CMS Partnership to Drastically Cut Errors

Donald M. Berwick, MD, MPP


July 13, 2011

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Hi. I'm Don Berwick, a pediatrician and the Administrator for the Centers for Medicare and Medicare Services (CMS). I want to tell you about an exciting -- and unprecedented -- project that CMS and our partner agencies in the Department of Health and Human Services launched in May. We call it, "The Partnership for Patients." It has 2 simple goals: better care and lower cost by improving care.

The Partnership for Patients is a public-private partnership. It's a broad collaboration -- including hospitals, doctors, nurses, and consumer advocates; CEOs from major companies, state officials, and more. All of these partners have signed a pledge to work to keep patients from getting injured in healthcare and helping them heal without complications. The US Department of Health and Human Services is investing $1 billion from the Affordable Care Act to help achieve these shared goals.

The Partnership has set concrete and thrilling objectives. By the end of 2013, we aim to cut preventable hospital-acquired conditions -- avoidable complications that patients get in hospitals -- by 40%. We're talking about problems like pressure ulcers, nosocomial infections, medication errors, and falls, for example. We also aim to reduce preventable hospital readmissions by 20% -- the sorts of readmissions when, say, a patient with congestive heart failure goes home from the hospital and then bounces back in within a few weeks because the handoff to primary care doesn't go well, and no one recognizes that the patients is gaining back weight from edema or is failing to get onto the proper medication regimen.

If the Partnership for Patients is successful, our country will have 1.8 million fewer healthcare-acquired injuries to patients over the next 3 years. More than 1.6 million patients will recover from illness without going back to the hospital within 30 days of discharge. And we will have saved 60,000 lives.

This is something that every single doctor, nurse, and other healthcare professional can participate in. Most of the time, when an injury occurs in healthcare, it's not at all the fault of the clinicians taking care of the patient. I know first-hand that when an error in care occurs and a patient gets hurt, doctors and nurses and other providers are doing everything they can to deliver the best care to patients. And the science of safety, which is actually quite well developed, confirms that. People get hurt when systems of care break down and fail to help the clinicians succeed in what they want to do most: give safe, superb care. Safety problems, by and large, are system problems.

We actually know a ton about how to make healthcare systems safer -- much safer. With proper improvements in designs, many hospitals, for example, have already virtually eliminated central venous line bacteremias and ventilator-associated pneumonias. And that's just the start. Supporting that change -- supporting better, safer designs in healthcare systems -- is the aim of the Partnership for Patients. This Partnership is a matter of making sure that you -- doctors, nurses, pharmacists, clinicians of all types, and hospitals -- all have the easy access you want and need to the best practices to craft your systems in a way that will reduce adverse events to patients. And, more good news, investing in saving lives and improving health has an indirect benefit: healthcare costs drop... a lot.

So far, the total number of Partners is over 3000. We hope that you will take the pledge too. Sustainable, high-quality, safe, and continually improving healthcare is not an imaginary target. It's real, it's feasible, and it's time.

Go to to learn more about the Partnership and find out how you can get involved. Thank you.


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