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10 'Basic Patient Safety Reforms' to Save 85,000 Lives, $35 Billion

John Commins, for HealthLeaders Media, August 7, 2009

The consumer activist group Public Citizen says it has 10 basic patient safety reforms that could save 85,000 lives and $35 billion annually.

The report "Back to Basics," analyzes the results of several studies of treatment protocols for chronically recurring, avoidable medical errors. Most of the reforms in Public Citizen's report involve fundamentals as simple as practitioners consistently washing their hands, sufficiently tending to patients to prevent bed sores, and following simple safety checklists to prevent infections and complications stemming from operations.

The financial toll of failing to follow accepted safety procedures is astounding, PC says. Severe pressure ulcers cost an average of $70,000 apiece to treat. A catheter infection costs $45,000. Collectively, avoidable surgical errors cost an estimated $20 billion a year, bed sores $11 billion, and preventable adverse drug reactions $3.5 billion.

"There are many incentives to order expensive tests and procedures and too few rewards for providing basic, sensible care," says David Arkush, director of Public Citizen's Congress Watch division. "As the largest investor in the nation's healthcare system, the federal government should ensure that fulfilling basic patient safety standards is a condition of receiving federal reimbursements."

Public Citizen proposes that healthcare providers:

1. Use a checklist to reduce avoidable deaths and injuries resulting from surgical procedures (this would save $20 billion a year)

2. Use best practices to prevent ventilator-associated pneumonia (this would save 32,000 lives and $900 million a year

3. Use best practices to prevent pressure ulcers (this would save 14,071 lives and $5.5 billion a year)

4. Implement safeguards and quality control measures to reduce medication errors (this would save 4,620 lives and $2.3 billion a year)

5. Use best practices to prevent patient falls (this would save $1.5 billion a year)

6. Use a checklist to prevent catheter infections (this would save 15,680 lives and $1.3 billion a year)

7. Modestly improve nurse staffing ratios (this would save 5,000 lives and $242 million a year)

8. Permit standing orders to increase flu and pneumococcal vaccinations in the elderly (this would save 9,250 lives and $545 million a year)

9. Use beta-blockers after heart attacks (this would save 3,600 lives and $900,000 a year)

10. Increase use of advanced care planning (this would save $3.2 billion a year)

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