The Affordable Care Act carries with it a carrot-and-stick approach to improving hospital safety. And while debate continues about the fairness and equity of the rewards and punishments, there’s no argument that hundreds of hospitals already are paying a steep price when they don’t measure up to the Centers for Medicare and Medicaid Services’ quality and safety measures.

That was readily apparent late last year when the federal government released records showing that Medicare payments to 721 hospitals were cut because these institutions had high rates of infections and other patient injuries. A Kaiser Health News analysis estimated the penalties at $373 million and noted that academic medical centers were hit particularly hard, with roughly half being penalized.

These penalties are in addition to other significant financial incentives Medicare has implemented. In short, financial penalties to hospitals are more severe than any prior government effort designed to reduce harm and improve safety.

Ironically, the penalties came at a time when hospitals were demonstrating success in reducing some avoidable errors. Yet, even with those improvements, the Agency for Healthcare Research and Quality noted that one in eight hospital admissions in 2013 included a patient injury.

These numbers, much like the penalties being levied, have caused everyone with a stake in improving patient safety to examine more closely the many and often interrelated factors that play a part in medication administration errors, patient falls, health care-associated infections and other areas of avoidable patient harm.

In the reports that follow, Health Facilities Management’s editors take a penetrating look at how the patient safety movement is shaping hospital design, operations and engineering, environmental cleaning and infection prevention, and the supply chain. The many experts we interviewed for these articles offer valuable insights that can help you and your team stay focused on the most important issues that can improve performance and create safer environments in which to deliver patient care. 

Bob Kehoe is a senior editor with Health Facilities Management.