Qualidigm Authors National Study on Patient Safety Trends Published in the New England Journal of Medicine

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Adverse Events for Heart Attack, Heart Failure Decline; Improvements Lag for Pneumonia and Surgical Patients

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Adverse events for patients being treated for heart attack and heart failure in hospitals have declined, reports a new study published in the January 23rd issue of the New England Journal of Medicine. The study, “National Trends in Patient Safety for Four Common Conditions, 2005 to 2011,” was funded by the Agency for Healthcare Research and Quality (AHRQ). Qualidigm, a mission-driven national healthcare consulting company based in Wethersfield, Conn., with AHRQ, the Centers for Medicare & Medicaid Services (CMS), and other national leading institutions, conducted the study.

The researchers used medical record data of Medicare patients 65 and older from the Medicare Patient Safety Monitoring System, the nation’s largest randomly selected medical record abstraction-based database designed for patient safety tracking. They looked at 21 adverse events common among patients hospitalized in the United States from 2005 to 2011 relating to these four conditions:

  •     Acute Myocardial Infarction (heart attack)
  •     Heart Failure
  •     Pneumonia
  •     Surgical Care

The 21 adverse events that jeopardize patient safety included drug reactions, hospital-acquired pressure ulcers (bed sores), falls and numerous healthcare-related infections. The researchers found that within the study’s timeframe, the rate of heart attack patients experiencing one or more adverse events fell from 26.0 percent to 19.4 percent; the rate for heart failure patients experiencing adverse events fell from 17.5 percent to 14.2 percent. Both results were considered statistically significant. In the areas of pneumonia treatment and patient surgery, results were less encouraging as pressure ulcers and catheter-associated urinary tract infections (CAUTIs) negatively impacted improvement efforts. As a result, no significant changes in the rate of adverse events were measured in the pneumonia or surgical patient populations.

“The results of this study show that when a determined group of diverse healthcare stakeholders align on a national scale and work toward common goals, patient safety can be significantly improved,” said Mark Metersky, M.D., a co-author of the study and also the director of the Center for Bronchiectasis Care, Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine. “We hope that ongoing efforts will build on this success and become even more effective at preventing patient harm in the future.”

“Cardiac patients are safer today than ever before, which is a major achievement for the nation,” said Thomas Meehan, M.D., Qualidigm’s chief medical officer. “Qualidigm has been working on patient safety since 2001. We are pleased to see that national efforts have led to fewer adverse events for patients being treated for heart attack and heart failure in hospitals. However, as we celebrate this positive outcome, we must be mindful that significant challenges remain in our redoubled efforts to make care safer for all patients," said Dr. Meehan.

Since the Institute of Medicine’s landmark article, “To Err is Human: Building a Safer Health System” revealed the staggering number of patients who die in U.S. hospitals each year due to the “nation’s epidemic of medical errors,” wide-ranging efforts have been implemented by a multitude of America’s healthcare stakeholders to improve patient safety, care coordination and processes, health outcomes and cost efficiencies.

The study’s authors are Yun Wang (Harvard School of Public Health, also affiliated with Qualidigm); Noel Eldridge (AHRQ); Mark Metersky (University of Connecticut, also affiliated with Qualidigm); Thomas Meehan, M.D.; Nancy Verzier, Michelle Pandolfi, Shih-Yieh Ho (all from Qualidigm); JoAnne Foody (Brigham and Women’s Hospital, also affiliated with Harvard Medical School and Qualidigm); Deron Galusha (Yale Medical School, also affiliated with Qualidigm); Harlan Krumholz (Yale Medical School); Rebecca Kliman, Nancy Sonnenfeld (both from CMS); and James Battles (AHRQ).

“National Trends in Patient Safety for Four Common Conditions, 2005 to 2011” is available via the New England Journal of Medicine’s website, http://www.nejm.org.

About Qualidigm:
Qualidigm’s mission is to advance the quality, safety and cost-effectiveness of healthcare. The company provides consulting services to public and private sector clients nationwide. These services include consulting, data analysis, health information technology, patient safety, quality improvement and utilization review. Statewide, Qualidigm continues to refine its burgeoning Care Transitions initiative, an effective, community based approach to significantly reducing preventable hospital admissions and readmissions for all cause disease states. In collaboration with the Connecticut Hospital Association, Connecticut's Quality Improvement Organization (QIO) began this program in 2010; first focused on reducing hospital readmissions for heart failure Medicare patients. http://www.HeartTalk.org.

About AHRQ:
The Agency for Healthcare Research and Quality’s mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work with HHS and other partners to make sure that the evidence is understood and used. http://www.ahrq.gov


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