Partnership for Patients – Summary of success
The Centers for Medicare and Medicaid Services’ (CMS’s) Innovation Center initiated ” The Partnership for Patients” in April 2011 as a public-private partnership that offers support to physicians, nurses and other clinicians working in and out of hospitals to make patient care safer and to support effective transitions of patients from hospitals to other settings. The two goals of this partnership were to:
- Reduce harm caused to patients in hospitals. By the end of 2014, preventable hospital-acquired conditions would decrease by 40% compared to 2010.
- Improve care transitions. By the end of 2014, preventable complications during a transition from one care setting to another would be decreased such that all hospital readmissions would be reduced by 20% compared to 2010.
Achieving the Partnership’s two goals had the potential to both save lives and costs for CMS programs. On December 2, 2014, HHS Secretary Sylvia Burwell announced a new report that showed an estimated 50,000 fewer patients died in hospitals and approximately $12 billion in healthcare costs were saved as a result of a reduction in hospital-acquired conditions from 2010 to 2013. According to the report, preliminary estimates show that hospital patients experienced 1.3 million fewer hospital-acquired conditions from 2010 to 2013. This translates to a 17% decline in hospital-acquired conditions over the 3-year period. The PFP program ended December 9, 2014.
Partnership for Patients – Areas of focus
The Partnership for Patients identified ten areas of focus, but addressed all-cause harm, as well. The CMS website provides links to a variety of resources. The Safety Institute has assembled additional selected resources and links below to tools for harm reduction.
- Adverse drug events (ADE)
- Antimicrobial stewardship – overview and resources
- CMS Partnership for Patients (PFP) adverse drug events (ADE) resources
- Opioid analgesics and patient safety
- Catheter-associated urinary tract infections (CAUTI)
- Central line associated blood stream infections (CLABSI)
- Injuries from falls and immobility
- Pressure ulcers
- AHRQ Preventing pressure ulcers in hospitals. A toolkit for improving quality of care.
- CMS Partnership for Patients (PFP) Pressure ulcer prevention and management resources
- National Pressure Ulcer Advisory Panel (NPUAP) website and international guidelines (2014)
- Preventable readmissions
- AHRQ Project RED (Re-engineering hospital discharge)
- Institute for Healthcare Improvement (IHI) how-to guides for improving transitions from the hospital to reduce avoidable re-hospitalizations
- National Patient Safety Foundation (NPSF) “safety as you go from hospital to home” – a consumer fact sheet
- Washington State Hospital Association care transitions toolkit
- Surgical site infections (SSIs)
- Venous thromboembolism (VTE)
- American Academy of Orthopedic Surgeons (AAOS). Guidelines for preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty
- American College of Chest Physicians. CHEST™ Antithrombotic guidelines, 9th edition.
- American Heart Association (AHA): Top 10 things to know: VTE management
- CMS Partnership for Patients (PFP): VTE prevention resources
- Ventilator-associated events (VAE)
- “Ventilator-associated events (VAE): Background, definitions and surveillance methods” Download slides of Dr. Shelley Magill’s presentation from Oct. 4, 2012
- CDC NHSN Device-associated module: VAE (January, 2014)
- CDC NHSN Surveillance for VAE, including VAE calculator (ver 3.0)
Partnership for Patients – Hospital Engagement Networks
The design of the partnership included 26 Hospital Engagement Networks (HENs) who worked to develop learning collaboratives for hospitals and provided a wide array of initiatives and activities to improve patient safety. They were required to conduct intensive training programs to teach and support hospitals in making patient care safer, provided technical assistance to hospitals so that hospitals could achieve quality measurement goals and established and implemented a system to track and monitor hospital progress in meeting quality improvement goals.
Premier’s Hospital Engagement Network
With more than 450 hospitals participating, Premier was the largest national HEN approved by the Centers for Medicare and Medicaid Services to participate in the initiative and over 2012 and 2013 helped its participants avoid more than 35,600 readmissions, contributing to a savings of at least $313 million.
PFP – Leading Edge Advanced Practice Topics (LEAPT)
In addition to working on the 10 PFP patient safety areas of focus, 6 HENs also pursued Leading Edge Advance Practice Topics (LEAPT) during 2014 to enhance overall progress on the Partnership for Patients’ goals. The following HENs implemented strategies to address harm in not only their hospital network, but also the broader Partnership for Patients community:
- Ascension Health System
- Carolinas Healthcare System
- Georgia Hospital Association
- Ohio Hospital Association
- Washington Hospital Association
These 6 LEAPT HENS each addressed a minimum of 5 out of 11 advanced practice topics and implemented strategies to reduce harm in not only their hospital network, but also shared their learnings to the broader Partnership for Patients community. The topics choices included:
- Severe Sepsis and Septic Shock (mandatory)
- Clostridium Difficile (C diff)
- Hospital Acquired Acute Renal Failure
- Airway Safety
- Iatrogenic Delirium
- Procedural Harm
- Undue Exposure to Radiation
- Failure to Rescue
- Results beyond 40/20 AIMs
- Hospital Culture of Safety
- Cost Savings Calculations for Hospital Acquired Conditions
To support all HENs, the Premier Safety Institute has compiled publicly accessible resources to support improvement efforts in several of the LEAPT areas of focus. This downloadable LEAPT Advice Package covers:
- Clostridium difficile (C diff)
- Sepsis/Severe Sepsis
- Procedural Harm
- Radiology/Imaging Safety
- Worker Safety
QUEST – Premier’s ongoing national quality and safety collaborative
QUEST® is one of the most comprehensive hospital collaboratives in the nation. Including approximately 350 members, QUEST has become one of the only initiatives to help healthcare organizations deliver the best possible care to each patient, every time. QUEST members have avoided 136,375 hospital deaths and saved approximately $11.65 billion since its inception in 2008.
Organizations in QUEST have committed to save lives, safely reduce the cost of care, deliver the most effective care, improve patient safety and increase patient satisfaction. In fact, QUEST is about more than succeeding under reform; it’s also about leading the transformation to high-quality, cost-effective healthcare.
While national hospital costs have increased by 37 percent since 2008, costs for QUEST hospitals have only risen 14 percent and remained flat for the past year. This averages out to an annual 2.3 percent year-over-year cost increase that is only 0.4 percent above the rate of inflation, suggesting that QUEST members are bending the cost curve in healthcare comparable to the rest of the economy. In fact, if all 5,700+ acute-care hospitals nationwide were able to achieve QUEST standards of performance, $21 billion could have been saved last year.
In addition to lowering costs, QUEST members have made substantial gains in quality, including reducing their mortality rates 14 percentage points lower than a matched sample of hospitals not in QUEST. Of the deaths avoided, the largest improvements were made in sepsis (21 percent of all deaths prevented), stroke, heart failure and respiratory infections (reduced by 6 percent each).
QUEST uses healthcare informatics to provide the best patient care and drive performance in 7 domains: mortality, safety, evidence-based care, cost and efficiency, appropriate hospital use, patient and family engagement, and community health.
- Information on QUEST and additional QUEST resources
- QUEST year five press event presentation and speaker bios