Partnership for Patients an investment in safety

The federal government's new Partnership for Patients initiative has all the markings of becoming a landmark event in the patient safety movement.

The initiative, which was unveiled on April 12 by the Dept. of Health and Human Services, aims to cut preventable hospital-acquired conditions 40% by 2013, translating into 1.8 million fewer injuries to patients. During the same period, it hopes to reduce unnecessary returns to the hospital by 20%, preventing more than 1.6 readmissions. In the first three years alone, the partnership seeks to prevent 60,000 needless deaths.

In financial terms, the targets are savings of $35 billion across the health care system in the next three years, and about $50 billion in Medicare cost reductions and billions more in Medicaid savings over 10 years.

Meeting those goals requires a substantial financial commitment as well as support from across the full spectrum of the health care community. The partnership is starting out with both.

The government has pledged $1 billion as part of the health system reform law. This represents a major investment in patient safety, one with good potential to pay lasting dividends.

What will make the partnership true to its name is a pledge signed by more than 1,600 hospitals; 830 health professional organizations and clinicians; and 510 patient, community and consumer groups. They promised to do their parts to redesign activities in clinical settings to reduce harm and preventable readmissions, implement practices that foster patient-centered care and coordination, and share their experiences to make care safer and better coordinated.

The American Medical Association is among the signers. The AMA's involvement reflects its history of protecting patients, through the promotion of medical science and professional standards, that goes back to the Association's first meeting in 1847.

More recently, the AMA has been active on the patient safety front in several notable ways.

In 1996, the AMA established the National Patient Safety Foundation. The Association has donated more than $7 million to support its work.

The AMA played a central role in the passage of the Patient Safety and Quality Improvement Act of 2005. The law makes it possible for physicians to submit information about errors and other safety concerns in a confidential, voluntary and nonpunitive way.

The AMA's new Center for Patient Safety is now conducting a review on ambulatory patient safety during the last decade. The center expects to release a report this year that will examine how organized medicine can help physician offices improve quality, including avoiding hospital readmissions.

That hospitals are a setting for both healing and harm was underscored less than two weeks before the partnership announcement. A study in April's Health Affairs found that one in three hospital patients experienced an adverse event, and roughly 7% are harmed permanently or die from it.

The Partnership for Patients will start by asking hospitals to focus on nine types of medical errors and complications, including adverse drug events, central line-associated bloodstream infections, pressure ulcers and surgical site infections. The Centers for Medicare & Medicaid Services Innovation Center will help hospitals develop evidence-based approaches to prevent patient injuries. The CMS center also will test models of improving care and coordination.

With the plan, partners and pocketbook in place, the question now is if even all that is enough for the initiative to effectively combat such a widespread problem. With a 2013 target date set for safety improvement milestones, the answer will come relatively soon.