Today's guest blogger advocates for the creation of a national council of patient safety organizations. What do you think? What role do employers play in ensuring patient safety in hospital settings? Share your thoughts in the comments. —Andrea Davis, Managing Editor
Hospitals may soon have to post signs saying “Enter at Your Own Risk” or “Hospitals Can be Hazardous to Your Health.”
In 1999, the Institute of Medicine issued its landmark study, “To Err is Human,” which revealed that one million people become ill or injured while in the hospital because of medical mistakes; 100,000 of them die. Now, nearly a decade and a half later — and despite the intervention of 15 or so organizations dedicated wholly or partly to patient safety — the number of such deaths has increased two and a half times to 250,000. During this same general period, according to the American Hospital Association, the number of hospital admissions increased by only 4% (from 35 million in 2000 to 36.5 million in 2011, the last year for which complete data are available).
Clearly, whatever is being tried to solve the problem isn’t working and something more must be done.
Employers — especially those who serve on the boards of and/or who make financial contributions to hospitals (along with the organizations that advocate for their health interests) — are well positioned to help hospitals reduce their error rates. This includes insisting that the recommendations of a team commissioned by the federal Agency for Healthcare Research and Quality be adopted. This group’s recommendations — among other targets — are aimed at reducing “never events” identified by the National Quality Forum and re-admissions, both of which have been increasing. This can be best be accomplished by penalizing hospitals with reduced payments and other sanctions when they don’t comply and thus don’t meet certain standards.
Medicare and some insurance companies already don’t pay for certain preventable mistakes. More payers need to follow their lead. In addition, hospitals could be fined — and possibly lose their accreditation — if they are found guilty of such “malpractice.”
Peter Pronovost, MD, PhD, head of Johns Hopkins Armstrong Institute for Patient Safety and Quality and a member of AHRQ’s patient safety team, notes “more people die per year from errors than died per year in the Civil War.” Dr. Ponovost believes the problem is so serious that he would go so far as to install a government agency, modeled after the Security and Exchange Commission, to monitor and respond to infractions.
A middle ground approach would be to form a national council of patient safety organizations. Using its collective clout, this proposed council could issue guidelines to improve patient safety and help create programs, strategies and techniques to ensure the safety of patients and thereby improve the quality of care and reduce costs. These remedial measures could then be used by private and public health programs as the basis for taking appropriate action.
Without taking a more aggressive approach to improving patient safety, any reform efforts, including the initiatives generated by the Patient Protection and Accountable Care Act and multiple private sector projects, will be severely compromised.
Ozga is the president of Medical Business Exchange, which links progressive purchasers with innovative providers, and the founder of the forerunner to the National Business Coalition on Health. He can be reached at firstname.lastname@example.org.
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