For the second time in as many months, a prominent U.S. healthcare group has launched a sweeping, if vague, patient-safety initiative. But already, at least one consumer advocate is questioning its relevance.
The American Hospital Association unveiled its fledgling effort to launch a center for healthcare quality May 1 at the Chicago-based trade association's annual meeting in Washington. "There are too many preventable deaths and injuries and too many errors in our hospitals, and the question of what we are doing about these challenges will not go away," said George Lynn, chairman of the AHA's board of trustees, according to the text of his remarks.
The hospital association's push follows the Joint Commission on Accreditation of Healthcare Organizations' early March announcement of plans to create its own international patient-safety center. Officials from both organizations say the explosion of quality and safety resources has created a demand for better coordination to help hospitals adopt successful measures quickly. Both organizations will launch free, comprehensive Web pages with healthcare safety resources and referrals. And quality experts have welcomed the JCAHO's and the AHA's heightened interest. Still, not everyone sees value in a pair of similar centers.
"Clearly, it makes no sense to have more than one of these centers," said Arthur Levin, director of the Center for Medical Consumers. "I'd rather see more willingness on the part of the AHA to take on real quality initiatives." He cited the Institute for Healthcare Improvement's so-called 100K Lives Campaign, an 18-month effort to enlist hospitals in a safety-improvement effort. The AHA declined the IHI's invitation to join the campaign. Officials said the AHA, though supportive of the campaign, would instead focus on existing efforts.
The pair of centers arrive as consumers' ability to find hospital-specific quality data has increased. Public and private efforts to boost accountability and safety have followed the 1999 Institute of Medicine report that faulted errors for 44,000 to 98,000 deaths annually. HHS now ties public disclosure of quality data to higher Medicare payments.
Lynn said the AHA's center is an effort to reorganize and expand its existing quality efforts as the nation's patient-safety efforts evolve.
Lynn and a JCAHO official insist that the similar missions won't create competing centers. "We think it's an outstanding idea," Cathy Barry-Ipema, a JCAHO spokeswoman, said of the AHA's center. She said Richard Davidson, president of the AHA, and Dennis O'Leary, president of the Joint Commission, discussed the AHA's plans for a center.
There are some differences between the AHA and the JCAHO efforts. Unlike the Joint Commission, the AHA will not offer consulting services or sell products through its center. Georgia Hospital Association President Joseph Parker, who is also an AHA trustee, dubbed the hospital association's planned center a "clearinghouse," not competition for existing services.
"I'm not saying that there isn't merit to the idea of having a clearinghouse of information," Levin said. It's not clear that the proposed efforts will contribute to quality improvement, he said.
The AHA will draft more concrete plans for its center after creating an advisory board, said spokesman Richard Wade. Lynn said the center will collect and sift through a barrage of safety efforts, including those within the AHA, to help hospitals network or find critical information.
AHA members welcomed news of the hospital association's effort.
Kevin Roberts, president and chief executive officer of Castle Medical Center in Kailua, Hawaii, said a resource to help hospitals keep up with changing evidence, guidelines and therapies would be helpful. "There is a whole industry surrounding quality right now," he said. "It's hard to get your head around it."
"I'm thrilled the AHA is doing this," said Carolyn Clancy, director of the AHRQ, which has spent $160 million since 2001 on patient-safety grants and contracts.