Hospitals make gains in patient safety, but challenges remain

Hospitals have made significant progress in improving patient safety, but they still have to tackle many challenges to continue making gains, an article in JAMA Viewpoints argues.

Data from the Agency for Healthcare Research and Quality has found that the number of adverse events has dropped by about 4 percent each year between 2010 and 2014. However, the reasons for this decline are less clear, write Richard Kronick, Ph.D., professor of family and preventative medicine at UC San Diego; Sharon Arnold, Ph.D., deputy director of the AHRQ; and Jeffrey Brady, M.D., director of AHRQ’s Center for Quality Improvement and Patient Safety.

They name four potential reasons why there was a decline in harm:

  • More research was done on how to improve safety, and with that evidence hospitals made needed changes

  • New tools and technical assistance enabled hospitals to address safety issues

  • Hospitals now have access to data and measures to assess safety culture and the rate of patient harm

  • Hospital leaders are more engaged in and committed to promoting patient safety

Though this progress is clear, the authors write, the biggest question for the future is how to best maintain, or even speed up, the decline in harm that already exists. Concerns continue, they write, because the rates of adverse events were the same in 2013 and 2014. Initiatives to improve safety must also include patients in ambulatory care and long-term care settings, not just those who are hospitalized, according to the commentary.

Hospitals also need to develop more reliable methods to measure adverse events and leaders need to continue to make safety a high priority, the authors write. A focus on minimizing diagnostic errors is another strategy, they suggest.

- read the commentary