Safety First

AHA participates in panel on public reporting of quality data

As more emphasis is placed on hospital quality performance, it is important that the quality measurements are scientifically sound, actionable and fair, American Hospital Association Vice President for Quality and Patient Safety Nancy Foster said April 27 during a panel discussion on public reporting of quality outcomes. At the Washington, D.C., event, sponsored by the Alliance for Health Reform and the Commonwealth Fund, panelists representing a spectrum of health care stakeholders spoke about major quality performance improvements hospitals have made during the 25 years since they began reporting quality data.

Foster said hospital CEOs across the country have agreed to “share their report cards” with the public. “Hospitals are committed to doing this because it’s so extraordinarily important to them to improve the work that they do,” Foster said. In addition, she said quality data is driving discussions at hospital board meetings and action from leadership teams.

CMS seeks comments on proposed medication-related quality measures

The Centers for Medicare & Medicaid Services is seeking comment on seven proposed medication-related quality measures. The measures, developed using Medicare administrative claims data, focus on improving medication adherence, appropriateness of therapy and patient outcomes.

They include: adherence to antipsychotics for individuals with schizophrenia; adherence to mood stabilizers for individuals with bipolar I disorder; adherence to antiplatelet treatment after stent implantation; polytherapy with oral antipsychotics; avoiding acetaminophen toxicity; short-acting opioid formulation for breakthrough pain in individuals with cancer; and bleeding outcomes related to oral anticoagulants. The measures were developed for use by states and/or heath plans but are being considered for other care settings such as physician offices.

To comment on the measures, visit http://www.surveymonkey.com/s/med-measures-public-comment.

[ via AHA News Now ]

Report: More Clinicians Speak Out On Safety Shortcuts

H&HN contributing editor Bob Kehoe talks to VitalSmarts researcher David Maxfield about a report finding that 93 percent of nurses and other clinicians believe 10 percent or more of their co-workers have taken dangerous workplace shortcuts. Listen to the podcast here.

ISMP launches 2011 assessment of medication safety

The Institute for Safe Medication Practices, in partnership with the American Hospital Association and Health Research & Educational Trust, on April 21 launched the 2011 Medication Safety Self Assessment for Hospitals. The AHA encourages all hospitals to complete the online assessment.

“Hospitals and health systems are committed to providing safe, high-quality health care, and medication safety is part of that commitment,” said AHA President and CEO Rich Umbdenstock. “The 2011 assessment will enable the field to track national progress and also identify and enhance opportunities to improve the safety of medication use practices.”

Respondents can compare their confidential results with aggregate results of similar organizations. Previous assessments conducted in 2000 and 2004 have helped hospitals improve medication safety through their own initiatives and targeted educational resources, such as the Pathways for Medication Safety tools.

The Commonwealth Fund provided funding for the 2011 assessment.

[ via AHA News Now ]

CMS launches ‘dry run’ of new outpatient imaging efficiency measures

Hospitals participating in the hospital outpatient quality reporting program can review through May 27 hospital-specific reports on the three new outpatient imaging efficiency measures for calendar year 2012. The reports, available at My QualityNet, are part of the Centers for Medicare & Medicaid Services’ national “dry run” of the measures, which will be publicly reported on the Hospital Compare website next year.

Hospitals should submit questions or comments on the reports at http://cms-ocsq.custhelp.com/app/utils/login_form/redirect/ask  and may contact the QualityNet Help Desk at qnetsupport@sdps.org or (866) 288-8912 for help accessing the reports. For more on the new and currently reported outpatient imaging efficiency measures, visit www.qualitynet.org.

AHRQ reports 52% rise in drug-related adverse events

The Agency for Healthcare Research and Quality reported that the number of drug-related hospitalizations in the U.S. increased from 1.2 million to 1.9 million from 2004 to 2008, with patients age 65 and older accounting for 53% of such hospitalizations. Unspecified medicines and painkillers led the way for the most cases of emergency department visits while corticosteroids made up the biggest share of hospital admissions for drug-related side-effects and injuries, the report found.

HHS announces new patient safety partnership

Health and Human Services Secretary Kathleen Sebelius on April 12 announced the Partnership for Patients - a collaboration with hospitals and others to reduce hospital acquired conditions and preventable hospital readmissions. The initiative will use $1 billion in Patient Protection and Affordable Care Act funding to test models of safer care delivery, promote best practices, and help Medicare patients at high risk for readmission safely transition from the hospital to other care settings.

By 2014, participants hope to reduce HACs by 40% and preventable readmissions by 20% to save up to $35 billion across the health care system. "Ultimately, our safety goals should be the same as other industries have adopted," Sebelius said, citing the airline industry's safety improvement efforts in remarks to American Hospital Association Annual Membership Meeting attendees after the announcement. "Their goal is no safety errors and they work on it day in and day out" by examining their systems and re-engineering processes.

Joining Sebelius at the AHA meeting, Centers for Medicare & Medicaid Services Administrator Donald Berwick, M.D., noted that when errors occur, "it isn't the workforce, it's the system." AHA President and CEO Rich Umbdenstock said the association will be an active partner with HHS in this effort and encourages hospitals to join in. "We will spotlight best practices and share them broadly with the field, and link them to the assistance HHS is making available," he noted.

New Health Affairs: Hospital Errors Ten Times More Common Than Thought?

Despite more than a decade of national focus on patient safety, medical errors and other adverse events occur in one-third of hospital admissions—as much as ten times more than some previous estimates have indicated, according to authors of a new study in the April issue of Health Affairs. The April issue is funded by the Robert Wood Johnson Foundation.

The study is one of several articles in this month’s Health Affairs that address persistent challenges facing the US health care system with respect to closing the gaps in quality and safety of care—challenges identified as far back as 2001 by the Institute of Medicine’s landmark report, Crossing the Quality Chasm. This thematic issue of the journal also looks at the profound costs incurred by shortfalls in quality; the optimal ways to measure quality; and the most successful ways to date of improving the quality of care. Taken together, the Health Affairs papers portray a mixed picture of health care quality in the United States.

Read more here.

AHRQ Reports Declines in Diabetes Care

The proportion of low income adults with diabetes who had annual blood sugar level testing and eye and feet exams declined from 39% to 23% between 2002 and 2007, an Agency for Healthcare Research and Quality report shows. Read more here.