A recent report from the Department of Health and Human Services noted that hospitals reduced hospital-acquired conditions by 17 percent between 2010 and 2013. The focus on safety prevented 50,000 unnecessary deaths, potentially avoided 1.3 million incidents of patient harm and saved the country $12 billion, according to preliminary HHS data.
Most of the gains came in 2013, which saw a reduction of 34,500 hospital deaths, nearly 800,000 harmful incidents and a savings of $8 billion, compared to 2010, HHS officials said.
Expensive, often-fatal errors included adverse drug events, falls, bed sores (also called pressure ulcers), catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, ventilator-associated pneumonia, and postoperative venous thromboembolism.
“The reasons for this progress are not fully understood,” said the report.
However, likely factors included better vigilance, improved processes and payment reforms, including the Medicare policy since 2012 of no longer reimbursing for certain preventable hospital readmissions within 30 days of initial discharge. The readmission policy, implemented in 2012 based on 2011 measurements as part of the Patient Protection and Affordable Care Act — yes, the ACA is about a lot more than just insurance exchanges — created a financial incentive for hospitals to prevent errors and assure patients had adequate follow-up care upon discharge.
In announcing the results in December, HHS also cited improved care coordination and greater involvement of patients in making decisions about their own care, particularly through the Partnership for Patients, a public-private collaboration led by , the federal Agency for Healthcare Research and Quality, an HHS division.
“Never before have we been able to bring so many hospitals, clinicians and experts together to share in a common goal – improving patient care,” American Hospital Association President and CEO Rich Umbdenstock said in an HHS press release. “We have built an ‘infrastructure of improvement’ that will aid hospitals and the healthcare field for years to come and has spurred the results you see today.”
One thing notably absent from the report was the effect electronic health records and other information technology had on the quality improvements. The federal EHR incentive program known as meaningful use does require hospitals and medical practices to report limited outcomes data to the Center for Medicare and Medicaid Services. The reporting should increase in meaningful use Stage 3, which will begin in 2017.
In any case, the report also said the gains were not sufficient. Even after the 17 percent decline in the number of hospital-acquired conditions at the end of the three-year measurement period, U.S. hospitals were still responsible for 121 HACs for every 1,000 patient discharges, and nearly 10 percent of all hospitalized patients suffered from at least one of the conditions the study measured. “That rate is still too high,” the report concluded.