Patient safety improves post-pandemic

For the report, Vizient analyzed data from 715 general, acute care hospitals that had information from the fourth quarter of 2019 to the first quarter of 2024. The hospitals regularly report clinical information to Vizient's Clinical Data Base.

Compared to before the pandemic, hospital discharges are now 1.6% higher, and patient acuity has increased by 3%. However, despite seeing more patients who require more complex care, Vizient found that patient safety measures have improved.

Since 2022, hospital mortality rates have been better than expected, and the difference between expected and observed mortality rates continues to increase. In the first quarter of 2024, risk of mortality was 0.78, or almost 22% lower than the baseline of 1 in 2019.

Based on this analysis, hospitals' safety efforts have helped 200,000 patients hospitalized between April 2023 and March 2024 to survive episodes of care that they would not have in 2019.

At the same time, rates of hospital-acquired infections, including central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infection (CAUTI), have decreased since 2019. Currently, CLABSI rates are at 0.7 out of 1,000 encounters, and CAUTI rates are at 13.51 out of every 10,000 encounters.

The report also found that there has been a significant increase in breast, colon, and cervical cancer screenings. In the first quarter of 2024, breast cancer screenings were 83.1% higher than the 2019 fourth-quarter baseline, colon cancer screenings were 82.3% higher, and cervical cancer screenings were 61.2% higher.

There were two phases of growth for these cancer screenings. The first occurred by the winter of 2020 when screening rates for these cancers collectively exceeded levels seen before the pandemic. Since then, expansions to screening guidelines and options have led to broader recommended age ranges and risk factors for testing, which has led to more people qualifying for screenings earlier. New, less-invasive screening methods, particularly for colon cancer, have also helped encourage more people to be screened.

Commentary

"This report shows hospitals have made significant improvements on pre-pandemic performance in key patient safety outcomes," AHA CEO Rick Pollack said in a release. "Hospitals' commitment to improving patient outcomes and enhancing the patient experience continues to drive these efforts forward."

Similarly, Chris DeRienzo, AHA's chief physician executive, said, "We've heard the narrative that we lost ground during the pandemic and we still haven't gotten back to those levels. This evidence shows that's not true."

According to DeRienzo, high-level mortality improvements were due to quality initiatives implemented at individual hospitals, rather than one, industry-wide influence.

For example, MaineGeneral Health said that stabilization and thorough training of its workforce since the pandemic has helped it improve infection rates and error prevention. Steven Diaz, the system's CMO, also noted that it has reduced its reliance on travel nurses, implemented more standardized processes for patient care, and rewarded clinicians for speaking up about potential safety issues.

However, Diaz said that even with these changes, hospitals' efforts to improve care quality will never be done. "There's more procedures, more medications, more things we can do for patients to try to help them, and we need to never let our guard down," he said. "We always have to be vigilant."

"Hospitals' commitment to improving patient outcomes, advancing equity of care, and enriching the patient experience continues to drive efforts," AHA wrote. "The data in this report underscore the resilience and unwavering commitment of hospitals and health systems — and the millions of hospital team members across the country — to delivering better care and outcomes to the patients and communities they serve." (Reed, Axios, 9/12; Devereaux, Modern Healthcare, 9/12; Muoio, Fierce Healthcare, 9/12; AHA report, accessed 9/12)

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