17 Percent Reduction in Hospital-Acquired Conditions
Richard Kronick, Ph.D., Director, Agency for Healthcare Research and Quality
Rockville, Maryland, December 1, 2014Data in the a new report from AHRQ show that an estimated 50,000 fewer patients died in hospitals and approximately $12 billion in health care costs were saved as a result of reductions in hospital-acquired conditions (HACs) from 2010 to 2013.
This 17 percent decline in harms experienced by patients in hospitals between 2010 and 2013 includes national reductions in adverse drug events, falls, infections and other forms of harm. It also represents a total team effort within the U.S. Department of Health and Human Services and the hospital community that has resulted in very significant progress toward making our health care system safer.
AHRQ has had two primary roles in this effort. One has been in the measurement of adverse events that allow the department to track hospital-acquired conditions and monitor progress.
All told, 1.3 million adverse events—conditions like catheter-associated urinary tract infections, central line associated bloodstream infections, pressure ulcers, and surgical site infections among others—have been prevented.
And we are showing continued progress. The most significant of these gains occurred in 2012 and 2013. In 2013 alone, approximately 800,000 fewer incidents of harm occurred.
These results update data that were released in May. So that you can better mark this progress, the May report showed that we drove down patient harms by 560,000 incidents—a reduction of nearly 10 percent between 2010 and 2012.
AHRQ’s second role in this effort has been to develop the evidence base and many of the tools that hospitals have used to achieve the reductions in harms. But first, the numbers. Data on the rate of hospital-acquired conditions comes from three sources:
- Ninety-two percent of the data come from a review of approximately 18,000 to 33,000 medical records each year to determine whether any of 21 types of adverse events occurred. We used a structured protocol with a large sample and we are confident that these data are solid. The nine hospital-acquired conditions that were included in this project were abstracted from the Medicare Patient Safety Monitoring System.
- Two percent of the data are on surgical site infections and were generated by the Centers for Disease Control and Prevention as part of the Partnership for Patients.
- The remaining 6 percent of the data come from the AHRQ Patient Safety Indicators, based on Healthcare Cost and Utilization Project data, and include things like bleeding or trauma after childbirth.
- The 17 percent reduction in hospital-acquired conditions from 2010 to 2013 indicates that hospitals have made substantial progress in improving safety. Although we cannot measure the precise causality, this progress toward a safer health care system occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events. We know that it is highly likely that financial incentives created by the Centers for Medicare and Medicaid Services and other payers, public reporting of hospital-level results, technical assistance offered by the Quality Improvement Organization program to hospitals, and the efforts of the Partnership for Patients all contributed to these impressive declines.
AHRQ tools and resources include the Comprehensive Unit-based Safety Program, tools to train hospital staff on how best to prevent pressure ulcers and falls, the Re-Engineered Discharge Toolkit, TeamSTEPPS® and more.
Page last reviewed December 2014