Since the 1800s, the topics of patient safety and preventing infections have been known among healthcare workers and healthcare facilities. In the 1970s, the Centers for Disease Control and Prevention (CDC) recognized the need for infection prevention in healthcare settings and over the years, they along with hospital regulators and inspection agencies, have increased the information and regulations required of hospitals to improve safety and hand hygiene. In 2005, the Deficit Reduction Act was put in place and in October 2008, reimbursement changes to hospitals from the Centers for Medicare and Medicaid (CMS) attempted to address some of these negative hospital acquired conditions including healthcare-associated infections (HAIs). Lower reimbursements penalized hospitals for infections and other conditions the elderly Medicare patients acquired during the hospital stay. Today, the Department of Health and Human Services (HHS) requires measurement of patient satisfaction through Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and the results are starting to impact hospital inpatient reimbursement.
But are lower hospital reimbursements and penalties the best methods for improving patient safety? Lower reimbursements negatively impact the entire hospital by the errors of caregivers. These errors can cause death or extreme pain and suffering with the patient, and the patient’s family and healthcare workers are also impacted. However, the current solutions to increase patient safety driven by human efforts in a service industry are difficult.
On September 24, 2013, four leaders spoke at a hearing before the Senate Health, Education, Labor and Pensions Committee on U.S. efforts to reduce HAIs. These leaders discussed the improvements made in reducing infections as well as the systems and processes that have been and potentially could be put in place to increase safety.
What will be the outcome of this discussion? As the Senate hearing relayed, the government has tried to increase patient safety through increased funding for better record keeping and communication through healthcare information technology, procedure checklists and the negative reimbursements mentioned earlier. Many of the solutions have helped improve patient outcomes, but are there other processes and technologies that can help even more? Solutions that help caregivers communicate and remember to apply all the safety processes, including hand hygiene, can go far in achieving better patient and caregiver outcomes. Perhaps government and private insurers can focus on increased rewards for healthcare organizations and caregivers that apply the evidence-based practices for sustainability of increased patient safety and care.