IHI Helps Hospitals Prepare for New CMS Measures to Make Care Safer

This is a landmark moment for safe, person-centered care. The Centers for Medicare & Medicaid Services (CMS) recently announced two new structural measures that will help make care safer and better for millions of people in hospitals, including emergency departments and operating rooms. The measures were directly informed by IHI’s work on the National Action Plan to Advance Patient Safety and Age-Friendly Health Systems and together they represent a transformational shift in the policy landscape for patient safety and caring for older adults.

The Patient Safety Structural Measure and the Age-Friendly Hospital Measure were included in CMS’ Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals for 2025. IHI’s efforts to develop and advance the National Action Plan to Advance Patient Safety and the Age-Friendly Health Systems movement are specifically cited in CMS’ final rule. For many years, IHI and its partners have collaborated on these initiatives, and we regard the integration of many of the sentinel provisions into the prospective payment formula as an important moment for both patient safety and for age-friendly care of older adults.

Policy and payment are powerful levers for advancing change and ensuring adoption of evidence-based and best-known practices at scale. The collective efforts of our partners that have stewarded these measures now have the potential to shape the landscape of safety and older adult care, so that all patients receive the best possible care. 

Patient Safety Structural Measure (PSSM)

According to CMS, the Patient Safety Structural Measure (PSSM), “is informed by Safer Together: A National Action Plan to Advance Patient Safety, developed by the National Steering Committee for Patient Safety convened by the Institute for Healthcare Improvement (IHI), as well as scientific evidence from existing patient safety literature, and detailed input from patient safety experts, advocates, and patients.” This measure marks a pivotal shift toward potential payment for systems-level improvement across patient safety infrastructure, culture, leadership, governance, and engagement. 

Here’s how IHI supports hospitals preparing for the new measure: 

IHI convened and co-chairs the National Steering Committee for Patient Safety, and offers a number of resources to help hospitals prepare for the new measure: 

• Register for the IHI Forum and secure you spot in one of the following sessions: Half-Day Workshop (MH14) or General Session (C14) on the topic, “Actioning the National Action Plan and National Action Alliance: From Assessment to Results.”
• Attend an upcoming webinar with leaders from IHI and CMS to discuss the measure and how hospitals can prepare (details and registration will be available soon).
• Review Safer Together: A National Action Plan to Advance Patient Safety, which includes recommendations across four foundational areas that health care leaders can use to make significant advances toward safer care and reduced harm across the continuum of care.
• Take the online Self-Assessment Tool to get aligned on the recommendations and tactics in the National Action Plan (NAP).
• Join the Patient Safety Executive Professional Development Program, which kicks off this September 10. The program will provide direction on key strategic, clinical, operational, and cultural components involved in achieving safe and reliable operational excellence across multiple measure domains.
• Register for IHI’s course, Redesigning Event Review with Root Cause Analyses and Actions (RCA2), which begins September 10 and will align your team’s efforts when conducting event analysis of serious safety events as a critical component of your learning system, as described in the measure.
• Join the nearly 7,000 patient safety leaders who have earned  the Certified Professional in Patient Safety (CPPS) credential, demonstrating excellence in patient safety core standards so you can lead safety initiatives in your organization.​
• Stay tuned for information about a new safety recognition program from IHI. Contact IHI’s Jeff Salvon-Harman, MD, CPPS, at jsalvonharman@ihi.org to learn more. 

Age-Friendly Hospital Measure

The Age-Friendly Hospital Measure aims to “…ensure that hospitals are reliably implementing the “4Ms” (What Matters, Medication, Mentation, Mobility), and thus providing evidence-based elements of high-quality care for all older adults.” The measure will assess a hospital’s commitment to improving care for patients aged 65 years and older who receive services in the hospital, operating room or emergency department. The rule specifically notes, “The elements in the Age Friendly Hospital measure align with IHI’s and The Hartford Foundation’s national initiative for Age Friendly Systems in which many hospitals already participate.” 

Here’s how IHI supports hospitals preparing for the new measure: 

With the rule set to take effect in 2025, IHI invites hospitals to take action now to earn Age-Friendly Health Systems recognition:

• Attend a webinar hosted by IHI with leaders from CMS to discuss the specific measure and how hospitals can prepare (sign up for here to be notified of the date and details).
• Join the Age-Friendly Health Systems movement with nearly 5,000 other organizations.
• Register for an  Action Community to accelerate reliable practice of 4Ms care in hospitals.
• Start working toward earning Age-Friendly Health Systems Recognition.
• Enroll in IHI’s free Open School course: PFC 203: Providing Age-Friendly Care to Older Adults, which includes actionable steps to get started in the Age-Friendly Health Systems movement.
• Bookmark this page for Age-Friendly Health Systems resources and news (including getting started guides).
• Engage IHI’s consulting services to co-design solutions to help you prepare for the new CMS measure.

It is not an exaggeration to say that these new measures will help ensure that all patients and older adults receive the best possible care across care settings all over the US. At IHI, we are incredibly proud of the work from the thousands of health systems around the country that have informed these important changes. We now look forward to continuing to partner with hospitals that are working to make care safe, equitable, and reliable for all. 

Kedar Mate, MD, is the President and CEO of the Institute for Healthcare Improvement.

Photo by Caiaimage/Martin Barraud.

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IHI Urges Hospitals to Join Age-Friendly Health Systems Movement as CMS Enacts New Age-Friendly Measure for 2025