Massachusetts Hospitals: Where Every Week Is Patient Safety Week

We recently celebrated National Patient Safety Awareness Week, and Mass. Hospital Assoc. (MHA) provider members marked the occasion by highlighting some of their ongoing work to reduce readmissions, mortality, and central line-associated bloodstream infections (CLABSI) at hospitals across the Bay State.

Patient safety and high-quality care — measuring it, assessing it, and improving it — is the fundamental mission of hospitals. Massachusetts hospitals are national leaders in voluntary reporting of patient quality and safety information, and our hospitals are committed to doing even more to improve health care quality and patient safety.

The MHA board of trustees has unanimously endorsed an association-wide initiative to move beyond public reporting and transparency to make measurable, concrete improvements in hospitals’ performance. This Strategic Performance Improvement Agenda (SPIA) focuses on three priorities. The goal is for Massachusetts hospitals to collectively:

• Improve quality by reducing preventable mortality;
• Improve efficiency by reducing preventable readmissions; and
• Improve safety by reducing central line-associated bloodstream infections.

To date, the boards of trustees for 48 hospitals have made specific commitments to SPIA, and the list is growing. MHA, in turn, is providing numerous tools to help hospitals in their fight to reduce readmissions, mortality, and CLABSI.

A multi-state project dubbed the State Action on Avoidable Re-hospitalizations Initiative was launched by the Institute of Healthcare Improvement in May 2009 with grant funding from the Commonwealth Fund. Participating hospitals — including 49 from Massachusetts — have formed cross-continuum teams and are now focusing on how to improve patient transitions from the hospital to the post-acute setting.

On the mortality front, MHA is undertaking a new initiative to combat sepsis, which is the leading cause of death in non-coronary intensive care units. A new portfolio of offerings from MHA called Mortality: Learning in Network (M-LiNk) will be publicly available shortly.

M-LiNk offers strategies to help hospitals improve the effectiveness of their mortality-review programs, as well as concrete tools with evidence-based strategies to reduce mortality for those at greatest risk.

For central line-associated bloodstream infections, MHA has been overseeing the Comprehensive Unit-based Safety Program (CUSP). Hospitals that have joined the CUSP-CLABSI program have project teams from their intensive care units participating in national content calls and state coaching calls. They also submit data on CLABSI, unit patient-safety culture, and team progress.

These teams adopt best practices and work to ensure that the culture of their ICUs promotes teamwork and trust so that all staff can point out errors and shortcomings.

Evidence indicates that CLABSI efforts nationwide are working. Recently the Centers for Disease Control and Prevention (CDC) released its latest CLABSI data, and bloodstream infections in intensive care unit patients with central lines decreased by 58{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} in 2009 compared to 2001. The decrease over those nine years represented up to 27,000 lives saved across the U.S. and $1.8 billion in excess health care costs avoided, according to the CDC.

Specific examples of care improvement success stories in Massachusetts hospitals are available on PatientCareLink, the health care quality, transparency, and patient-safety Web site sponsored jointly by MHA and the Mass. Organization of Nurse Executives.

Every week is Patient Safety Week at Massachusetts hospitals. MHA is proud to support the work our hospitals do continually to ensure outstanding patient safety and quality care.

Lynn Nicholas is president and CEO of the Mass. Hospital Assoc.