressure Injury (HAPI) Prevention - An Evergreen Solution, highlights the importance of prevention and what successful strategy looks like. With proper awareness and prevention, HAPIs can become a thing of the past.

If your hospital is struggling with HAPI management and prevention, contact Wound Care Advantage to discuss how we can help assist.


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