Partnership for Patients - Frequently Asked Questions
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1. What is the Partnership for Patients?
2. What are the goals of the Partnership for Patients?
3. How does the Partnership for Patients align with the MHS Strategic Priorities?
4. Does each MTF need to pledge to be a part of the Partnership for Patients?
5. Do we have a Concept of Operations (CONOPS) from DoD?
6. How will the MHS be involved with the Partnership for Patients?
Roles in the Partnership for Patients
7. What is the role of the Partnership for Patients?
8. What is the role of the DoD Patient Safety Program (PSP)?
9. More specifically, what is the role of the DoD PSP’s Patient Safety Analysis Center (PSAC)?
10. More specifically, what is the role of the DoD PSP’s Patient Safety Solutions Center?
11. What is the role of the Service Headquarters?
12. Who are the key players within the Services and what are their roles?
Data & Metrics
13. How will data be collected from the MTFs by the DoD PSP?
14. What type of data will be collected?
15. Where will the data be pulled from?
Facility-Level Guidance
16. Would you recommend facilities make the recommendation to their Leadership or formulate a group?
17. How should information be briefed to MTF Leadership?
18. How can facilities prepare for this initiative?
Alignment & Support
19. What are the current Patient Safety and Quality initiatives in place to reduce hospital acquired conditions?
20. How can the MHS improve care transitions to reduce hospital readmission rates?
21. What does the DoD PSP provide to support the Partnership for Patients?
22. Does the Partnership for Patients pertain to both inpatient and outpatient facilities?
23. How is this different from what has been done through the National Patient Safety Goals (NPSGs)?
24. What are the current marketing strategies?
25. Contact Information
In April 2011, the White House Administration unveiled a new patient safety initiative, Partnership for Patients: Better Care, Lower Costs, a public-private partnership to improve the quality, safety, and affordability of health care for all Americans. Led by the Secretary of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS), the Partnership for Patients initiative highlights the administration’s priority to improve the quality of health care delivery. To date, over 2,000 public and private health care facilities have signed a pledge promising to work toward achieving these ambitious goals.
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The Partnership for Patients aims to reduce preventable injuries and cut hospital readmissions in the next three years.
- Goal 1 - Preventing additional injury and illness: Increase efforts to prevent patient harm in hospitals by the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010.
- Goal 2 - Helping patients heal without complication: Improve continuity and effectiveness of care during transitions from one care setting to another. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010.
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The Military Health System (MHS) has joined the Partnership for Patients and has agreed to work toward making hospital care safer, more reliable and less costly. The goals of the Partnership support the Quadruple Aim, and will help the MHS achieve lower per capita cost, and improve population health, experience of care and overall military readiness.
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No. Dr. Jonathan Woodson, the Assistant Secretary of Defense for Health Affairs, signed the Partnership for Patients pledge on June 7, 2011, dedicating support on behalf of the entire Military Health System (MHS).
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The CONOPS will be posted to the DoD Patient Safety Program web site once the final version is complete.
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Specifically, the MHS will work to:
- Provide resources for technical support to physicians, nurses and other clinicians to test large-scale implementation of care delivery models that make patient care safer and to support effective transitions of patients from hospitals to other settings. The MHS will customize these tools to meet the local needs of different settings and clinicians.
- Develop better measures for the quality and safety of care that patients receive, help support hospital efforts to improve care, and provide better information to help consumers and employers in their decision-making. The MHS will develop these measures through public processes, with the goal of reducing the burden on providers while collecting the best information possible.
- Learn from, and partner with, the private sector in using incentives to drive improvements in health care safety, quality and value. The MHS will encourage innovation, while recognizing that the payment systems between hospitals, providers and private payers vary by facility.
- Ensure that MHS facilities implement proven tools to reduce hospital-acquired conditions and facilitate better care transitions.
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Roles in the Partnership for Patients
In support of the Partnership for Patients, the recently formed Innovation Center at CMS intends to test models of safer care delivery and promote implementation of best practices in patient safety. CMS will also invest in a Community-based Care Transition Program created by the Affordable Care Act to support hospitals and community based organizations in helping Medicare beneficiaries at high risk for readmission to the hospital safely transition from the hospital to other care settings. The learnings from these initiatives will provide best practices to organizations aligned with the Partnership for Patients.
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As part of this effort, the PSP will work to promote practices that reduce hospital-acquired conditions and hospital readmissions, and collect, analyze, and report progress in administering safer care and improving military readiness. The DoD PSP will guide the MHS effort to achieve the aims laid out by the Partnership for Patients.
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In support of the Partnership for Patients, the PSAC will be responsible for analyzing data related to hospital-acquired conditions and hospital readmissions and reporting this data to PSP leadership, as well as the Patient Safety Solutions Center (PSSC). Within the DoD PSP, the PSAC tracks and trends data to analyze and report patterns identified through patient safety reporting, sentinel events notifications, root cause analyses and failure modes and effects analyses. From these data, the PSAC develops actionable information from which solutions and mitigations are formulated to prevent further harm and improve the administration of health care across the organization.
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As part of the Partnership, the PSSC will identify and/or develop actionable solutions to reduce hospital-acquired conditions and readmissions, and communicate these recommendations out to the field. The PSSC provides education, training and best practices aimed at improving performance, advancing safety and quality in the experience of care and eliminating preventable harm. The PSSC leverages findings from the PSAC to address leading causes of harm and take advantage of opportunities to make care safer.
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The Services will be responsible for ensuring that their Service is achieving the goals of the Partnership at the aggregate level. Service Headquarters will be accountable for ensuring that their Service is making progress against the goals in a timely fashion, and Service-level progress against the goals will be regularly reported by DoD PSP to the Clinical Proponency Steering Committee (CPSC).
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The DoD PSP will rely on MTF leadership, MTF Commanders, Patient Safety Managers, Quality Managers, Risk Managers, change teams, and other designees and support staff tasked with improving quality and patient safety, who will be responsible for supporting initiatives within their facilities.
See the reporting structure and accountability chart below:
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Data & Metrics
Metrics will be collected from MTFs (hospitals and clinics), excluding facilities in combat zones and purchased care. The DoD PSP and partners will establish baseline data based on information gathered in 2010 related to hospital-acquired conditions and readmissions. The DoD PSP will aggregate data from the Services and report a single number on behalf of the entire MHS to mitigate variation of demographics of beneficiary populations at individual facilities.
See key milestones below:
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Data will be gathered relating to hospital-acquired conditions, including (as defined by the Partnership for Patients):
- Adverse Drug Events
- Catheter-Associated Urinary Tract Infections
- Central Line Associated Blood Stream Infections
- Injuries from Falls and Immobility
- Obstetrical Adverse Events
- Pressure Ulcers
- Surgical Site Infections
- Venous Thromboembolism
- Ventilator-Associated Pneumonia
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Sources for hospital-acquired conditions data include the Patient Safety Reporting (PSR) system, National Perinatal Information Center (NPIC) data, and the National Healthcare Safety Network (NHSN) out of the Centers for Disease Control (CDC). The PSAC aims to develop a methodology for aggregating data from these different sources that is consistent with the definitions, parameters, and methodologies of other groups in the Partnership.
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Facility-Level Guidance
To encourage staff support and help achieve success, it will be critical to obtain buy-in and generate appropriate support for the initiative. It is recommended that you first notify Leadership of your intentions and engage leadership for permission to create a work group. If leadership is appropriately supporting initiatives and promoting recommendations and successes in facilities, staff is much more likely to be engaged in efforts. Next, formulate a work group of multi-disciplines in your facility enabling you to look at what current measurements and actions each discipline across your facility is focused on. This will allow you to determine which best practices may be most applicable.
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Facilities should engage leadership by informing them of the following, for example:
- We are on board with this initiative
- What we are currently measuring in line with the focus areas of the Partnership for Patients
- We have implemented some of our best practices; and what plans we are formulating to close the loop to align with the initiative
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Facilities can access the following resources available through the DoD Patient Safety Program:
PSLC: To prepare, Patient Safety Managers (PSMs) can log in to the Patient Safety Learning Center (PSLC). The PSLC includes a section for Partnership for Patients that addresses the question “What Is It?”
Webinars: The DoD PSP offers the following useful links to Patient Safety Learning Circles and webinars focused on the Partnership for Patients:
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Alignment & Support
Currently within the MHS, there are several existing initiatives and interventions designed to improve the safety, quality, and coordination of care delivered to DoD beneficiaries. These programs and strategies support and align with the goals of the Partnership for Patients. Below are the interventions in place right now:
- Patient-Centered Medical Home (PCMH) - A team-based model, led by a personal physician, which provides continuous, accessible, family-centered, and comprehensive healthcare in order to achieve the best outcomes for patients. A PCMH practice is responsible for all of a patient’s healthcare needs and for coordinating/integrating specialty healthcare and other professional services as needed.
- TeamSTEPPS® - An evidence-based teamwork system designed to improve the quality, safety, and efficiency of patient care in an effort to optimize clinical outcomes by improving communication and other teamwork skills among healthcare professionals. TeamSTEPPS produces highly effective medical teams that optimize the use of information, people, and resources to achieve the best outcomes for patients and eliminate barriers to quality and safety.
- Medication Reconciliation - An important process by which to combat potential medication errors. Medication Reconciliation is a multi-step and ongoing process defined as “the process of creating the most accurate list possible of all medications a patient is taking — including drug name, dosage, frequency, and route — and comparing that list against the physician’s admission, transfer, and/or discharge orders, with the goal of providing correct medications to the patient at all transition points within the hospital”.
- Patient Safety Reporting System (PSR) - A web-based application that standardizes event reporting across the MHS and allows for the ability to capture, track, and analyze patient safety event information. Military Treatment Facilities (MTFs) are able to easily access, aggregate, and trend their data to identify risks to patient safety and opportunities for process improvement.
- Universal Protocol - Established by The Joint Commission in 2003 and became effective in 2004 for all accredited hospitals as a mechanism for preventing wrong site, wrong procedure, and wrong person surgery. The Universal Protocol is built on three key components: pre-procedure verification, site marking, and pre-procedure time out.
- Patient Activation - Patients and families must be actively engaged in decisions about their care and must have broader access to information and support. Activated patients are goal-oriented, possess a good knowledge base, and are capable of achieving self-care best practices. Related tools are forthcoming.
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The DoD Safety Program recommends that the Services implement the Institute for Healthcare Improvement (IHI) How-to Guide: Creating an Ideal Transition Home, as an evidence-based, tactical framework and tested approach for reducing hospital readmissions by addressing the safety and quality issues associated with coordination of care across the continuum and as a patient is transferred between care settings (“home” in this case is used generally to mean transfer into any other care setting following an admission into acute care).
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The DoD PSP has many resources to offer that can help support the initiatives outlined in the Partnership for Patients. The following support services and strategies are available to help build a community of interest and share best practices:
Patient Safety Learning Center
The PSLC is a member-based community wiki that allows multiple users to create, modify and organize Web page content in a collaborative manner. The PSLC provides secure online discussion forms, file sharing and storage, lessons learned and best practice sharing, and community calendars. PSLC members can use the PSLC as a forum to share best practices and initiate discussions around meeting the goals of the Partnership. Also available to PSMs on the PSLC are focus reviews that identify and analyze patient safety trends, and recommended solutions to mitigate risk. Several of these topics are included in the CMS-recommended list of hospital-acquired conditions. The PSLC is a DoD-only site, and can be accessed through the PSP website at http://health.mil/dodpatientsafety/ProductsandServices/PSLC.aspx.
Commanders Forum
The PSP Commanders Forum was created to secure, promote and sustain wide-spread support of MTF Commanders in creating and leading a culture of safety in medical facilities across the MHS. The Forum seeks to advance the DoD PSP goals with the understanding that leaders (Commanders) must direct the required change in safe practices. The Forum is a ‘safe’ environment where Commanders can share successes and challenges, celebrate the impact of safe practices on patient care, engage the wisdom of the Forum, connect available solutions, and share hard-fought lessons learned related to the Partnership’s goals.
Patient Safety Planning and Coordination Committee
The Patient Safety Planning and Coordination Committee is made up of PSP leadership, patient safety leads from Service headquarters and other leadership from the Office of the Chief Medical Officer. The PSPCC supports the efforts of the Partnership, and PSPCC meetings provide an opportunity for program leadership to disseminate information related to the Partnership, and for all attendees to share best practices and lessons learned. The PSPCC convenes approximately every six weeks, providing regular opportunities for status updates.
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Yes, this initiative pertains to both inpatient and outpatient facilities. This is particularly the case in addressing readmissions, which requires careful coordination among various levels of care. Of note, civilian facilities that partner with the DoD to provide services may also have pledged to participate in the Partnership for Patients.
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The Partnership for Patients is in alignment with the National Patient Safety Goals, and builds on them with a goal of 40% reduction in preventable hospital acquired conditions. The NPSGs target harm reduction in various clinical and procedural areas, such as healthcare-associated infections, patient identification and medication safety. These are in direct alignment with the Partnership for Patients focus areas. While there is no patient safety goal that specifically addresses readmissions, good practices that relate to readmission prevention are incorporated into the NPSGs.
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At this time, efforts have begun to market the Partnership for Patients initiative on a large scale. The DoD PSP, Service leads, and civilian organizations have utilized different methods and resources for heightening awareness, including:
- 150 Articles
- JAMA, American Medical News, WSJ blog, The Remington Report
- 300+ blog posts, Facebook links, and Twitter #HHSPFP hits posted post-launch
- Webinars and various online information sessions
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For more information, please contact the DoD Patient Safety Program at patientsafety@tma.osd.mil.
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