New Jersey hospitals participating in a nationwide quality and patient safety program have averted 9,206 adverse events for patients and more than $100 million in added healthcare costs in 2013, according to new data from the Partnership for Patients-New Jersey initiative.
Those results are attributable to reduced rates in 13 so-called "hospital-acquired conditions," or complications that can arise during a hospital stay – things such as post-surgical infections, pressure ulcers or medical errors. New Jersey hospitals posted a 32.2 percent average reduction in these conditions in 2013. N.J. hospitals also achieved an 8.7 percent decrease in the rate of patients readmitted to the hospital within 30 days of a prior hospital stay.
Partnership for Patients-New Jersey (www.NJHA.com/Pfp) is led by the New Jersey Hospital Association. NJHA is one of 27 "hospital engagement networks" selected by the U.S. Centers for Medicare and Medicaid Services in 2012. Based on the success of the Partnership for Patients' first two years, CMS extended NJHA's hospital engagement network contract through 2014.
NJHA's 63 participating hospitals achieved the following results between 2012 and 2013:
- Adverse drug events declined from 9.8 percent to 4.0 percent, a reduction of 58.7 percent.
- Catheter-associated urinary tract infections declined from a rate of 1.61 per thousand catheter days to 1.11, a reduction of 30.9 percent.
- Central line-associated bloodstream infections declined from arate of 1.39 infections per 1,000 central line days to 1.10, a reduction of 20.3 percent.
- Patient falls declined from 0.59 per 1,000 patients to 0.49, a reduction of 18.1 percent.
- Early elective deliveries declined from 4.9 percent to 3.0 percent, a reduction of 38.7 percent.
- Birth trauma injuries declined from a rate of 2.3 per 1,000 live births to 1.61, a 30.3 percent reduction.
- Obstetric trauma declined from a rate of 143 per 1,000 to 128.4 per 1,000 (with a medical instrument) and from 24.2 per 1,000 to 20.6 percent (without instrument.) The rate reduction is 10.3 percent and 14.9 percent, respectively.
- Pressure ulcers declined from 3.8 percent to 2.4 percent, a reduction of 37.1 percent.
- Surgical-site infections following colon surgery declined from 4.39 percent to 2.82 percent, a reduction of 35.8 percent.
- Surgical-site infections following hysterectomy declined from 1.48 percent to 1.04 percent, a reduction of 29.9 percent.
- Surgical-site infections following total knee replacement declined from 1.03 percent to 0.17 percent, a reduction of 83.8 percent.
- Venous thromboembolism (blood clots) declined from 0.75 percent to 0.67 percent, a reduction of 10.1 percent.
- Hospital readmissions within 30 days declined from 21.6 percent to 19.8 percent, an 8.7 percent reduction.
By comparing those new rates against the industry's standard expected rates, this work has averted a case of medical harm for 9,206 New Jersey patients in 2013. Those averted complications saved the healthcare system between $102 million and $125 million in added costs, according to cost data from the U.S. Agency for Healthcare Research and Quality.
Data collection is a key part of the quality improvement process. All hospitals routinely share their data with NJHA and CMS, along with an independent evaluator, so their performance can be benchmarked against other facilities.
"Our Partnership for Patients-New Jersey motto is 'working together to make healthcare better,' and that is very true in this initiative," said NJHA President and CEO Betsy Ryan. "We have hospitals across the state working with NJHA, with each other and with national experts to implement best practices, and then share and compare their results. It has resulted in care that is better for the healthcare system, and most importantly, better for the 18 million individuals served by New Jersey hospitals each year."
Aline Holmes, RN, director of NJHA's Institute for Quality and Patient Safety, said Partnership for Patients-New Jersey has helped deliver "care that is better and safer, with fewer complications and faster recoveries. We've made tremendous strides in our state, but there's always room for additional improvement, and we remain very focused on that goal."