AHA Comments on AHRQ’s RFI on Creating a National Health Care System Action Alliance to Advance Patient Safety

The Honorable Robert Valdez, Ph.D.
Director Agency for Healthcare Research and Quality
5600 Fishers Ln.
Rockville, MD 20857

RE: Request for Information on Creating a National Health Care System Action Alliance to Advance Patient Safety, Dec. 12, 2022.

Dear Dr. Valdez:

On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) appreciates the opportunity to comment on the Agency for Healthcare Research and Quality’s (AHRQ) request for information (RFI) on the establishment of a new National Health Care System Action Alliance to advance patient safety. We commend AHRQ and the Department of Health and Human Services (HHS) for their leadership in focusing national attention on patient safety, a longstanding priority for the AHA and our member hospitals and health systems.

The establishment of the action alliance comes at a pivotal time for the health care field. Hospitals approach their patient safety work heartened by important gains made over the past few decades, but also realistic about the profound challenges facing health care. Prior to the COVID-19 pandemic, hospitals implemented robust changes that lead to tangible improvements in patient safety, including double-digit percentage reductions in healthcare- associated infections (HAIs) and other preventable adverse events. Yet, the aftershocks of the COVID-19 pandemic have left hospitals facing often severe staffing shortages, higher patient acuity and complexity, ongoing and unpredictable supply chain disruptions, and unsustainable rises in costs for drugs, supplies and labor. Data showing increases in some HAIs during the pandemic underscore how these circumstances have challenged hospitals’ ability to sustain the patient safety progress that hospitals anticipate and patients and communities deserve.

The AHA believes there is a tremendous opportunity to accelerate progress on patient safety by drawing on both past successes and lessons learned from the COVID-19 pandemic. Indeed, hospitals have never viewed delivering safe care as a one-time achievement. Rather, they recognize that it requires persistent focus and a relentless process of assessment, measurement, implementation, learning and improvement. In this context, we believe AHRQ’s Patient Safety Action Alliance can best support the field in advancing patient safety by:

• Aligning its efforts with other federal agencies to ensure federal efforts to accelerate patient safety complement one another;
• Prioritizing resources on addressing the most preventable adverse safety events;
• Engaging patients and providers along the full care continuum — including hospitals, post-acute care providers, behavioral health providers and clinician offices — to identify and advance opportunities for shared progress; and
• Backing the action alliance with robust logistical support to capture and broadly share important learnings and evidence-based care improvement tools.

Additional details on these recommendations follow.