As patient safety declines amid the pandemic, the United States must rebuild a healthcare delivery system in which safety is built into every step of a process, with clear metrics that are aggregated, evaluated and implemented, according to an analysis published on February 12 by The New England Journal of Medicine.
The article was written by Lee Fleisher, MD, Chief Medical Officer and Director of CMS; Michelle Schreiber, MD, associate director for quality and value at CMS; Denise Cardo, MD, director of the Health Care Quality Promotion Division for the CDC’s National Center for Emerging and Zoonotic Infectious Diseases; and Arjun Srinivasan, MD, associate director of health care-associated infection prevention programs in the Division of Health Care Quality Promotion at the CDC’s National Center for Emerging and Zoonotic Infectious Diseases.
Since the onset of the COVID-19 pandemic, tracking measures for healthcare-associated infections and other complications of care indicate a significant deterioration in several patient safety measures.
“It is abundantly clear that the health 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 solid foundation of wellness and on instilling and rewarding a culture of safety.”
The authors call for renewed national harm-elimination goals across the health system. Federal officials have committed to a renewed focus on patient safety, including the following efforts:
1. Join health leaders to examine safety practices and seek better, more deeply integrated solutions that also help reduce health disparities.
2. Expand the collection and use of safety indicator data in CDC and CMS programs, including data in key areas such as maternal health and mental health. Aim to work with other governmental and non-governmental organizations to further improve patient safety.
3. Develop security measures that rely on clinical data captured digitally in electronic medical records that incorporate information from all payers. Some electronic measures of clinical quality are already being considered for monitoring patient safety under the CMS Quality Payment Scheme.
4. CMS should use monitoring functions to ensure that emergency preparedness and quality improvement programs are more than just plans.
“The healthcare industry owes it to patients and its own staff to respond now to the pandemic-induced decline in safety by rethinking our current processes and developing new approaches that will enable the delivery of safe and equitable care across the continuum of health care during normal times and extraordinary times,” the four leaders conclude. “We cannot afford to wait for the pandemic to end.”