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What the Government Should Do

Provide sustained leadership

The Department of Health and Human Services (HHS), along with public and private partners, has focused on eliminating the medical errors, infections and complications that cause harm to hundreds of thousands of patients each year, but more can be done. HHS should convene public and private stakeholders to continue defining the source of the problem and identify effective solutions. This must be among the highest priorities for HHS and related institutions.

  • As the Partnership for Patients - a new public-private partnership to help improve healthcare quality and safety for all Americans - progresses, the government could show further leadership and help bolster local progress by issuing reports that highlight common problems; quantify the scope of the problem; propose pathways for improvement; share results in fixing problems; and showcase best practices.
  • Congress should reinforce the importance of patient safety at federal agencies such as the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA). Congress should provide additional resources to support safety-related activities such as scientifically rigorous reviews and surveillance of drugs and medical devices.

 

Incorporate incentives in Medicare and Medicaid to promote safety

Medicare and Medicaid have taken meaningful steps to address safety, but additional actions must be taken to stop avoidable errors such as drug-to-drug interactions and other preventable complications that can occur in a healthcare setting.

  • The government should expand current initiatives by refining or incorporating new patient safety measures in pay-for-quality programs.
  • It can take several years to incorporate a new measure into Medicare’s Hospital Value-Based Purchasing (VBP) Program. CMS should develop a fast-track process for incorporating new, high-priority safety measures in hospital VBP and in Medicaid fee-for-service.

 

Use technology to drive safer, better care

Technology has the power to transform healthcare delivery by improving the safety and overall quality of each patient encounter. To encourage better use of technology, the government should:

  • Use the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program - which rewards providers for the “Meaningful Use” of certified EHRs - as a platform for advances in patient safety. Safety should be made a core expectation of the Meaningful Use Program, with safety-related quality measures built directly into the program. In addition, the federal government should work with stakeholders to develop outpatient safety measures to incorporate into the EHR Incentive Program.
  • Pilot the use of innovative technologies, such as the virtual ICU, to improve safety and outcomes in intensive care units and other critical care settings in underserved areas. This would enable physician specialists to be available “virtually” to treat patients and assist nurses and other medical staff in providing the best care.

 

Promote medication safety

The government should continue to educate consumers on the adverse health impacts of certain drug interactions - such as accidental acetaminophen overdosing - and the importance of taking prescriptions regularly as prescribed (“medication adherence”).

  • HHS should employ enhanced medication management techniques -reminder mailings or phone calls and mail order pharmacy services - for Medicare and Medicaid beneficiaries identified as high risk for harmful drug interactions or gaps in medication adherence.
  • To minimize the risks of negative drug interactions and assure they can be addressed rapidly, HHS should encourage the use of safety alerts - or “edits” - at the time a physician writes a prescription. This would be in addition to edits already in place at the pharmacy counter.
  • The government should continue to educate consumers about the importance of safe drug disposal to prevent misuse and abuse, including leveraging and expanding the Drug Enforcement Administration’s successful Drug Take-Back initiative.

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