Summit Attendees Get Called to Reduce HAIs and Spark Systematic Change in the Health Care System
Along with PatientSafetyFocus.com, over 400 people (about three-quarters of whom represent hospitals) attended Cardinal Health's first Chasing Zero Summit in Washington DC today. According to their spokesperson, Cardinal's mission is to help improve health care and reduce costs. Their aim for the Summit is to bring leaders together to share actionable steps to reduce hospital acquired infections (HAIs).
Pushing for systematic health care change
Director of the Engelberg Center for Health Care Reform at the Brookings Institution and past administrator of the Centers for Medicare & Medicaid Services (CMS), Dr. Mark McClellan opened the 2-day event with a strong call to action: Now is the time for providers and other health care leaders to lead the effort to move away from a system of runaway costs and use of health care resources, to one based on value - where quality and cost are no longer independent variables. After stating that hospitals are making money from hospital-acquired infections, McClellan talked about CMS actions over the past few years to stop paying for certain "never events," or serious and costly errors in the provision of health care services that should never happen. The list of no-pay events has grown to include 11 hospital acquired conditions today, including HAIs. "Expect that list ot get longer," he intoned. But, it's not enough simply to keep adding to the list. McClellan drove home the point that we need to focus on a systematic effort to make our health care system sustainable. "We're in a vicious cycle of delivering care that isn't high value." Providers must work with patients to achieve the best care at the best cost for each individual.
He turned last to three trends beginning to drive systematic health care change. The first is the growth of activity on the measurement scene - from measuring health care outcomes, to cost and patient satisfaction. Payment reform is the second trend: from pay for reporting and pay for performance, to a shared savings model in which physicians are eligible for payments derived from savings from care management that's designed to anticipate patient needs, prevent chronic disease complications and avoidable hospitalizations, and improve quality. The third trend is changes in benefit design such as tiering, where for instance, hospitals that demonstrate the best quality and cost are put into the top tier of hospitals. Patients choosing these providers may get zero out-of-pocket expenses.
On McClellan's heels came Dr. Don Berwick, CEO of the Institute for Healthcare Improvement. He touched on IHI's 100,000 Lives (an effort to reduce preventable deaths in hospitals) and 5 Million Lives (designed to protect patients from five million incidents of medical harm during 2007 and 2008) campaigns. "If someone gets a hospital-acquired infection, it's the hospital board's fault," he stressed. "We can't survive in a cost plus system where there is no cap on the budget," he exclaimed. What's to be done, then? IHI's Triple Aim is an initiative to study high performing organizations that are demonstrating new approaches to health care delivery that counter current fragmentation and apply cost-effective and patient-centered care across well-defined populations. In our current system, each sector (hospitals, physicians, etc.) operates from its own goals and interests, and patients are often left to coordinate care and processes, compensating for fragmentation. The Triple Aim seeks to upend the current paradigm via three avenues: optimize the health of populations, per capita costs, and the experience of care. He acknowledged that the HMOs of the past look a lot like how the Triple Aim sounds, and closed by suggesting that we're heading for ruin in the face of more health care: more beds, more technology, more drugs...A sobering thought left to prompt listeners to action.
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