Hospitals improve in patient safety, even compared to pre-pandemic levels: Study

Hospitals are making strides in patient safety and quality measures, a new report suggests.

Hospitals have made strides in improving patient safety, including reductions in hospital-associated infections, according to a new report from the American Hospital Association.

In fact, hospital performance in some measures are now surpassing pre-pandemic levels, according to an analysis done by Vizient and released Thursday by the American Hospital Association.

On average, patients in hospitals were 20% more likely to survive in the first quarter of 2024 than in the fourth quarter of 2019, the analysis found.

Patients treated in hospitals were generally suffering more acute and complex illnesses in the first three months of 2024 than those examined in 2019, yet outcomes still improved, according to the study. And hospitals treated more patients in the first quarter of 2024 than in the last quarter of 2019.

Chris DeRienzo, MD, chief physician executive and senior vice president for the American Hospital Association, says the report illustrates the progress hospitals have made in patient safety. He also says it’s significant that the analysis utilizes much more recent data than other reports examining safety metrics in hospitals.

“The evidence is clear that hospitalized patients are even safer today than they were in 2019, and that holds true across numerous crucial measures of patient safety,” DeRienzo tells Chief Healthcare Executive®.

“It excites us because we know how committed hospitals are, and obviously the people who work within those hospitals, to driving continuous improvement in patient safety and in clinical outcomes,” he says.

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Reduced infections

Vizient examined 715 general acute care hospitals in 49 states and Washington, D.C. The company examined data from 18 quarters between the fourth quarter of 2019 and the first quarter of 2024.

Hospitals experienced fewer central line-associated bloodstream infections and fewer catheter-associated urinary tract infections in the first quarter of 2024 than in 2019, the report found.

“What we're seeing in these hospital-acquired infections is evidence of the ongoing commitment to do the hard work needed to keep raising the bar of excellence,” he says.

Hospitals are seeing a rebound in volume, after a dip compared to the heaviest months of the pandemic, followed by some COVID-19 spikes as patients sought treatment after deferring some healthcare needs. Hospital discharges have dropped since the worst of the pandemic, but they are a bit higher than in 2019 (a 1.6% increase).

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Sicker patients

Hospitals are admitting patients with more serious or complex conditions in 2024 than five years ago. The report states that patient acuity in early 2024 was 3% higher than in the last three months of 2019.

Hospitals are seeing better outcomes despite dealing with sicker patients, the analysis found. According to the AHA's projections based on Vizient’s data, 200,000 Americans who were admitted to hospitals between April 2023 and March 2024 survived illnesses and conditions that would have proven to be fatal five years earlier.

The analysis found a drop of about 20% in the risk of mortality in 2024, compared to 2019. “That is a substantial improvement,” DeRienzo says.

The report also found that screenings for certain cancers, including breast cancer, cervical cancer, and colon cancer, have reached higher levels than in 2024. Screenings for breast cancer and colon cancer were more than 80% higher in the first quarter of 2024 than in the last quarter of 2019, the study found.

The analysis includes a wide range of hospitals, and DeRienzo says the study reflects more than large academic systems. The average hospital included in the hospital had about 200 beds. While the largest hospital had 1,500 beds, the study also included a 22-bed hospital.

“This is a broadly representative sample of hospitals that make up the fabric of health care in this country,” DeRienzo says.

Other studies have shown hospitals faring better when it comes to patient safety.

The Leapfrog Group found hospitals were reporting a significant drop in infections in their Spring 2024 Hospital Safety Grades. The patient safety organization, which releases its safety grades twice a year, also found solid gains in the fall of 2023.

Room to improve

The uptick in safety and quality measures comes after hospitals saw higher rates of infections and other troubling signs during the height of the COVID-19 pandemic.

Federal officials said the COVID-19 pandemic eroded gains in patient safety. In an analysis published in the New England Journal of Medicine in February 2022, they cited sharp increases in infections. While officials conceded that hospitals faced unprecedented challenges, they also said they were worried that declines in patient safety occurred so quickly.

DeRienzo says it’s important to realize “how hard battling a once-in-a-century pandemic can be.”

“What we walked through with the COVID-19 pandemic was a once-in-a-century challenge, a challenge to healthcare, but also a challenge to society,” he says. “And so we've learned a lot, no question.”

Hospitals faced a disease course far different than the health system had experienced before, and doctors and researchers have generated an enormous amount of data and evidence to improve patient safety.

“We have built a significant amount of resiliency and a significant amount of experience,” DeRienzo says.

While the report outlines important progress in safety measures, DeRienzo says there’s still room for hospitals to get better.

“Our intent here is not to say: mission accomplished,” he says.

Hospitals are working to improve, and he says improving safety requires an ongoing effort.

But DeRienzo says it’s gratifying to see tangible progress.

“It's a reflection on the commitment of a workforce that we know has been through a lot,” he says. “You know, the kinds of improvement that you see here in the inpatient side, in the dramatically increased rates of preventive screenings for cancer, that doesn't happen without a deep commitment of the clinicians who are doing the work at bedsides, and all of the people who support them across hospitals and health systems.”