Medical errors in U.S. hospitals fall

Feds report that medical errors are down in U.S. hospitals

Hospitals nationwide are making fewer mistakes in treating patients, sparing 50,000 lives and saving $12 billion in health spending over the past three years, according to a new analysis of billing data by federal health officials.

The report from the Department of Health and Human Services, released during a conference on health care quality held Tuesday in Baltimore, examines data collected between 2010 and 2013 from health care providers across the country, including 13 of Maryland's 46 general hospitals.

Federal officials said the downward trend was the result of years of efforts to reduce errors that led to infections, falls, pneumonia, pressure ulcers, wounds and other complications. The 17 percent drop was welcomed by those working on tracking and prevention measures.

"Clearly, this is an encouraging trend," said Dr. Peter J. Pronovost, a doctor at Johns Hopkins and leading patient safety researcher and advocate. "A lot of attention has been given to the problem at hospitals in Maryland and around the country."

The rate for such incidents fell to 121 per 1,000 hospital discharges in 2013 from 145 per 1,000 in 2010, according to the report.

The focus on improvements began in earnest after a landmark report in 1999 from the Institutes of Medicine that found about 100,000 people were killed each year by such mistakes. More recently, studies have concluded that closer to 400,000 people die each year because of mistakes and many times that number are harmed.

The Affordable Care Act calls for measures to prevent harm to patients, including changes to how Medicare reimburses hospitals that readmit too many patients within 30 days. Maryland has added its own penalties.

But much of the data is derived from codes on patient bills, which can prove unreliable, said Pronovost, senior vice president for patient safety and quality for John Hopkins Medicine and the director of the Armstrong Institute for Patient Safety and Quality. He said hospitals have taken steps to improve the coding.

His work focuses on devising better methods of collecting data so doctors and administrators have a more accurate and timely picture of problems and can take more effective steps to prevent harm.

For example, Pronovost pushed safety checklists to prevent infections from central catheters used to supply fluids to patients. Clinical data collected by the U.S. Centers for Disease Control and Prevention showed there was a 44 percent drop in such infections from 2008 to 2012.

The overall drop in errors was touted by federal officials, who said they will continue to work on the problems.

"Today's results are welcome news for patients and their families," said Sylvia M. Burwell, secretary of the U.S. Department of Health and Human Services. "These data represent significant progress in improving the quality of care that patients receive while spending our health care dollars more wisely. HHS will work with partners across the country to continue to build on this progress."

According to the data, the greatest progress occurred in 2013, the most recent year assessed. Nearly 35,000 fewer people died in U.S. hospitals and there were about 800,000 fewer incidents of harm than in 2010, with a savings of about $8 billion, the report said.

"Never before have we been able to bring so many hospitals, clinicians and experts together to share in a common goal, improving patient care," said Rich Umbdenstock, president and CEO of the American Hospital Association. "We have built an 'infrastructure of improvement' that will aid hospitals and the health care field for years to come and has spurred the results you see today."

The report was based on tens of thousands of medical records, but safety experts such as Pronovost say information in general and on individual hospitals remains difficult for patients to find and understand.

To that end, Maryland health officials said Tuesday that they have repackaged and released information about hospitals in the state, as well as long-term care facilities and surgery centers, on a new website, marylandqmdc.org.

The site provides consumer ratings of care, and safety and pricing information on 25 common services such as childbirth and heart failure.

"The Maryland Health Care Quality Reports represent a shift in public reporting toward more consumer-centered tools that enable consumers to become more engaged in their health care decisions," said Ben Steffen, executive director of the Maryland Heath Care Commission, an independent state regulatory agency.

meredith.cohn@baltsun.com

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