CDC and CMS Report Alarming Decline in Patient Safety During Pandemic
An analysis by the CDC and CMS indicates important metrics in patient safety reversed during the COVID-19 pandemic.1
Central line-associated bloodstream infections (CLABSIs) in U.S. hospitals had dropped by 31% in the five years before the pandemic. But in the second quarter of 2020, CLABSIs increased by 28%, compared to the same quarter in 2019. Catheter-associated urinary tract infections (CAUTIs) and ventilator-associated events also increased.
“The public health emergency has put enormous stress on the healthcare system and disrupted many normal activities in hospitals and other facilities,” the authors wrote. “Unfortunately, these stressors have caused safety problems for both patients and staff.”
Skilled nursing facilities (SNFs) also saw declines in patient safety. Falls causing major injury at SNFs rose by 17.4%, while pressure ulcers increased by 41.8%.
“U.S. healthcare safety has declined severely, suggesting that our system lacks a sufficiently resilient safety culture and infrastructure,” the authors concluded.
It is important for risk managers to look at their own data to determine if the same declines occurred within their own organizations.
“Now that we are looking at a more stable period heading into the endemic phase, they also should look to see if you are seeing a quick recovery or a slow recovery of these safety indicators,” says Lee A. Fleisher, MD, lead study author, professor of anesthesiology and critical care at the University of Pennsylvania Perelman School of Medicine, and chief medical officer and director of the CMS Center for Clinical Standards and Quality. “For many systems, where they saw a dramatic detriment, look at how you build back. It’s more about the culture, so that when another emergency occurs you will be more resilient and won’t see this decline in safety indicators.”
Fleisher notes the lessons from the pandemic can be applied to any future stressors, such as weather emergencies, and not just another disease crisis.
“The emergency preparedness plan every organization has may be limited and be understood by a limited number of people,” Fleisher says. “Practicing that plan may be one of the best things you can do.”
- Fleisher LA, Schreiber M, Cardo D, Srinivasan A. Health care safety during the pandemic and beyond — building a system that ensures resilience. N Engl J Med 2022;386:609-611.
- Lee A. Fleisher, MD, Professor of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Email: [email protected].
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