Partnership for Patients to improve patient safety

When physician blogger Kevin Pho wrote about involving patients in healthcare reform in a recent article in USA Today, one thing he failed to mention is a novel government initiative that has been flying below most of our radar screens — the “Partnership for Patients: Better Care — Lower Costs.”

Why was it necessary to call out patient centeredness as a separate initiative?

Although no one disputes that those of us who work in the U.S. healthcare system are committed to delivering the best possible care to our patients, the truth is that unacceptably large numbers of patients continue to be harmed by errors in medical judgment, processes, and practice.

The administrative leaders of hospitals and other healthcare organizations seem to need stronger external incentives to bring about necessary changes; and, despite their unquestionable dedication, clinicians seem to need greater stimulus to tackle improvements in all aspects of the care they provide.

So the Obama administration launched the Partnership in April of this year. It is to focus on improving the quality, safety, and affordability of healthcare for all Americans by bringing together the leaders of major hospitals, employers, physicians, nurses, patient advocates, and state and federal governments in a shared effort to make hospital care safer, more reliable, and less costly.

The Partnership’s dual goals are to:

Accelerate the Reduction of Harm to Patients in Hospitals – specifically, to decrease hospital acquired conditions by 40% by 2013, thereby saving more than 60,000 lives.
Decrease Preventable Hospital Readmissions Within 30 Days of Discharge – specifically, to reduce preventable conditions during transitions of care (from one setting to another) by 20% by 2013, thereby reducing the incidence of additional suffering from complications requiring re-hospitalization.

At its core, the Partnership seeks to alter the mindset and strategies of everyone involved in healthcare – including the patient — and to increase the rate at which all forms of patient injury are identified and eliminated by building a national network of information and idea exchange.

The approach taken by the Partnership identifies and tackles multiple aspects of the issue:

Aligning the public and private health sectors
Introducing aligned incentives
Improving accountability and oversight (e.g., by improving certification processes, targeting preferred behaviors, and linking poor performing facilities with appropriate learning resources)
Stimulating patient, family, and caregiver engagement
Adopting metrics that encourage learning and progress
Assuring that validated patient safety improvement models are adopted throughout the U.S. healthcare system

Even at this early stage, the Partnership’s Web page offers a wealth of patient-centered information for families with children, individuals, persons with disabilities, seniors, young adults, and employers on topics ranging from prevention to insurance options to tools for comparing the quality of care at hospitals, nursing homes, home health agencies, and dialysis facilities.

So, if this Partnership is purely voluntary and has no “teeth,” what would prompt clinicians and healthcare organizations to sign on?

In addition to moral suasion, elements in health reform – such as reduced Medicare payment for poor performance — may supply an additional nudge for hospitals and healthcare organizations to participate.

At the physician level, I hope that the Partnership will help drive home the point that, if we really believe the patient is central to all that we do, we must take stock of our own practices and processes of care and be willing to change for safety’s sake.

David B. Nash is Founding Dean of the Jefferson School of Population Health at Thomas Jefferson University and blogs at Nash on Health Policy.