Between 2010 and 2014, we estimate that 87,000 fewer patients died from hospital-acquired conditions (HACs), such as adverse drug events, pressure ulcers, and potentially dangerous infections. In 2014 alone, 37,000 fewer patients died than would have died if the rate of adverse events had remained at the 2010 level. That is approximately equal to the number of women who die from breast cancer in the United States each year.

The incidence of these events overall has been reduced by 2.1 million, for an estimated savings of $19.8 billion. This hard-won progress is the result of concerted national attention by everyone from front-line staff in hospitals to policymakers in Washington.

If some of these findings sound familiar, it’s because they build on the data that AHRQ released last year that showed HAC rates declined by 17% between 2010 and 2013. Data at the 3-year mark showed that 50,000 lives and nearly $12 billion in health care costs were saved. In 2014, the interim data indicate that the overall HAC rate stayed at the 2013 level, sustaining the overall gains and increasing the overall impact of the effort over 4 years (2011–2014).


Public and private involvement

The latest findings confirm an encouraging trend: Patients in America’s hospitals are safer today than they were in 2010. Of course, providing safer patient care is a goal shared by all of us who care for, and care about, patients. But the hard work of reducing and sustaining declines in HACs required ongoing involvement from the public and private sector, including Medicare payment incentives, hospital-based electronic health records, education and outreach, and evidence-based tools to implement best practices.

For example, the Affordable Care Act included Medicare payment incentives specifically designed to improve the quality of care. Following the passage of the Affordable Care Act, HHS created the Partnership for Patients, a public-private initiative focused on making care safer, more reliable, and more affordable. At the outset of this partnership initiative, AHRQ helped coordinate the development and use of a national measurement strategy, which is the baseline for this report, Saving Lives and Saving Money: Hospital-Acquired Conditions Update.


Patient safety tools and resources

In addition to the measurement strategy, AHRQ has established the evidence base and created many of the tools and resources that hospitals and other providers use to prevent HACs.

Just last month, we released the Toolkit for Reducing CAUTI in Hospitals based on the experiences of more than 1,200 hospitals nationwide that participated in an AHRQ-funded project to apply the Comprehensive Unit-based Safety Program to reducing catheter-associated urinary tract infections (CAUTIs). Preliminary data indicate that hospitals using these tools reduced CAUTIs by approximately 15% overall. AHRQ continues to work with our HHS colleagues and researchers across the country to create new knowledge about how to improve care, particularly in understudied areas such as diagnostic errors and antibiotic resistance.

Not only has the national reduction in HACs saved lives and saved money, it has helped policymakers and health providers recognize the magnitude of what can be achieved. Providers have learned what they need to do to prevent patient harm, while HHS and its partner agencies have identified how best practices can most effectively be put into widespread practice.


Still more work to be done

Certainly, there is more work to be done. The report we just released shows that there were 121 adverse events in 2014 for every 1,000 hospitalizations, a rate that is still too high. And following big declines in that rate in 2012 and 2013, the rate plateaued from 2013 to 2014, emphasizing the need for redoubling our collective efforts.

But this report shows that we’re moving in the right direction. At AHRQ, we’re proud to facilitate this effort through measurement, evidence generation, and tool development. We are eager to continue working with our colleagues within HHS and with hospitals across the country to ensure that these resources are put to use on the front lines of care.

This has been modified, with permission, from a post on the AHRQ website published 12/3/15.

Jeff Brady MD, MPH
Jeffrey Brady, M.D., M.P.H. is a Rear Admiral, United States Public Health Service and the Director, Center for Quality Improvement and Patient Safety (CQuIPS) at the Agency for Healthcare Research and Quality (AHRQ) . In this role, he serves as a member of the AHRQ Senior Leadership Team and leads a part of the Agency that conducts several AHRQ Programs, including: Patient Safety Research, Healthcare-Associated Infections Prevention, the Patient Safety Organization Program, the National Healthcare Quality & Disparities Reports (NHQR/DR) Program, and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Program. The AHRQ Patient Safety Research Program, which Dr. Brady led from 2009 to 2013, supports projects aimed at understanding and enhancing the safety of health care through approaches such as increased teamwork, prevention of healthcare-associated infections, use of medical simulation, expansion of a culture of patient safety, and other quality improvement initiatives. In a prior position at AHRQ, Dr. Brady led the team that produces the National Healthcare Quality Report and National Healthcare Disparities Report—annual reports to Congress on the status of health care quality in the United States. Before moving to AHRQ in December 2006, Dr. Brady served as a medical officer and clinical reviewer for the Food and Drug Administration’s Office of Vaccines. Additionally, he has held positions as a medical epidemiologist for the Department of Defense, and primary care physician in the U.S. Navy. Dr. Brady attended the Medical College of Georgia, completed internship training in Internal Medicine at the Naval Medical Center, San Diego, California, and earned a Master’s degree in public health from the Uniformed Services University of the Health Sciences (USUHS), in Bethesda, Maryland. He completed the Navy’s General Preventive Medicine Residency, also at USUHS, and is board-certified in Public Health and General Preventive Medicine.


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