A Bold Step Forward for Patient Safety: CMS Introduces Groundbreaking Hospital Safety Measure

Preventable medical errors, infections, and injuries are too common in American hospitals, killing an estimated 250,000 people a year and harming many more. A recent report issued by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) estimated that one in four Medicare patients experienced unintended harm during their hospital stays.

The good news is that we are finally seeing progress nationally, with significant improvements in safety indicators reported over the past decade. One major policy strategy that contributed to this change: leadership from the Centers for Medicare & Medicaid Services (CMS). In 2010, CMS expanded public reporting by hospitals on rates of patient safety events, and thanks to the Affordable Care Act, began tying performance to the payment formula for Medicare.

Now, CMS just finalized a rule requiring reporting of seven new measures on patient safety in hospitals. All the measures are welcome, but one is truly a game-changer: the Patient Safety Structural Measure, which takes effect in 2025. This measure could hardwire patient safety into hospitals throughout the country and transform the delivery of care.

Why is this measure so important?
The Patient Safety Structural Measure assesses whether hospitals are taking the steps necessary to protect patients, and whether they have in place the protocols and policies known to work. Hospitals will attest to whether they engage in evidence-based practices within each of these five domains to achieve a score:

1. Leadership commitment: Does the hospital’s leadership and governing board ensure that patient safety is the highest priority for the hospital? Is patient safety central to all strategic, financial, and operational decisions?
2. Strategic planning and policy: Does the hospital have a clear roadmap for achieving safety goals, with well-defined policies in place?
3. Culture of safety and learning: Does the hospital gather data to integrate protocols that optimize safety? Do people and systems work collaboratively to implement these practices?
4. Accountability and transparency: Does the hospital have a safety reporting system that prompts feedback? Are safety measures tracked and reported, internally and externally?
5. Patient and family engagement: Does the hospital actively involve patients and families in their care, empowering them to participate in their own safety? Is patient and caregiver input about safety events or issues incorporated?

By focusing on these complementary core areas known to improve patient safety, the new measure gives hospitals a checklist of best practices and the incentive to put them in place. By monitoring this measure year after year, CMS is also encouraging hospitals not only to make patient safety a priority and accelerate improvement, but also to sustain this effort over time. Patient safety needs to be a priority every minute of the day. 

While most hospitals are aware of the importance of these practices, until now, patients knew little about them, nor could they find out whether their hospital took the right steps. That’s why this new measure is so important: it will be publicly reported by each hospital.

Transparency galvanizes change like nothing else. Leapfrog uses those CMS measures for our biannual Leapfrog Hospital Safety Grade: the A, B, C, D, or F we calculate for all general hospitals on how safe they are for patients. Hospitals across the country watch their grade closely, and those that earn an A tend to tout it loudly in their community. This helps build momentum and pride, which in turn reinforces the importance of keeping people safe.

While we have made progress as a country in reducing needless death and suffering in healthcare, much more progress is needed. No one in America should lose a loved one to a preventable error. This new CMS measure, coupled with existing safety and quality measures, is a powerful leap in the right direction.

Programming note:

Listen to Leah Binder report this story live during Talk Ten Tuesday, Aug. 20, 10 Eastern with Chuck Buck and Dr. Erica Remer.