Another encouraging feature of the Partnership for Patients is its collaborative approach, bringing a wide range of stakeholders to the table, said Wyatt, who is also the director of the U.S. Defense Department's Patient Safety Analysis Center. “I am more than heartened by the involvement of businesses and payers because for once, it seems like we are all on the same sheet of music,” he said.
The partnership has two main improvement targets: preventable hospital readmissions and hospital-acquired conditions, such as pressure ulcers and surgical-site infections. HHS set goals of reducing the number of hospital-acquired conditions by 40% and lowering the rate of hospital readmissions by 20%, all by the end of 2013.
Additionally, HHS predicted the initiative would save 60,000 lives over the next three years and could save as much as $50 billion in Medicare costs over the next decade.
To reach those ends, HHS announced it would make an initial $500 million in funding available immediately through the Community-based Care Transitions Program, a provision of the healthcare reform law aimed at improving care transitions and reducing readmissions. The remaining $500 million will be made available through the CMS Innovation Center to support community-based organizations that develop local approaches to reducing preventable harm.
At a heavily attended HHS news conference announcing the partnership, Dr. Richard Gilfillan, director of the CMS Innovation Center, said the grants for demonstration projects will begin to roll out over the next few months.
Jennifer Dingman, co-founder and state coordinator of PULSE of Colorado, a patient-safety advocacy organization based in Pueblo, commended HHS for the initiative's focus on patient engagement.
“Patients and families are a valuable resource,” said Dingman, whose organization signed on to the partnership. “Unfortunately, in most places, patients are not invited to participate in their own care. They and their families are often perceived as a nuisance, and that is tragic.”
Helen Haskell, patient-safety advocate and director of the Empowered Patient Coalition, agreed, saying an “all-out campaign” was needed to address issues of quality.
A host of other organizations also issued statements of support for the initiative, including the New York-based Northeast Business Group on Health, the National Association for Home Care & Hospice, the National Patient Safety Foundation, the Federation of American Hospitals and Aetna.
But among the enthusiasm was some concern about the overarching need for transparency. In a statement, the Leapfrog Group, a healthcare quality improvement organization formed by large employers, applauded HHS for launching the program but emphasized the importance of making Medicare and Medicaid data accessible to the public.
“It is very important that the initiatives that take place in pursuit of patient safety are done in the sunlight,” Leah Binder, Leapfrog Group's CEO, said in an interview. “Patients and purchasers deserve to know how hospitals are doing, especially in matters of life and death, and we consider that our role as part of this partnership.”
Hospitals' roles, on the other hand, will be to refine their own quality-improvement tools and adopt best practices from other organizations, said Dr. Dana Kellis, chief medical officer at 599-bed PinnacleHealth System, Harrisburg, Pa. “The bottom line is we're trying to identify all opportunities for improvement,” said Kellis, who personally signed on to participate.
Some providers and advocates worried that Berwick's uncertain future as head of the CMS could endanger the partnership's future. Dr. Leigh Hamby, CMO, chief quality officer and executive vice president of four-hospital Piedmont Healthcare, Atlanta, expressed concern that if Berwick—a target of scorn by Republicans—is forced out, the safety initiative might lose momentum and the CMS could return to “business as usual, operating as a payer instead of an agent of change.”
But former IHI fellow Wyatt said he's not worried. Berwick may have spearheaded the IHI programs that form the basis for the current initiative, but providers and past fellows “are the ones who continue to bang the drum.”
“This is a highly sustainable initiative,” Wyatt said. “It would be great if Don was there, but if he's not, I believe we will still move forward and see measurable outcomes.”
— with Jessica Zigmond
