Patient safety progress 'excruciatingly slow,' expert says

Patient safety progress is "excruciatingly slow," mainly because hospitals lack incentive to improve care and performance measures often miss the mark, one health expert told Forbes.

Despite improvements in preventable hospital errors due to lower hospital infection rates and a cultural shift from individual to organization-wide responsibility, hospitals lack clear and strong incentives to make patient care safer, Ashish K. Jha, M.D., a professor at the Harvard School of Public Health, told Forbes contributor Leah Binder.

Hospital mortality rates have trivial financial consequences, Jha said, and under the Affordable Care Act, individual pay-for-performance for doctors and nurses doesn't hold entire healthcare systems accountable.

"It's not on the top priority list for CEOs. It's not what keeps CEOs awake at night. And until we get CEOs losing sleep about unsafe care, we're not going to make a big dent in the failures of our healthcare system," Jha told Binder.

Another concern is readmission-based hospital reimbursements, he said. 

"Readmissions [are] not a measure of quality, [they are] a surrogate marker for quality," Jha said. Readmissions for medical conditions such as heart attacks and pneumonia often occur because of measures that are not related to hospital care quality, such as how sick the patients are and what kind of social support they have at home.

Jha suggests Medicare use a more long-term approach, such as bundled payments tied to real quality measures over 90 days as opposed to 30 days. Hospitals must have a better understanding of post-acute and longer-term care, and be accountable for long-term patient outcomes, he said. Only then will the healthcare industry see major improvements and positive changes.

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