"Look at the data from around the country," McCannon replied. "It will show you there's still enormous variation in practice; some places are able to reliably provide care that reduces the incidence of adverse events, but there are other places where that just isn't the case."
"We know that where organizations reliably introduce these best practices, they get good results. So what we're seeking to do is help them introduce these evidence-based practices and study what has worked in other places," said McCannon.
Progress will be systematically checked, McCannon says. "We'll track changes in all-cause and specific forms of harm by conducting retrospective chart audits of records from a random selection of facilities to study change in harm over time," with various interventions and through databases such as the National Healthcare Safety Network, that are already kept by either CMS or the Centers for Disease Control and Prevention.
Hospitals will be the first targets for these efforts with the aim to reduce these categories of harm:
1. Adverse drug events
2. Catheter-associated urinary tract infections
3. Central line-associated bloodstream infections
4. Injuries from falls and immobility
5. Obstetrical adverse events
6. Pressure ulcers
7. Surgical site infections
8. Ventilator-associated pneumonia
9. Venous thromboembolism
10. Nearly two dozen other hospital-acquired conditions.
The results will not be risk-adjusted because no hospital will be publicly singled out, he says. The money will be awarded to organizations that make a good case that others can learn from their strategies.