Imagine you are the CEO of a 200-bed community hospital and have heard that Medicare hospital payments will continue to be trimmed for patients who experience harms considered to be largely preventable, such as blood clots, surgical infections, ventilator-associated pneumonias, and others. You want to make sure that your hospital prevents all possible avoidable harms to patients.

Imagine you are the CEO of a 200-bed community hospital and have heard that Medicare hospital payments will continue to be trimmed for patients who experience harms considered to be largely preventable, such as blood clots, surgical infections, ventilator-associated pneumonias, and others. You want to make sure that your hospital prevents all possible avoidable harms to patients.

Your assistant summarizes the issues for you: denied payments focus exclusively on additional care required to treat the injury (e.g., when a second procedure is required to retrieve a surgical instrument). To date, the denied payments are for hospital care only, but some analysts have recommended that the same policy be applied to physician payments.

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One measure your hospital has already taken is to require that all workers who interact with patients wash their hands, to prevent hospital-acquired infections. Although this would seem a simple and obvious initiative, it has met with limited success. In response to additional queries, you learn that the hospital’s patient safety department does not track the kinds of events for which it may be financially penalized.

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