Safety effort seeking to reduce hospital errors

Patient safety has been a top-shelf theme in health care for years.

But alarming data continue to demonstrate potential dangers of a health care experience. The safety numbers include:

  • A study published in the journal Health Affairs in April found that on average, one in three patients admitted to a hospital suffers a medical error or adverse event.
  • An estimated 1.7 million Americans annually suffer an infection acquired in a hospital, leading to about 100,000 deaths per year.
  • On average, one in seven Medicare beneficiaries is harmed during the course of care, which costs the federal government an estimated $4.4 billion a year.

A public-private partnership led by the Obama administration aims to reduce medical errors and the enormous costs associated with them.

The Partnership for Patients proposes to unite hospital systems, employers, insurers, medical providers and patients to help make the health care system safer. The goals: to lower hospital-acquired conditions by 40 percent in three years, saving 60,000 lives; and to reduce patient readmissions to hospitals by 20 percent over that same time period.

The U.S. Department of Health and Human Services, through the health reform law, is investing $1 billion in the safety initiative.

The health system falls short on safety  “far too often, for too many patients,’’ Anton Gunn, regional director of HHS, said at an Atlanta event Tuesday describing the initiative. Providing medical services safely, he added, ‘’is a lot cheaper than doing it wrong in the first place.’’

HHS says more 500 hospitals, along with physicians, nurses groups, consumer groups and employers have pledged their support. Companies including Walmart, IBM, Intel, and Johnson & Johnson have joined.

Georgia organizations signed up for the safety effort include the Georgia Hospital Association; Tenet Healthcare and HCA hospitals in Georgia; WellStar Health System; and Visiting Nurse/Hospice Atlanta.

Washing hands

The initiative will ask hospitals to focus on nine types of medical errors, including reducing pressure ulcers or bedsores and lowering surgical site infections.

Infection rates, in particular, have captured the attention of medical experts, policymakers and consumer groups.

Simple steps such as doctors and nurses washing their hands before procedures can save lives, experts say. Following checklists for medical procedures has been shown to reduce errors.

“A lot more could be done,’’ said Dr. P.J. Brennan, chief medical officer for the University of Pennsylvania Health System, at a recent Association of Health Care Journalists conference. “The things we know work should be done.’’

Bill Marella of ECRI Institute, a patient care research organization, said that health care-acquired infections are at least as bad in nursing homes as in hospitals.

Twenty-seven states require hospitals to report their infections to a state agency, with 10 of those states providing public reporting to consumers, Marella said.

Pennsylvania requires statewide infection reporting for both hospitals and nursing homes. The data and effective strategies are shared with hospitals to improve their infection rates, said Fran Charney of the Pennsylvania Patient Safety Authority. Last year, she said, the state’s hospitals reduced their infections by 12 percent.

Georgia has no such reporting requirement.

Payment tied to quality

Georgia hospitals already report safety data to the Centers for Medicare and Medicaid Services (CMS) and to the Joint Commission, said Vi Naylor, executive vice president of the Georgia Hospital Association. She said Tuesday that she doesn’t  oppose the state having access to infections data, but said the reporting process should not be burdensome to hospitals.

GHA will encourage all hospitals to participate in the partnership, Naylor said. The initiative mirrors efforts already under way among Georgia hospitals, she said.

Denise Flook of GHA said hospitals in the state have followed a Michigan initiative to eliminate catheter-related bloodstream infections. “Several of our hospitals have [reached] zero,’’ Flook said. Another effort, she added, is working to reduce catheter-related urinary tract infections.

Kelly McCutchen of the Georgia Public Policy Foundation said that improving patient safety is clearly needed, but that “throwing more money at the problem will have little impact unless we change the system.”

”Making health care cost and quality data more transparent to consumers will encourage and reward better outcomes,” McCutchen said.  He also said the current malpractice system has not improved patient safety and should be changed to one that uses medical review panels to identify and address ”true malpractice.”

The focus on reducing infections, meanwhile, will likely become even more intense.

CMS has announced initiatives to reduce payments to medical providers for safety problems, and rewarding providers for good quality of care.

And the federal agency has released information on hospital-acquired conditions on its Hospital Compare website.

Some state safety efforts are already paying off. A collaboration in Rhode Island between insurers and hospitals has produced a 42 percent decrease in central-line associated bloodstream infections. And about 150 health care facilities in New Jersey have lowered pressure ulcers by 70 percent.

Here’s a list of 10 patient safety tips for consumers from the CDC.