News from South Carolina Business Coalition on Health

Chasm April's issue of Health Affairs takes a sobering look at the journey of quality in the United States healthcare system over the last ten years. The journey begins with the two eye-opening reports, Crossing the Quality Chasm and To Err Is Human, which illustrated the critical need for better quality and patient safety in the U.S. Healthcare system.

Over the last ten years, there have been significant strides made in efforts to reduce medical errors and increase patient safety. One major success story in quality improvement was the campaign to reduce preventable bloodstream infections. As a result of this multi-stakeholder collaborative effort, "data from the Centers for Disease Control and Prevention show that the number of patients in US intensive care units suffering a bloodstream infection contracted through a "central line" - a tube inserted through the chest into the heart or vena cava - declined by 63 percent between 2001 and 2009."

Although there has been progress made in many areas, some advancements in quality measurement have revealed the problem is actually much worse than initially reported. In one article, authors researched a variety of methods used to track adverse events. One method, not commonly used in healthcare facilities, "picked up ten times more confirmed significant adverse events than other methods - and determined that adverse events occurred in one-third of hospital admissions, even in hospitals that had instituted advanced patient safety programs."

The April Issue also provides direction for future efforts of quality improvement including: getting patients more involved through shared decision making, many federal initiatives being developed from the health reform law have the potential to accelerate progress, and suggested framework for organizational change. One article authored by the leaders of the Joint Commission, urges health organizations to look outside of health care for solutions to maintaining high levels of safety. "The study of "high reliability" - or consistent performance at high levels of safety over long periods of time- began with investigations of organizations that manage extreme hazards with exemplary safety records, far better than those in health care today." The authors suggest that for a health care organization to become highly reliable, three critical changes must take place: strong commitment to high reliability from the leadership team, the development and implementation of an organizational culture of safety, and they must put in place robust process improvement tools.

One thing is made clear in this issue; the health care system is highly complex and highly fragmented, making it easier for medical errors to become a common occurrence. We must build upon the successes that have been demonstrated by other organizations inside and outside of healthcare and look to develop new ways to achieve better patient safety.

Health Affairs, 30, no.4 (2011)

Partnership for Patients Initiative

The Obama Administration has launched the Partnership for Patients: Better Care, Lower Costs, a new public-private partnership that will help improve the quality, safety, and affordability of health care for all Americans. The Partnership for Patients brings together leaders of major hospitals, employers, physicians, nurses, and patient advocates along with state and federal governments in a shared effort to make hospital care safer, more reliable, and less costly.

The two goals of this new partnership are to:

· Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010. Achieving this goal would mean approximately 1.8 million fewer injuries to patients with more than 60,000 lives saved over three years.

· Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010. Achieving this goal would mean more than 1.6 million patients would recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge.

Achieving these goals will save lives and prevent injuries to millions of Americans, and has the potential to save up to $35 billion dollars across the health care system, including up to $10 billion in Medicare savings, over the next three years. Over the next ten years, it could reduce costs to Medicare by about $50 billion and result in billions more in Medicaid savings. This will help put our nation on the path toward a more sustainable health care system.

http://www.healthcare.gov/center/programs/partnership/index.html

National Infant Immunization Week

April 23-30, 2011 is National Infant Immunization Week (NIIW)

NIIW provides an opportunity to:

· Highlight the dangers of vaccine-preventable diseases, especially to infants and young children, and the importance and benefits of childhood immunizations

· Educate parents and caregivers about the importance of vaccination in protecting their children from birth against vaccine preventable diseases

· Focus attention on our immunization achievements and celebrate the accomplishments made possible through successful collaboration

· Step up efforts to protect children against vaccine-preventable diseases and thereby give them a healthy start in life

· Encourage better communication between parents and health care professionals

· Remind parents and caregivers they need to make and keep needed immunization appointments

· Provide parents and caregivers with a toll-free number, 800-CDC-INFO (800-232-4636), to locate a facility that offers immunizations through the Vaccines for Children Program, a federally funded program that provides vaccines at no cost to children whose parents cannot afford to pay for them

For more information, visit: http://www.cdc.gov/vaccines/events/niiw/overview.html

Use this as an opportunity to education employees on the importance of vaccines. The CDC's recommendations for adult vaccines are based upon age, occupational, medical, and other risk factors. Vaccines for which recommendations are issued include flu (influenza), pneumococcal polysaccharide, tetanus, diphtheria, whooping cough (pertussis), hepatitis A, hepatitis B, measles-mumps-rubella, chickenpox (varicella), meningococcal (meningitis), human paplilomavirus (HPV), and shingles (varicella zoster).

A study in 2001, researched the cost-benefit analysis of a strategy to vaccinate healthy working adults against influenza showed that flu vaccination on average results in a $13.66 cost savings per person vaccinated.

The federal government recently released a new consumer website, vaccines.gov, a gateway of information on vaccines and immunization for infants, children, teenagers, adults, and seniors. Vaccines.gov provides resources from federal agencies for the general public and their communities about vaccines across the lifespan.

(Sources: Pfizer, GSK, CDC, HHS)