AHRQ Releases National Scorecard on Hospital Safety

WASHINGTON, D.C. (June 6, 2018)—Data released this week by the Agency for Healthcare Research and Quality (AHRQ) show continued progress in improving patient safety, a signal that initiatives led by the Centers for Medicare & Medicaid Services (CMS) are helping to make care safer. National efforts to reduce hospital-acquired conditions, such as adverse drug events and injuries from falls helped prevent an estimated 8,000 deaths and save $2.9 billion between 2014 and 2016, according to the report.

 The AHRQ National Scorecard on Hospital-Acquired Conditions estimates that 350,000 hospital-acquired conditions were avoided and the rate was reduced by 8 percent from 2014 to 2016. Federal experts note that the gains in safety among hospital patients echoed earlier successes, including 2.1 million hospital-acquired conditions avoided between 2010 and 2014.

CMS has set a goal of reducing hospital-acquired conditions by 20 percent from 2014 through 2019. Through the work of the Hospital Improvement Innovation Networks (HIINs), CMS drives this aim through intensive, focused quality improvement assistance to more than 4,000 of the nation’s 5,000 hospitals by spreading best practices in harm reduction. The HIINs, together with federal agencies, private partners and patient advocacy organizations work collaboratively to make hospital care safer. Once the 20 percent reduction goal is met, AHRQ projects that during 2015 through 2019 there would be 1.8 million fewer patients with hospital-acquired conditions, resulting in 53,000 fewer deaths and saving $19.1 billion in hospital costs from 2015 through 2019.

Examples of hospital-acquired conditions include adverse drug events, catheter-associated urinary tract infections, central-line associated bloodstream infections, pressure injuries and surgical site infections, among others.

“Today’s results show that this is a tremendous accomplishment by America’s hospitals in delivering high-quality, affordable healthcare,” said CMS Administrator Seema Verma. “CMS is committed to moving the health care system to one that improves quality and fosters innovation while reducing administrative burden and lowering costs. This work could not be accomplished without the concerted effort of our many hospital, patient, provider, private and federal partners—all working together to ensure the best possible care by protecting patients from harm and making care safer.”

To that end, CMS supports multiple programs and initiatives focused on making care safer. Among them are the Quality Improvement Network–Quality Improvement Organizations (QIN-QIOs), activities of the HIINs, and the ESRD (End Stage Renal Disease) Network Program. These networks provide direct technical assistance and support the spread of evidence-based best practices to reduce HACs via systematic quality improvement work.

AHRQ analyzes data on these conditions and calculates rates to help HHS track efforts to reduce patient harm by 20 percent from 2014 to 2019.

“Estimates in the new National Scorecard identify important goals for ongoing efforts to protect patients,” said AHRQ director Gopal Khanna, MBA. “These data not only help us track how we’re doing, but they help us set the target for where we need to go. We continue to work with HHS and others to develop tools and resources hospitals and clinicians can use to reach those goals.”

Updated estimates in AHRQ’s new National Scorecard were based on a new, expanded population set of hospital patients and were calculated despite recent changes in medical coding. In addition to developing this measurement strategy, AHRQ developed many of the tools used by hospitals to reduce hospital-acquired conditions.

Data in the new National Scorecard showed that overall harms decreased in several categories, such as infections and adverse drug events, which dropped 15 percent from 2014 to 2016. Opportunities for further improvement exist for reducing some harms, such as pressure injuries (pressure ulcers), which increased from 2014 to 2016.

The newly measured declines in hospital-acquired conditions parallel earlier gains. Hospital-acquired conditions overall dropped 17 percent from 2010 to 2014, saving $19.9 billion in health care costs and preventing 87,000 deaths. Preliminary data for 2017 are expected within the next year to determine if the reductions seen in 2014 through 2016 have continued.

The HHS agencies will continue their support of front-line providers in furthering these promising results—improving patient safety and reducing health care costs while helping providers deliver the best, safest possible care to patients.

Read the full AHRQ report here.

Find a fact sheet on CMS-led safety efforts here.