Health-Care Providers Stress Patient Safety

By Olenchek, Christina

In 1999, the Washington, D.C.-based Institute of Medicine reported statistics showing that tens of thousands of people nationwide die every year because of medical errors. The health- care industry reacted with a torrent of quality-improvement initiatives, determined to tackle problems such as medication errors and infections.

Yet medical organizations have much work left to do when it comes to patient safety, according to a group of hospital administrators who spoke at an event Sept. 23 in Harrisburg. The administrators discussed which quality-improvement efforts work for their institutions and urged other organizations to join these efforts.

The success of the health-care industry’s push to improve quality could have a significant effect on companies’ health-insurance costs. Pennsylvania’s general hospitals reported 11,668 cases of hospitalacquired infections last year, according to the Pennsylvania Health Care Cost Containment Council in Harrisburg. These infections were associated with 1,793 deaths and an estimated $2 billion in additional hospital charges.

“There’s tremendous energy that pervades the country about quality improvement,” said Dr. Dana Kellis, chief medical officer of Harrisburg-based PinnacleHealth System. “…We have seen a sea change here.”

Much of the panel’s discussion focused on the 100,000 Lives Campaign, a program of the Cambridge, Mass.-based Institute for Healthcare Improvement. Hospitals participating in the program adopt certain quality-improvement efforts, which include preventing adverse drug events and preventing infections (see “Safety first,” this page). The campaign’s goal is to save 100,000 lives by June 14.

PinnacleHealth uses a rapid-response team, a group of staff members who provide special attention to patients whose health quickly declines. The team has helped the system reduce the number of cardiac and respiratory arrests and deaths from such arrests, Kellis said. York-based WellSpan Health is trying to reduce surgical- site infections by standardizing procedures surgeons use to prepare patients before operations.

The effort illustrates the growing trend among health-care organizations to embrace evidence-based medicine instead of allowing different providers to treat patients differently, said Dr. Charles Chodroff, senior vice president of care management with WellSpan Health. Evidence-based medicine encourages doctors and hospitals to use proven treatments.

The success of quality-improvement projects will depend on whether hospitals can encourage cultural change within their staffs, said Angela O’Toole, director of the Center for Pulmonary Health at St. Clair Hospital near Pittsburgh. Some hospital employees are wary to call a rapid-response team because they fear they are inconveniencing the team, O’Toole said.

“We need to convince them not to worry about it,” she said.

Pay-for-performance initiatives could give new fuel to qualityimprovement efforts, said Dr. P.J. Brennan, chief medical officer and senior vice president with University of Pennsylvania Health System in Philadelphia. Government agencies and some insurance companies have rolled out initiatives that provide higher reimbursements; or preferential treatment to healthcare organizations that meet quality standards.

“It certainly gets the leadership’s attention,” Brennan said.

Chodroff believes the 100,000 Lives Campaign will be one program in a long string of quality-improvement efforts among health-care organizations.

“We view the continuous improvement of health care as our duty,” he said.

Copyright Journal Publications Inc. Oct 07, 2005