As patient safety declines amid the pandemic, the U.S. must rebuild a healthcare delivery system in which safety is embedded in every step of a process, with clear metrics that are aggregated, assessed and acted on, according to an analysis published Feb. 12 by The New England Journal of Medicine.
The article was penned by Lee Fleisher, MD, chief medical officer and director at CMS; Michelle Schreiber, MD, deputy director for quality and value at CMS; Denise Cardo, MD, director of the division of healthcare quality promotion for the CDC's National Center for Emerging and Zoonotic Infectious Diseases; and Arjun Srinivasan, MD, associate director for healthcare-associated infection prevention programs in the division of healthcare quality promotion at CDC's National Center for Emerging and Zoonotic Infectious Diseases.
Since the COVID-19 pandemic began, metrics tracking healthcare-associated infections and other complications of care indicate significant deterioration of multiple patient safety measures.
"It is abundantly clear that the healthcare ecosystem cannot ask clinicians and staff to work harder," the authors wrote, "but must instead provide them with more tools and an environment built on a strong foundation of wellness and on instilling and rewarding a culture of safety."
The authors call for renewed national goals of harm elimination throughout the healthcare system. The federal officials are committed to a renewed focus on patient safety, including the following efforts:
1. Joining healthcare leaders in reviewing safety practices and seeking better and more deeply embedded solutions that also help close health disparities.
2. Expand the collection and use of data on safety indicators in CDC and CMS programs, including data in such key areas as maternal health and mental health. Aim to work with other government and nongovernment organizations to further enhance patient safety.
3. Developing safety metrics that draw on clinical data captured digitally in electronic medical records which incorporate information from all payers. Some electronic clinical quality measures are already being considered for patient-safety monitoring in the CMS Quality Payment Program.
4. CMS must use oversight functions to ensure emergency-preparedness and quality-improvement programs are more than just plans.
"The healthcare sector owes it to both patients and its own workforce to respond now to the pandemic-induced falloff in safety by redesigning our current processes and developing new approaches that will permit the delivery of safe and equitable care across the healthcare continuum during both normal and extraordinary times," the four leaders conclude. "We cannot afford to wait until the pandemic ends."