Obama’s next target - medical error reduction for patient safety

By Dr. Ananya Mandal, MDApr 12 2011

Finally serious efforts are being made to ensure patient safety. The Obama administration announced this Tuesday an aggressive approach called ‘The 'Partnership for Patients Program’ to reduce medical errors, partnering with private insurers, business leaders, hospitals and patient advocates to tackle a problem that kills thousands of Americans every year.

This effort is funded by the healthcare overhaul the president signed last year and it aims to cut by 40% over the next three years the number of harmful preventable conditions such as infections that patients acquire in the hospital. It seeks to cut readmissions to hospitals 20% by encouraging better care for patients after they leave.

According to Dr. Don Berwick, a leading national advocate for patient safety who oversees the federal Medicare and Medicaid programs, “Those are big goals. But the results for patients and families will be dramatic - millions of people … suffering less, tens of thousands of deaths averted, and anguish and worry decreased beyond measure.”

According to a recent study published in the journal Health Affairs, 1 in 3 hospital patients experienced an “adverse event” such as being given the wrong medication, acquiring an infection or receiving the wrong surgical procedure. Though top-performing institutions across the country have made dramatic improvements in reducing errors, many healthcare experts and patient advocates think progress has been slow.

This new healthcare law provides billions of dollars to improve care by rewarding hospitals and physicians that meet higher standards, such as lowering readmissions that result from poor care. There are plans in the coming months to hand out $500 million in grants to community-based organizations that partner with hospitals to develop programs targeting patients immediately after they are discharged. Research has shown this is a crucial time for patients, a period in which the right follow-up care can prevent complications that result in costly and potentially dangerous readmissions. The commission would also spend $500 million to test models for reducing nine types of medical errors, including surgical site infections, pressure ulcers and complications from childbirth. All this would happen after healthcare providers come together.

“As business has demonstrated in various industries over the last three decades, quality costs less, not more,” said David Cote, chief executive of manufacturing giant Honeywell, who joined Health and Human Services Secretary Kathleen Sebelius as she announced the Partnership for Patients initiative.

Not surprisingly, the campaign has won the backing of hospital groups, leading insurers, physician groups such as the American Medical Association and consumer groups such as Consumers Union. Debra Ness, president of the National Partnership for Women and Families, a leading patient advocacy group, said that the quality initiative was particularly important at a time when some in Congress are pushing to slash billions of dollars in federal support for healthcare programs like Medicare and Medicaid. “It's initiatives like this that get to the root of the problem … not cutting services,” Ness said. Over 10 years, the Medicare savings could reach $50 billion, with billions more saved in Medicaid spending.

Health and Human Services Secretary Kathleen Sebelius underscored the need for the Partnership for Patients program today by citing the new study published in the journal Health Affairs. Sebelius pointed to hospitals that have made tremendous strides in making care safer. By adopting sophisticated production processes from the carmaker Toyota, for example, Virginia Mason Medical Center in Seattle, Washington, has reduced the number of patient falls by 25%, and bed sores by 75%. In addition, introducing a surgery checklist developed by Johns Hopkins Hospital in Baltimore, Maryland, helped a coalition of Michigan hospitals decrease the occurrence of a common infection by two thirds, saved 1500 lives, and cut costs by $200 million in just 18 months.

The announcement comes as a new poll finds most Americans are not very impressed with the quality of the nation's health care system. The poll, conducted last month for the Robert Wood Johnson Foundation by the Harvard School of Public Health, found only a third of those polled rated the system as deserving an ‘A’ or a ‘B’, while 28 percent said it rated only a ‘D’ or an ‘F’. 38 percent, said it deserved a grade of ‘C’.