Here are some impressive numbers:
- 2,806 catheter-associated urinary tract infections avoided
- 611 patients who did not get a central line-associated blood stream infection
- 50,442 readmissions averted
- 13,340 babies delivered at term, rather than a nonmedically necessary early elective delivery
- 69,000 patients who weren't harmed in the hospital
- $200 million in estimated savings
Those are just some of the accomplishments that more than 1,500 hospitals and 31 state hospital associations involved in the HRET Hospital Engagement Network achieved between 2011 and 2013.
Colloquially known as HEN, the initiative was launched by HHS in 2011 with the aim of reducing patient harm by 40 percent and readmissions by 20 percent over two years. The department awarded $218 million in grants to 26 HENs. The HRET collaborative was the nation's largest HEN.
Yesterday, AHA President Rich Umbdenstock and HRET President Maulik Joshi hosted a webinar to discuss a new report on the HRET HEN and highlight its performance.
Three things stood out to Joshi as he looked back over the two years of data:
- Breadth — The hospitals worked on initiatives the cut across all levels of the organization.
- Depth — The hospitals embarked on long-lasting change.
- Focus — "It is all about the patients."
At the 84-bed Eastern Oklahoma Medical Center, participation in the HEN resulted in a 28 percent drop in readmission sand adverse drug events fell by 40 percent. Chief Nursing Officer Melinda Davis, R.N., also presenting on the webinar, said that the hospital has worked closely with home health agencies to better coordinate care and improve patient safety. She said that the hospital didn't make big sweeping changes, but rather continually tweaked processes until they got it right. The hospital relied heavily on resources provided by the HRET HEN, especially peer-to-peer encounters to learn best practices.
For Gary Kaatz, president and CEO of Rockford Health System, the HEN was the perfect vehicle to help "accelerate" activities already under way at the large suburban Chicago system. Ten years ago, the board embarked on a comprehensive effort to improve patient safety.
Through participation in the HEN, the Rockford Health System reduced readmissions for congestive heart failure patients by 30 percent. Overall, the system reduced incidents 40 percent across eight of 10 HEN measures. "We buy into chasing zero for everything," Kaatz said during the webinar.
Kaatz also noted that the system is pushing toward greater transparency. Giant LCD screens displaying readmission rates and other measures are in full public view in the ICU, with plans to add more in other locations. Greater transparency created a deeper engagement with patients and family, Kaatz said.
The HRET HEN data are indicative of what's occurring nationwide through the initiative, according to Patrick Conway, M.D., deputy administrator for innovation and quality, and chief medical officer at CMS. Overall, CLABSI rates dropped 45 percent and early elective deliveries 50 percent, he said during the webinar. And overall harm? Preliminary data show that it is down 10 percent nationwide.
"That's hundreds of thousands of patients" who were not harmed, he said emphatically.
The program has shown so much progress, Conway said, that it is moving out of the CMS Innovation Center and into the Quality of Care Center so it can be closer aligned with the "core work of CMS."
Umbdenstock hailed the work of all hospitals involved in the HEN program, saying "this is a really great effort." Looking beyond the data, hospitals are building a foundation and infrastructure to ensure that the good work continues.