Hospitals and the people who work in them are all about saving lives and always have been. But it’s nothing short of amazing how the focus on preventing harm in health care settings has intensified in the last several years and how quickly we’ve seen impressive improvements.
This spring, data came in from several sources trumpeting good news in a wide range of patient safety areas. The numbers prove that by setting specific standards, sharing and embedding best practices in everyday processes, and continually measuring and reporting progress transparently within and outside an organization, American health care is capable of achieving excellence in quality while taking costs out of the system.
Here are three of the good-news reports that have crossed my desk in the last several weeks:
1. Earlier this month, Health & Human Services reported a 9 percent decrease in six types of harm from 2010 to 2012, as well as an 8 percent decrease in Medicare fee-for-service, 30-day readmissions. The “measured harm” rate dropped from 145 harms per 1,000 discharges in 2010 to 132 per 1,000 discharges in 2012. HHS estimated that those accomplishments prevented 15,000 deaths in hospitals and saved $3.2 billion in 2012 alone.
The “dramatic reductions” were the result of the Partnership for Patients program and several national initiatives, specifically:
• Hospital Engagement Networks reported a 64.5 percent drop in early elective deliveries and a 15.8 percent decrease in the obstetric trauma rate.
• The American Nurses’ Association National Database of Nursing Quality Indicators reported a 53.2 percent decrease in ventilator-associated pneumonia, a 25.2 percent decrease in pressure ulcers and a 14.7 percent reduction in falls and trauma.
• The Centers for Disease Control and Prevention reported a decline of 12.9 percent in venous thromboembolic complications.
2. In March, the HAI Progress Report from the Centers for Disease Control and Prevention showed what it called “significant reductions” in 2012 for nearly all health care-associated infections. These include:
• A 44 percent decrease in central line-associated bloodstream infections between 2008 and 2012
• A 20 percent decrease in infections related to the 10 surgical procedures tracked in the report between 2008 and 2012
• A 4 percent decrease in hospital-onset MRSA bloodstream infections between 2011 and 2012
• A 2 percent decrease in hospital-onset Clostridium difficile infections between 2011 and 2012
3. The third piece of good news comes from hospitals' participating in the Preventing Falls with Injury project launched by the Joint Commission Center for Transforming Healthcare. The seven participants, ranging from a 178-bed community hospital to a 1,700-bed academic medical center, reduced the number of patients injured in a fall by 62 percent and the number of patients who fell by 35 percent.
The center reports that between 30 and 35 percent of patients who fall sustain an injury and that, on average, these injuries result in an additional 6.3 days in the hospital. By using the project’s approach, the center estimates that a typical 200-bed hospital could reduce falls with injuries from 117 to 45 and save about $1 million annually.
All of these results are terrific and everyone who is working on improving patient safety should be proud. But obviously, we can’t rest on our laurels. Those already making progress will no doubt keep getting better. And those not yet participating in one or more of these initiatives need to jump in.
In March, American Hospital Association President and CEO Rich Umbdenstock said the HAI report should inspire additional hospitals to participate in a Hospital Engagement Network. The report “shows that while hospitals are making good progress in reducing infections, others like MRSA and C. difficile, pose an immense challenge — and even one preventable infection is one too many,” Umbdenstock wrote in his March 28 Vantage Point. “Turning this around requires the kind of cultural change HEN participants, who nationally have saved billions of dollars in health care costs, have embraced with remarkable results.”