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Sharing patient safety data cuts number of surgical complications

by Brendon Nafziger, DOTmed News Associate Editor | October 19, 2010
A group of Michigan hospitals managed to drop surgical complications by nearly one-tenth through an innovative scheme that compelled the hospitals to share patient safety data with their rivals, according to a new study.

The results, which appeared Monday in the journal Archives of Surgery, suggest the health care system could save millions of dollars a year and prevent complications - like blood infections - by rewarding hospitals for swapping tips on how to improve patient safety.

In contrast to increasingly popular pay-for-performance schemes, in this "pay-for-participation" project, Blue Cross Blue Shield of Michigan and its Blue Care Network paid 16 hospitals simply for participating in a program, regardless of their results.

"We think this fosters a less competitive atmosphere," study author Dr. Darrell A. Campbell Jr., professor of surgery and chief medical officer at the U-M Health System, said in a statement on the health system's website. "They're willing to share their best ideas, and that's what makes the collaborative work."

The study compared general and vascular surgeries between 2005 and 2007, performed at the collaborating 16 Michigan hospitals before and after the patient safety data-sharing program started, with results from 126 other hospitals over the same period.

While mortality rates stayed the same for all hospitals, for the 35,000 or so patients in the Michigan program, complications fell around 9 percent after the sharing collaborative started, from 10.7 percent to 9.7 percent. There was no change in complication rates - at 12.4 percent - among the non-participating hospitals.

For the hospitals in the program, the greatest results were seen in blood infections, septic shock, pneumonia, prolonged ventilator duration and cardiac arrest, the study said.

The drop in complications could potentially result in big savings to the health system, according to Campbell. Ventilator-associated pneumonia after surgery adds $50,000 to the procedure costs, according to the study. Thus, a 1.8 percent drop in complications every year for three years could make up for the cost of the pay-for-participation system, according to the study.

"If this system was adopted nationally, not just in Michigan, I think you would find a greatly accelerated pace of surgical quality improvement," Campbell said.