Medical errors cause as many as 400,000 deaths per year in the United States alone, making it the nation's third leading cause of death. Patient safety advocates have begun to demand that a National Patient Safety Board be created to decrease the rate of preventable deaths, according to FierceHealthCare. It is undeniable that the healthcare industry requires patient safety reforms and a renewed dedication to improving care quality.
Robert Wachter, M.D., associate chair of the University of California at San Francisco's Department of Medicine and a patient safety expert, recently told audience members at a forum for the Institute for Healthcare Improvement that, "We are being pressured to change because we need to be pressured to change. The care that we have delivered and the system that we have concocted does not reliably deliver high-quality, safe and affordable care." He suggested a number of things healthcare leaders should consider to build safer hospitals:
Times have changed: While patient safety has always been paramount to hospital proceedings, it did not always have the business impact it does now. When the watershed patient safety report "To Err is Human: Building a Safer Health System," was released in 1999 the healthcare industry was not required to report on safety and patient satisfaction to receive payment. Things are much different today. Wachter predicts that 8 to 10 percent of hospital Medicare payments will depend on performance by 2017, meaning that the current trend is not going anywhere. Competitive pressures, steps towards transparent care and remuneration changes all demand that hospitals improve care quality.
Leadership: Healthcare is a team effort, with individuals across a variety of departments coming together to provide patient's with top-quality service. That doesn't mean that the hierarchy is disappearing. Leaders are essential to building hospitals that value safety and produce good outcomes. There should be individuals in the industry who are capable of making changes when they are needed, and who can recognize what facilities need to work on.
Think locally: Successful care improvement techniques aren't secrets to be learned from outsourced experts. "The answers to many of the questions that you're struggling with probably can be found under your roof," Wachter said. Look for strategies within an organization which are already being implemented. Departmental procedures are often tried and tested and can easily be adapted to the rest of the hospital.
Don't depend on incentives: Incentives are wonderful and can be a great motivator, but in the healthcare industry, which is dedicated to the service of others, clinicians usually find their drive in other places. Incentives are not the cure-all. Leaders should take advantage of pay-for-performance concepts such as those used by Medicare, but should also ensure that they are inspiring their workers in other ways.
Focus on people: It can be easy to get tunnel vision when focusing on improving a system as a whole, and forget that many safety and quality care issues must be solved by individuals. Doctors have the knowledge and skill to decrease diagnostic errors. Surgeons have the technical expertise required to produce the best patient outcomes. Nurses have the ability to interact with patients regularly and lower readmission. Organizations should make sure they are empowering individuals within the hospital to help them improve practices they are directly involved in.
Accountability without blame: Sometimes the only thing preventing a system from working is compliance. Ensure that employees are held accountable for errors that occur so that it is clear when failures are the fault of the system in place, and when something else entirely is causing the problem.
Hospitals and doctors can use programs like Patient Approved to judge where they can improve and where their services are meeting the needs of patients.