Association Between Hospital-Acquired Harm Outcomes and Membership in a National Patient Safety Collaborative

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Health Services Research

Background:

• Hospital engagement networks (HENs) have reported success in reducing hospital-acquired harm.
• Methodological limitations and lack of peer review have raised questions about the effectiveness of HENs.
• The US Centers for Medicare & Medicaid Services Partnership for Patients program supports many HENs.

Purpose of the Study:

• To evaluate the association between membership in Children's Hospitals' Solutions for Patient Safety (SPS) network and hospital-acquired harm.
• To utilize standardized definitions and secular trend adjustment for a rigorous evaluation.
• To assess the impact of a specific federally funded hospital engagement network.

Main Methods:

• Prospective hospital cohort study including 99 children's hospitals.
• Interrupted time series analyses with staggered intervention introduction.
• Analysis adjusted for pre-existing secular trends, with evaluation of early-adopting and late-adopting cohorts.

Main Results:

• Membership in SPS was associated with reduced rates for 3 of 8 evaluated hospital-acquired conditions.
• Significant reductions observed in central catheter-associated bloodstream infections and falls of moderate or greater severity.
• Reductions in adverse drug events were also noted; early adopters showed greater decreases than late adopters.

Conclusions:

• Rigorous methods confirm an association between the HEN model and reduced hospital-acquired conditions.
• Findings strengthen previous claims regarding the effectiveness of this patient safety model.
• Inconsistent results across conditions warrant caution in attributing all observed effects solely to the HEN model.