CMS Patient Safety Efforts and the AHRQ National Scorecard on Hospital-Acquired Conditions
In working toward a healthcare system that brings down costs and improves the quality of patient care, CMS supports multiple programs and initiatives focused on making care safer. Among them are the Quality Improvement Network – Quality Improvement Organizations (QIN-QIOs), activities of the Hospital Improvement Innovation Networks (HIINs), and the ESRD (End Stage Renal Disease) Network Program. These programs provide direct technical assistance and support the use of evidence-based best practices to reduce hospital-acquired conditions (HACs) via systematic quality improvement work.
Hospital Improvement Innovation Network Organizations
The HIINs, together with federal agencies, private partners and patient advocacy organizations, are working to improve the quality of care provided and make hospitals safer. HIINs have coordinated with the QIN-QIOs to provide comprehensive quality support to hospitals and the surrounding communities in an effort to foster improvement across the care continuum of the Medicare program.
The 16 Hospital Improvement Innovation Networks (listed in alphabetical order) are:
- Carolinas Healthcare System.
- Dignity Health.
- Healthcare Association of New York State.
- The Health Research and Educational Trust of the American Hospital Association.
- Health Research and Educational Trust of New Jersey.
- Health Services Advisory Group.
- The Hospital and Healthsystem Association of Pennsylvania.
- Iowa Healthcare Collaborative.
- Michigan Health & Hospital Association (MHA) Health Foundation.
- Minnesota Hospital Association.
- Ohio Children’s Hospitals’ Solutions for Patient Safety.
- Ohio Hospital Association.
- Premier, Inc.
- Vizient, Inc.
- Washington State Hospital Association.
CMS has set a goal of reducing HACs by 20 percent between 2014 and 2019. The HIINs support this goal through quality improvement assistance to more than 4,000 acute care hospitals across the nation. If this goal were met, the Agency for Healthcare Research and Quality (AHRQ) projects there would be 1.8 million fewer patients with hospital-acquired conditions, resulting in 53,000 fewer deaths and saving $19.1 billion in health care costs. These projections are based on the reductions that would occur from 2015 to 2019, compared to the rates for hospital acquired conditions staying the same for 2015 to 2019 as in 2014.
AHRQ National Scorecard on Hospital-Acquired Conditions
AHRQ has developed a foundation of patient safety research and tools, and this work continues to provide valuable assets and advance the scientific framework for implementation of these collaborative efforts, including the AHRQ National Scorecard on Hospital-Acquired Conditions. The National Scorecard presents cumulative data on the nation’s progress toward reducing HACs.
The scorecard shows an overall decline of HACs, such as adverse drug events, catheter-associated urinary tract infections, central line associated bloodstream infections, and surgical site infections, among others. This decline resulted in 350,000 fewer HACs in 2015 and 2016, representing an 8 percent decline, and 8,000 inpatient deaths averted and $2.9 billion in health care costs saved from 2014 to 2016.
Created in 2011, the National Scorecard was developed to serve as a measurement strategy for HHS to track HAC rates from 2010 through 2014. Between 2010 and 2014, the National Scorecard showed that overall HACs dropped 17 percent, resulting in 2.1 million fewer harms to patients, saving almost $20 billion in health care costs and preventing 87,000 deaths. In 2016, CMS established a new goal of reducing HACs by 20 percent between 2014 and 2019. In addition, this year, AHRQ has established a revised method for calculating the national HAC rates, and progress beginning in 2014 will be tracked from this baseline through 2019 using this methodology.
Data in the new National Scorecard showed that most—but not all—HACs have declined over the period from 2014 to 2016. For example, from 2014 to 2016, adverse drug events dropped 15 percent while pressure ulcers or pressure injuries increased 10 percent. While most harms have decreased and major progress in reducing HACs has been shown since 2010, opportunities remain for continued improvement.
Further Opportunities to Get Involved
CMS is committed to working with partners to capitalize on this success in improving patient safety and reducing health care costs while providing the best, safest possible care to patients. To learn more about the work of the HIINs please visit https://partnershipforpatients.cms.gov/ or to become involved in the initiative please contact the National Content Developer at NCD@impaqint.com for assistance.