While the U.S. healthcare industry has made strides in lowering the number of adverse events, many problems still remain. And one thing could be holding the industry back from achieving the goal of zero adverse events, according to a recent JAMA article: good measures of quality and patient safety.
"The healthcare industry lacks valid patient safety measures, which are fundamental to improvement. Without these measures, the key ingredient in these efforts is missing…Without effective measurement and reporting, progress in patient safety will be arduous and slow," wrote Ashish Jha, MD, and Peter Pronovost, MD, PhD, in the piece.
Dr. Jha is with the Department of Health Policy and Management of the Harvard T.H. Chan School of Public Health in Boston, and Dr. Pronovost is with the Armstrong Institute for Patient Safety and Quality and Johns Hopkins Medicine in Baltimore.
In the JAMA piece, Drs. Jha and Pronovost provided three suggestions as to how policy makers and government agencies can improve quality measurement in healthcare, thereby furthering the goal of reducing adverse events to zero.
1. CMS can eliminate unnecessary or ineffective metrics from the programs it runs. The authors suggest cutting PSI-90 as a measure and instead focusing on the adverse events that tend to cause the most harm: adverse drug events, nosocomial infections, venous thromboembolism, pressure ulcers, falls, surgical complications and diagnostic errors.
2. CMS can also task an agency with "defining standards of what makes good measures and setting accuracy requirements before implementing measures in pay-for-performance and public reporting," the authors wrote. The agency could provide a common set of "sound" metrics.
3. Congress needs to fund research on systems engineering in the healthcare industry. "Improving safety depends on having good systems in place rather than on the efforts of individual clinicians. As such, the government — the largest payer in healthcare — needs to fund practically applicable studies on systems engineering to promote efficient, safe healthcare," the JAMA piece reads.