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February 11, 2015 12:00 AM

Patient-safety movement reboots

Sabriya Rice
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    Berwick

    Dr. Donald Berwick will help lead a new team of experts convened to find ways to streamline and refocus the patient-safety movement around clearer targets.

    Despite a national assault on medical errors over the past 15 years, patient-safety experts say there is still much work to be done to make hospitals safer. The National Patient Safety Foundation announced Wednesday that a new 25-person multidisciplinary panel will meet Feb. 23-24 in Boston to review the current literature and then deliver a report this summer with its recommendations.

    “We're trying to strategically think about which are the strongest levers to go forward and make the biggest improvements,” said foundation CEO Dr. Tejal Gandhi. “This is a convening of experts to develop consensus around what have we really have accomplished and where we need to go.”

    The panel's meeting has been titled “The State of Patient Safety: 15 Years Since the IOM Report To Err is Human.” There has been some disagreement about the progress made since that Institute of Medicine report in 1999. Safety leaders told a Senate panel last July that hospitals are no safer today than when the report was released. They emphasized the need for reliable data, metrics and monitoring systems that can consistently provide accurate comparisons on outcomes.

    A December report from the Agency for Healthcare Research and Quality painted a different picture, however. That report, which summarized the progress on a variety of measures against benchmarks set by the public-private Partnership for Patients, estimated that approximately 1.3 million fewer patients were harmed in U.S. hospitals between 2010 and 2013, and that 10 times more deaths were avoided in 2013 than in 2011, suggesting rapid progress.

    The Partnership for Patients was launched under Berwick's leadership during his tenure with the Obama administration.

    While many welcomed those numbers as evidence that the safety trend is bending in the right direction, others cautioned that it's much too soon to claim success.

    The progress noted in the AHRQ report did show that better understanding is breaking the “safety logjam,” the Commonwealth Fund wrote in a blog post Wednesday. The good news is that more entities have assumed roles in improving safety, the authors wrote. But they also pointed out that it has been difficult to gauge what works because of the lack of coordination among those efforts.

    “With so many overlapping contributors, isolating the effects of each becomes very difficult, not least because they may be mutually reinforcing,” wrote the foundation's president, Dr. David Blumenthal, and senior researcher David Squires. Having convincing data on the effects of each of these initiatives could help scale existing initiatives. “But it's a good problem to have,” Squires said in an interview.

    Berwick, a former CMS administrator and founder of the Institute for Healthcare Improvement, will be joined as co-chair of the new NPSF panel by Dr. Kaveh Shojania, director of the Centre for Quality Improvement and Patient Safety at the University of Toronto.

    Other panelists will include: Dr. Lucian Leape, a patient safety pioneer who contributed to the eye-opening IOM report in 1999; Dr. David Bates, who leads the Center for Patient Safety Research and Practice at Brigham and Women's Hospital, Boston; human factors engineering expert Pascale Carayon of the University of Wisconsin at Madison; and Helen Haskell, founder of Mothers Against Medical Error.

    Follow Sabriya Rice on Twitter: @Sabriyarice

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