A recent article in Vox offered this troubling takeaway on patient safety and health care quality in America: “Medical errors kill more people than car crashes or new disease outbreaks. They kill more people annually than breast cancer, AIDS, plane crashes, or drug overdoses.”
But the overall picture is not all doom and gloom. The Agency for Healthcare Research and Quality (AHRQ) recently reported national efforts to improve patient safety resulted in 50,000 lives saved from 2010 to 2013. But as Vox points out, there is debate on how broadly medical errors are decreasing. Through specific examples among essential hospitals, national reductions in medical errors are shown reaching vulnerable populations as well.
For example, Vox cites a 2006 study estimating 500,000 Americans go to the hospital each year because of a bedsore, or pressure ulcer, they developed during earlier care. Reducing pressure ulcers by 40 percent was one of the goals for the 23 hospitals in our Essential Hospitals Engagement Network (EHEN). Based on the latest three-month performance period of May 2014 to July 2014, the network achieved a 60 percent reduction from its 2010 baseline rate for the pressure ulcer measure AHRQ PSI-3. Going further, this control chart shows the EHEN below the mean rate for the past five months, with two of those months more than one standard deviation below the mean:
At the hospital-level, Truman Medical Center drastically reduced its pressure ulcers by 78 percent using a step-by-step approach. The hospital implemented turn clocks and turn teams as a standard of practice for all nurses.
As Vox points out, two of the barriers to reducing pressure ulcers and other medical errors are providers not knowing when errors occur and being too embarrassed to take accountability. Maricopa Integrated Health System implemented a diligent education and communications campaign on hospital-acquired infections to eliminate the perception among staff that some infections are unavoidable, given the system’s status as a level I trauma center with the only verified burn center in Arizona. In 2011, Maricopa had a central line-associated bloodstream infection on average every 79 days in its pediatric intensive care unit. As of June 30, 2014, it had gone 457 days without one.
Similarly, Harbor-UCLA Medical Center revamped its quality and safety bulletin boards to increase frontline staff awareness and ability to intelligently discuss its quality performance and lessons learned from individual cases. (To read more hospital-specific initiatives, check out the EHEN Outcomes series)
While debate about the extent of improvement in health care quality likely will continue, the bottom line is care is safer today than it was years ago in numerous hospitals that serve the most vulnerable. This is most important for patients and their families, but also for hospital finances, because the other headline in the news last week was, “Medicare looks to speed up pay for quality instead of volume.”
This post was co-authored with Veronica Amaya