PRESS RELEASE

For Immediate Release
Date: May 22, 2004

Quality-Improvement Standards:
Patient Safety Affects Businesses' Bottom Line

It's hardly news that serious medical mistakes happen every day in hospitals and physicians' offices throughout the country and our Commonwealth. The deadliest errors can arise from the simplest transgressions - misreading sloppy handwriting, transposing numbers on a prescription, spreading infection by failing to wash hands adequately between patients.

It's the national response to these threats that's changing. The catalyst came not quite five years ago, when the Institute of Medicine (an advisory group to the National Academy of Sciences) estimated that up to 98,000 people die each year from medical errors. That sobering statistic - higher than the annual deaths from breast cancer and car accidents combined - focused new attention on how mistakes occur and how to prevent them.

In Virginia, the call for better patient safety is increasingly being sounded not just by health care professionals but by the business community as well - and with good reason. Businesses large and small underwrite health care services for their employees, providing coverage for two of every three Americans under age 65, according to a 2002 report by the Kaiser Family Foundation.

Those numbers carry power. More and more, business leaders are coming to understand both their collective influence and the long-run cost savings that accompany quality care. When a hospital-borne infection or medication error sidelines an employee for additional weeks or months, it's the employer who must absorb not only the cost of lost productivity but also the eventual increase in insurance premiums that result from higher health care expenses.

That's one of the reasons Virginians Improving Patient Care & Safety, a not-for-profit consortium of hospital administrators, insurers, educators, regulators, and medical professionals, formed within weeks of the Institute of Medicine's eye-opening report, is encouraging greater participation by business interests in patient safety efforts. When we hold our annual conference May 26, one of the speakers will be Dr. Arnold Milstein, medical director of the Pacific Business Group on Health and a co-founder of The Leapfrog Group.

The Washington, D.C.-based Leapfrog Group was formed by a national association of CEOs about a year after publication of the Institute of Medicine's report. Its membership now includes more than 150 Fortune 500 corporations that account for more than 34 million health insurance enrollees. Like VIPC&S, the mission of the Leapfrog Group, so named for its goal of triggering a giant leap forward in health care quality, is to reduce medical errors through system-wide solutions.

Patient safety is a subject that's steadily penetrating the public consciousness, and political leaders have taken note. Last month, President Bush called on hospitals nationwide to install computerized medical records, charging that our "21st-Century health care system is using a 19th-Century paperwork system." Senator John Kerry is proposing federal reimbursements to encourage hospitals to install electronic safety systems.

Such initiatives reflect the primary goal of VIPC&S - to reduce patient harm through systemic safeguards that minimize the potential for human error. Some solutions require substantial investment, such as computerized prescription-ordering systems in hospitals that solve the problem of illegible handwriting and instantly cross-reference prescriptions with patients' other medications so deadly interactions are avoided.

Other strategies are simple and inexpensive, such as routinely giving aspirin to patients who show up in emergency rooms with chest pain, and encouraging flu vaccinations in at-risk populations. Still others are the province of educated consumers: Choose a hospital where many patients have had the surgery you need, and speak up if you have concerns or questions.

In my dual roles as president of VIPC&S and chief medical officer for the Virginia Health Quality Center (VHQC), I've seen concrete evidence of the shortand long-term cost savings that safer care can bring. A 2001/2002 study conducted by VHQC, in partnership with RAND Health and funded by the Centers for Medicare and Medicaid Services, examined the business benefits to Virginia hospitals and physicians' offices when quality improvement programs are instituted. One hospital created a set of clinical procedures that ensured its pneumonia patients received antibiotics more quickly, significantly reducing the average length of stay and saving an estimated $30,000 annually. One small physician's group created a simple diabetes flow sheet to track patient test and exam results, resulting in improved staff efficiency and an annual cost savings of more than $4,300.

Besides improving patient care, safety measures reduce the liability exposure that follows grievous mistakes. Investigating the series of events that led to the error helps prevent future missteps. What gets measured gets improved.

Enlightened business leaders, by paying closer attention to the quality of care they're purchasing and demanding greater accountability from health care professionals in all settings, are applying the same quality-improvement standards that they exercise when improving the excellence of their own products. The end result is enhanced performance - and healthier bottom lines.

Sallie Cook is the president of Virginians Improving Patient Care and Safety (VIPC&S).