Patient Safety in the U.S.A. Getting Better, But Concerns Remain

Patient Safety in the U.S.A. Getting Better, But Concerns RemainThe topic of patient safety in healthcare first entered the national spotlight back in 1999, when the Institute of Medicine released a groundbreaking report estimating that up to 98,000 patients die in U.S. hospitals each year because of preventable medical events. The report launched the patient safety movement in the U.S. and prompted immediate action in the healthcare community, with programs created to quantify, track and ultimately reduce patient harm. At the governmental level, The Joint Commission (responsible for certifying healthcare agencies and their commitment to meeting performance and quality standards) established its National Patient Safety Goals (NPSG) program in 2002; the NPSGs were established to help organizations address specific areas of concern in regard to patient safety.

How safe are patients today?

Over 15 years have elapsed since the release of the report, and it’s worthwhile to take a look at the current state of patient safety. In December of 2014, the Agency for Healthcare Research and Quality (AHRQ) reported significant improvements in the prevention of adverse health outcomes. It estimated that approximately 1.3 million fewer patients were harmed in U.S. hospitals between 2010 and 2013. That represents a cumulative 17 percent reduction, preventing about 50,000 deaths. The estimated 34,530 deaths avoided in 2013 alone were nearly 10 times more than in 2011, and the estimated three-year cost saving from harm reductions was nearly $12 billion.

That’s a great start, and one of the primary drivers of this improvement is thought to be the 2010 Patient Protection and Affordable Care Act, which introduced financial penalties for poor quality performance by providers. Specifically, reimbursement reflects provider performance on quality metrics based on adherence to certain care processes, scores on patient satisfaction surveys, or patient outcomes.

Still more work to be done

Despite the progress noted by the AHRQ report, safety concerns remain, with some experts doubting the improving picture because of unreliable performance measurements and the inability to consistently compare outcomes. Reflecting these concerns, The Joint Commission’s list of ongoing patient safety concerns for 2015 include the following goals:

  • Identify patients correctly
  • Improve staff communication
  • Use medication correctly
  • Use alarms safely
  • Prevent hospital-acquired infections
  • Prevent mistakes in surgery
  • Identify patient safety risks

Hand hygiene strongly linked to infection rates

While hospitals grapple with the complexity of these issues, one item on the list that is straightforward to tackle is preventing hospital-acquired infections. Hospital infections affect an estimated 1 in 25 patients nationwide and cost the U.S. healthcare system an estimated $10 billion a year. Experts consider proper hand hygiene/hand washing one of the easiest and most cost-effective methods for reducing hospital-acquired infections.

“Hand hygiene has well-documented ties to patient safety, yet median hand hygiene compliance is still only 40 percent, meaning healthcare workers clean their hands less than half the time they enter patient rooms,” says Jason Burnham, associate director of patient care solutions of Halyard Health, a global medical technology company affiliated with Kimberly Clark Health Care.

However, one hospital has been very successful at demonstrating how effective hand hygiene is in combating hospital infections. Since Vanderbilt University Medical Center instituted a comprehensive hand hygiene program in 2009, hand-washing rates jumped from 58 percent to 97 percent—and infections rates dropped. Urinary tract infections related to catheters in intensive care units fell 33 percent; pneumonia linked to ventilators declined by 61 percent and bloodstream infections associated with central lines dropped by 80 percent in ICUs.

Health IT issues harder to pinpoint and fix

With the recent proliferation of electronic medical record use in healthcare settings, new and novel issues are arising with data integrity.

“Organizations need to have better testing of the systems and checks and balances [after implementation] to make sure failure points for missing data or incorrect data entries are identified and addressed, ” says James P. Keller, MS, vice president of health technology evaluation and safety for the Emergency Care Research Institute.

Common examples of data integrity failures include the switching of patient data, default values being used by mistake and inconsistencies in patient data between paper and electronic records. To effectively address these problems, organizations must identify and fix data integrity failures as they occur in order to prevent problems from recurring. To achieve these goals, they must train both clinical workers and health IT system users to recognize and report all types of health IT-related incidents, including those that do not directly cause any harm as well as near-miss incidents.

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This post is brought to you in partnership with Health eCareers. Health eCareers is your destination for medical and healthcare opportunities. Access jobs from thousands of employers spanning small medical practices to large integrated health systems. This post was written by Trish Joyce for Health eCareers.