Patient safety: A call for more meaningful measures

Increased financial pressure provides hospitals with more incentives to improve patient safety, but policymakers must establish more meaningful measures to create lasting change, write two leading patient safety experts.

Many of the measures that the federal government uses to track hospitals' patient safety center on the number of adverse events that occur at facilities. But this focus can lead to larger penalties for hospitals that devote more attention to identifying such events, write Ashish Jha, M.D., of Harvard T.H. Chan School of Public Health and Peter Pronovost, M.D., Ph.D., of the Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, in a commentary for JAMA.

But it will take the work of three different sources to make measures more meaningful, write Jha and Pronovost:

  • The Centers for Medicare & Medicaid Services must tighten its focus to address the most common causes of patient harm, which include adverse drug events, surgical complications, falls, nosocomial infections and venuous thromboemboli. The federal agency's current strategy, they write, only uses an evidence-based approach for measuring nosocomial infections.
  • The Centers for Disease Control and Prevention, in addition to working with CMS on reducing surgical-site infections, must use clinical data to find detection methods for common patient harms, a strategy which already proved effective in the 1990s. "Given the sensational advances in computing in the past two decades and that most U.S. hospitals now have electronic health records, there are sufficient data that could be exploited to detect a wide variety of adverse events," they write.
  • Congress, they write, must allocate funding for research into engineering systems, an initial investment that will yield significant payoffs within the federal budget.

To learn more:
- read the commentary

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