Hearing of the U.S. Senate Committee on Health, Education, Labor and Pensions - First, Do No Harm: Improving Health Quality and Patient Safety
Statement of Chairman Tom Harkin (D-IA)
"We have convened this hearing to discuss a new strategy and initiative recently announced by the Department of Health and Human Services to improve the quality of health care by emphasizing patient safety and reducing medical errors. In addition to saving tens of thousands of patient lives, the Department estimates that this new effort will save up to $35 billion in health care costs, including up to $10 billion for Medicare. Saving lives and saving money -- now that's good policy.
"In the late 1970s, a group of researchers began to examine reports of patient deaths and injuries caused by anesthesia. They found wide variation in quality, and a disturbing incidence of medical errors, leading to 6,000 deaths or serious injuries annually. ABC's "20/20" news program covered the study, and the modern patient safety movement was born.
"But the urgency and importance of this cause was brought into sharpest focus by the Institute of Medicine's landmark 1999 study, "To Err Is Human," which sent a shockwave through the medical establishment. IOM found that almost 100,000 preventable deaths, and many times that number of injuries, occurred annually in the nation's hospitals.
"Since then, conscientious and innovative providers, scholars, and public officials have made great strides in improving quality of care for all Americans. Our witnesses, today, will talk about some of these life-saving innovations. For example:
* As CEO Tim Charles will describe, Mercy Medical Center in Cedar Rapids, Iowa has achieved extraordinarily low readmission rates by sharing information and best practices with competitors and by establishing a free clinic for uninsured patients. These practices led the Institute for Healthcare Improvement -- the path-breaking patient safety group founded by Dr. Donald Berwick -- to name Mercy a high-performing hospital;
* As Chief Medical Officer Dr. Philip Mehler -- and my colleague Senator Bennet -- will tell us, Denver Health System has created a quality assurance system of incentives, centralized leadership, and focus on high risk populations -- as a result, it's ranked first among 112 academic medical centers for patient safety.
"The Affordable Care Act makes the greatest single investment in quality improvement in history, building on models like those I just described to bring the highest quality health care to all Americans, regardless of income or geography. It is on these vital investments that our hearing will focus today.
"For the first time, the law gives public officials, providers, payers and other stakeholders the tools to reward high quality, not high volume, care. And, perhaps most importantly, the law stops payment for bad care. I'm pleased to see that the Administration is using these tools to aggressively attack weaknesses in our health care system.
"In March, the Department of Health and Human Services released a comprehensive National Quality Strategy that promises to drive broad quality improvement across both public and private markets. And in mid April, the Administration announced an exciting patient safety initiative -- the Partnership for Patients. As Dr. Clancy will describe, the Partnership's aims are ambitious:
* to reduce preventable hospital acquired conditions by 40% by 2013, saving more than 60,000 lives and preventing 1.8 million injuries;
* and to reduce hospital readmissions by 20% by 2013, saving more than 1.6 million patients the needless suffering of a preventable complication.
"In addition to the patient lives that will be saved through these efforts, as I said earlier, HHS estimates that reducing medical errors will save up to $35 billion in health care costs, including up to $10 billion for Medicare.
"We need such bold action. Just last month, a study published in the journal Health Affairs used a detection tool created by the Institute for Healthcare Improvement and found that, on average, a third of patients admitted to hospitals suffer a medical error or other adverse event -- ten times greater than previously thought.
"Findings like these show that the new quality improvement tools come just in time and cannot be implemented too quickly. I look forward to hearing our witnesses' perspectives on this national challenge."
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