Academy Health Research Meeting Research on Healthcare Acquired Conditions

1. Academy Health Research MeetingResearch on Healthcare Acquired Conditions Don Wright, MD, MPH Deputy Assistant Secretary for Healthcare Quality Office of Healthcare Quality Office of the Assistant Secretary for Health U.S. Department of Health and Human Services U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

2. Presentation Overview • Partnership for Patients Initiative • National Healthcare Quality Strategy • HHS HAI Initiative U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

3. U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

4. Partnership for Patients: Better Care, Lower Costs • Objectives: • Keep patients from getting injured or sicker.By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010.  Achieving this goal would mean approximately 1.8 million fewer injuries to patients with more than 60,000 lives saved over three years. • Help patients heal without complication.By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010.  Achieving this goal would mean more than 1.6 million patients would recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge.  U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

5. Partnership for Patients Areas of focus: Healthcare-Associated Conditions 1. Adverse Drug Events (ADE) 2. Catheter-Associated Urinary Tract Infections (CAUTI) 3. Central Line Associated Blood Stream Infections (CLABSI) 4. Injuries from Falls and Immobility 5. Obstetrical Adverse Events 6. Pressure Ulcers 7. Surgical Site Infections (SSI) 8. Venous Thromboembolism (VTE) 9. Ventilator-Associated Pneumonia (VAP) 10. All Other Hospital-Acquired Conditions U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

6. Next Steps for Partnership for Patients • If you want to learn more about the Partnership for Patients, go to http://www.healthcare.gov/center/programs/partnership/index.html. • If you want to sign the pledge, go to http://partnershippledge.healthcare.gov/ U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

7. National Healthcare Quality Strategy U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

8. National Healthcare Quality Strategy • National Aims • Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe. • Healthy People/Healthy Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social and, environmental determinants of health in addition to delivering higher-quality care. • Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government. U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

9. National Healthcare Quality Strategy • Priorities • Safer Care • Effective Care Coordination • Person- and Family-Centered Care • Prevention and Treatment of Leading Causes of Mortality • Supporting Better Health in Communities • Making Care More Affordable U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

10. National Healthcare Quality Strategy • Broad roadmap to improving healthcare quality. • Guides development of HHS Programs. • Implementation is underway. U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

11. National Healthcare Quality Strategy • Priority Examples • Safer care: • Michigan Keystone Project • Ensuring Person – and Family Centered Care: • Building Patients’ Perspectives Into All Performance Assessments • Promoting Effective Communication/Coordination of Care: • Improving Care Coordination Through HIT • Supporting Better Health in Communities: • Putting Prevention to Work in Communities • More information on the National Healthcare Quality Strategy can be found: • http://www.healthcare.gov/center/reports/quality03212011a.html U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

12. National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

13. U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

14. Phase I (2008-Present) Working Group Structure of the HAI Steering Committee Prevention & Implementation Lead: Centers for Disease Control and Prevention (CDC) Research Lead: Agency for Healthcare Research and Quality Incentives and Oversight Lead: Centers for Medicare and Medicaid Services (CMS) Federal Steering Committee for the Prevention of Healthcare-Associated Infections Information Systems & Technology Co-Leads: Office of the National Coordinator for Health IT & CDC Evaluation Lead: Office of Healthcare Quality Outreach & Messaging Lead: Office of Healthcare Quality Phase II (2009-Present) Ambulatory Surgical Centers Co-Leads: Indian Health Service & CDC End-Stage Renal Disease Facilities Lead: CMS Influenza Vaccination of Healthcare Personnel Co-Leads: CDC & National Vaccine Program Office Phase III Working Group (2011) Long-Term Care Lead: CMS U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

15. Action Plan Development • Released in June 2009 • Maintained as a “living document” • Serves as a “roadmap” for federal and state government U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

16. National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination • Phase 1 • Original focus on acute care hospitals • Targeted CAUTI, SSI, VAP, CLABSI, MRSA & C. difficile • Phase 2 • Ambulatory Surgical Centers • End-Stage Renal Disease Facilities (Hemodialysis Centers) • Flu Vaccination of Healthcare Personnel • Phase 3 • Long-Term Care U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

17. Measuring Progress Toward Action Plan GoalsMetric Source National 5-year Prevention Target On Track to Meet 2013 Targets? Bloodstream infections NHSN 50% reduction Adherence to central-line insertion practices NHSN 100% adherence Data not yet available* Clostridium difficile (hospitalizations) HCUP 30% reduction Clostridium difficileinfections NHSN 30% reduction Data not yet available* Urinary tract infections NHSN 25% reduction Data not yet available* MRSA invasive infections (population) EIP 50% reduction MRSA bacteremia (hospital) NHSN 25% reduction Data not yet available* Surgical site infections NHSN 25% reduction Surgical Care Improvement Project Measures SCIP 95% adherence *2009 or 2009 – 2010 is the baseline period.

18. Next Steps Affordable Care Act Release of 2011 Action Plan Development of Phase 3 – Long-Term Care Partnering to Heal: Teaming Up Against Healthcare Associated Infections Consumer Media Campaign Hospital Value-Based Purchasing – payment tied to performance $500 million from the CMS to test and implement innovations to reduce preventable harm in hospitals U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality

19. For more information Office of Healthcare QualityOffice of the Assistant Secretary for Health 200 Independence Ave, SW Washington, DC 20201 Telephone (202) 401-8006 ohq@hhs.gov Subscribe to the HAI listserv https://service.govdelivery.com/service/subscribe.html?code=USHHS_234 U.S. Dept of Health & Human Services www.hhs.gov/ash/initiatives/hai/ Office of the Assistant Secretary for Health www.hhs.gov/ash/ohq/ Office of Healthcare Quality