The administration promises to spend $1 billion allocated from health reform legislation on the effort, specifically to help coalitions of providers, state agencies, employers, insurance companies and others who have proven strategies for success show others how to achieve these goals. And as of Wednesday night, nearly 1000 hospitals, medical groups, and clinicians had signed a pledge to participate, as well as 256 patient advocacy groups or health plans, consumer groups and employers.
Some hospital officials are hopeful, but skeptical.
Jim Lott, executive vice president of the Hospital Association of Southern California, which represents 180 hospitals and 40% of the acute care beds in the state, says he doesn't fully understand the program or what it seeks to accomplish. He thinks perhaps the White House is feeling pressure to get something off the ground.
"I've got to believe some of this is prompted by the political activity regarding the Affordable Care Act, and the fact House Republicans want to defund all these initiatives, particularly those that give the Secretary this kind of discretion," he says. "The sooner the administration gets these types of preventive initiatives in place, the better argument they can make for their funding."
Lott says that he wishes the administration didn't feel so much pressure. "They need to slow down and find out what is the best use of that money," he said. California, he notes, already has just that kind of program already in place.
Joe McCannon, senior advisor to CMS administrator Don Berwick, MD, and the advocate who ran the Institute for Healthcare Improvement's "Protecting 5 Million Lives from Harm" campaign, explains the program this way:
Take ventilator-associated pneumonia, a hospital-acquired infection that the Partnership's research team estimates is 50% preventable, he says. The Partnership wants hospitals to reduce those cases by that amount by 2013, or about 17,500 cases.
McCannon says hospital teams learn from strategies shown to work elsewhere, such as elevating the head of a patient's bed to reduce the risk of aspiration, adjusting sedation to allow patients to follow commands, and better weaning strategies to reduce the time the patient is on the ventilator, he says.
Don't hospitals already do those things, and in spite of it VAP still occurs at alarmingly high rates? I ask.