A foundation sponsored by the American Medical Association has kicked off what it calls the first nationwide campaign to foster systemwide improvements in patient safety at America's hospitals.
But officials of the Chicago-based National Patient Safety Foundation, created in 1996 by the AMA, were unable to detail precisely how the initiative will result in fewer medical errors, providing only broad generalizations about yet another highly publicized patient-safety campaign aimed at raising the consciousness of patients and providers (April 22, p. 28).
While other, similar patient-safety initiatives predate the new initiative, foundation officials said the effort-which does not involve strict measurement of errors or the public reporting of problems-is just one more way to address an industrywide challenge underscored by the Institute of Medicine's 1999 report on medical errors.
"I think there have been a lot of initiatives since the IOM rang the patient-safety bell," said Timothy Flaherty, M.D., chairman of the AMA's board of trustees and a radiologist in Neenah, Wis. "We're trying to expand the knowledge base and also try-more than try-to give hospitals some of the tools they can work with to enhance safety."
Like many industry observers, David Page, a hospital executive in Minnesota, doesn't think the industry has done enough in the past several years to improve patient safety. Despite pockets of activity on both the local and national levels from many groups, Page says there has been a "rather disappointing level of embracing patient safety when you look industrywide."
Page, along with 16 other hospital executives, teamed with the foundation to create what officials described as the "first nationwide initiative to achieve measurable systems change" since the IOM's report.
"To date, I don't think dramatic changes have occurred," said Page, president and chief executive officer of seven-hospital Fairview Health Services, whose flagship is 935-bed Fairview-University Medical Center in Minneapolis. "This is the beginning of the wave."
The foundation was formed in 1996 by the AMA, CNA HealthPro, 3M and Schering-Plough to promote what it calls a new approach to patient safety that emphasizes "systems-learning" rather than focusing "only on blame and punishment for mistakes," according to its press release.
In its early stage, the initiative is quite modest-17 hospitals, scattered around the country, will attempt to lead the way in patient safety by taking a strong public stand through a campaign called "Stand up for Patient Safety," which was announced last week. Hospitals that join the initiative will receive educational materials and programs to help monitor and report on patient safety.
"This campaign is designed to spur real movement that will put hospitals at the forefront in addressing patient safety," said Paul Gluck, M.D., chairman of the patient-safety committee of the American College of Obstetricians and Gynecologists and a foundation board member. "Our goal is for all hospitals across the country to `stand up' and take part in this campaign, from the top executive and board of trustees to the professionals on staff to patients themselves."
But the foundation's description of its project as the first of its kind came as something of a surprise to the American Hospital Association, which says it has launched several similar initiatives involving all of its nearly 4,100 member hospitals since well before the release of the IOM report. Other organizations also have been active in this area, including national hospital alliance VHA and the Leapfrog Group, a business coalition urging hospitals to adopt specific patient standards.
"We feel we've been doing quite a lot with hospitals in patient-safety efforts," said Don Nielsen, M.D., senior vice president of quality leadership at the AHA and its representative to the foundation's board of directors. "Our initiatives have been national for the last three-plus years."
As early as July 1999, Nielsen said, the hospital association distributed a quality advisory on safe-medication practices to all of its members. Shortly after the IOM report's release, the AHA created a strategic alliance with the Pennsylvania-based Institute for Safe Medication Practices, developing a self-assessment tool that was sent to all members, Nielsen said. Since then, he added, the AHA has distributed an organizational assessment program on patient safety that was developed by VHA and has made available to its members a set of three, 30-minute videos on patient safety.
Despite a slight quarrel with the foundation's assessment of its program as one of a kind, Nielsen said, "We are very supportive of the educational effort; this is just one of the many we support."
Suzanne Delbanco, executive director of the Leapfrog Group, praised the foundation's initiative as a way to help hospitals share information about what works best in reducing medical errors. Last week, Delbanco's group announced it was expanding its efforts into 12 new regions of the country, where hospitals will be asked to complete a survey indicating their status in adopting three patient- safety standards. In the first six regions it surveyed, Leapfrog received responses from half of nearly 500 hospitals.
"It sounds like what they're trying to do is advance our thinking on how to improve the processes by having these hospitals learn from each other," she said.