HHS program seeks to improve patient safety

A new program launched by the Obama administration seeks to improve the quality and safety of health care for all Americans.

Funded with up to $1 billion provided by the Affordable Care Act, the program, called the Partnership for Patients, is a partnership between public and private entities, including hospitals, state and federal government, insurance companies, patients, doctors, nurses, employers, unions and others who work in tandem to improve care for all patients and to make the health care system more cost-effective.

According to a 1999 Institute of Medicine report, as many as 98,000 people die each year of preventable medical errors, and this number has not improved, despite many efforts. According to data from the Department of Health and Human Services, nearly one of 20 patients has an infection related to hospital care. In addition, one in seven Medicare beneficiaries is harmed during care, which costs an estimated $4.4 billion per year. Lastly, one in five Medicare patients is readmitted within 30 days, which costs more than $26 billion per year.

During a press conference to announce the Partnership for Patients initiative, patient advocate Sorrell King said although many hospitals, including small community hospitals, big academic centers and statewide hospital associations, are doing many things for the patient safety movement, their efforts are not happening fast enough.

“It is time to come together, the patients and families, hospitals, doctors and nurses, the government, insurance companies and businesses, and we’ve got to do it now,” said King, who is the founder of the Josie King Foundation, an organization that strives to prevent patients from dying of or being harmed by medical errors. “We cannot keep going at the pace we’ve been going. It seems simple to me that if we can make hospitals safer, then we can prevent people from dying. We can shorten hospital stays and reduce health care costs.”

Highest standards

According to Kathleen Sebelius, HHS secretary, countless Americans receive health care that is good or better than care at any other place in the world, and people travel to America from all over the world to get treatment that they cannot receive elsewhere.

“Far too often, we fall short of that high standard,” Sebelius said during the press conference. “In some cases, Americans go without care because they have been shut out of the insurance market. That is why we are working to implement the insurance reform and the Affordable Care Act, which eventually will give every American access to affordable health coverage. But in other cases, people actually make it into the system, and then something goes terribly wrong.”

Sebelius said a recent report in the journal Health Affairs found that errors and adverse events occur in nearly one of three hospital patients. Although sometimes it is an improper dose of medicine that leaves patients feeling dizzy or nauseous, too often, the consequences are far more tragic.

“What makes these results even more unacceptable is that I know we can do better,” Sebelius said.

Ensuring patient safety

The Partnership for Patients program has two goals, Sebelius said. The first is to reduce preventable injuries that happen in hospitals by 40%. This would prevent 1.8 million injuries and save 60,000 lives across the country. The second goal is to cut preventable hospital readmissions by 20%. This would save more than 1.6 million patients from complications that would force them to return to the hospital.

“To achieve these goals, we’ve reached out to hospitals, physician and nursing organizations, patient health plans and major employers in this country,” Sebelius said. “Already, 500 hospitals have stepped up to say they want to partner with us, and in the months to come, we know that number is going to grow. If we want to succeed, we need everyone’s contributions.”

The Partnership for Patients program will provide an unprecedented range of resources about what other health care providers are already doing to improve patient safety. Improvements in patient safety and reducing medical errors will not only improve patient health, but also reduce the rising health insurance costs, which have been a burden on patients, families, businesses and the government.

It is estimated that reaching these two goals would save more than $50 billion across the health system during the next 3 years, with up to a $10 billion savings for Medicare alone. Because Medicare is the source of health insurance for more than 45 million Americans, Medicare has a deep responsibility to help improve the quality of care, Sebelius said.

“As the country’s largest payer for care, Medicare has a powerful ability to be a catalyst for change,” she said.

Improving care

Also referring to the report in Health Affairs, Donald Berwick, MD, administrator of the CMS, said the number of adverse events that occur in hospitals could be 10 times greater than originally thought, injuring as many as one in every three hospital patients.

“As stunning as these rates may be, I suggest that they’re actually not that surprising,” Berwick said during the press conference. “This program is not meant to call into question the goodwill or commitment of the health care work force. Health care workers do everything possible to place patients on the road to health and keep them on the road to health. Despite that, millions of patients are injured because of defects in the care system in which good people get trapped.”

The Partnership for Patients will help hospitals and their staffs learn how to adopt the best known practices as quickly as they can adapt them to their local circumstances, Berwick said, adding that achieving the two goals of the program will require three things: will, learning together and executing the plan.

“We need to make major investments in helping hospitals and clinicians to translate the improvements into their own local action,” Berwick said. “One size doesn’t fit all. It will be hard work for them to adopt and then adapt the new reliable practices across their systems.”

Cecil B. Wilson, MD, president of the American Medical Association, said improving the quality and safety of health care has been a guiding principle of the AMA since its founding in 1847. The AMA works to improve patient safety through the “Making Strides in Safety” program, which provides physicians with patient safety materials and tools.

“The American Medical Association is proud to continue to promote patient safety by joining the Partnership for Patients,” Wilson said during the press conference. “We all need to do everything we can to lower the number of preventable patient illnesses and injuries, while also working to ensure that patients are able to heal without complications. Physicians work hard every day to provide excellent care to patients, and they need the best systems in place to support them. Our hope is that this initiative will improve hospital care, improve the health of individual patients and reduce the cost of health care while improving quality.” – by Emily Shafer

Van Den Bos J. Health Aff (Millwood). 2011;30:596-603.

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