|Four Safety Trends for 2020|
Patient safety has been a pressing issue in healthcare, spurred by the publication of the landmark report To Err Is Human: Building a Safer Health System in 1999. Anne Marie Benedicto, a vice president at healthcare accreditor The Joint Commission, recently shared her thoughts regarding the patient safety outlook for this year. She detailed four ongoing trends she feels will dominate the safety landscape in 2020.
1. Patient advocacy. In 2020, there will be two primary forces at play in patient advocacy, Benedicto says. "Healthcare providers have become more commercial in how they track patients as 'customers,' and patients are becoming more like consumers and using those skills to help navigate the healthcare system. This means more and more patients feel they have a say in what diagnoses mean for them, how they are treated and how they engage with their care teams," she explains.
Health systems and hospitals are increasingly embracing patient advocacy. For example, Benedicto's division at The Joint Commission is working with a Texas-based health system to boost quality improvement skills in neonatal intensive care units. The effort initially focused on clinicians, but the health system wanted to achieve quality and safety gains through empowering patients' families as well.
"Our biggest surprise has been that the organization not only wanted clinicians trained in improvement skills, but also the patient advisory council. We also provided training to parents of babies who were in the NICU for long periods of time. We found that the training gave parents permission to talk about quality issues with clinicians in a way that we had not seen before," Benedicto says.
2. Improving the work environment. Ensuring adequate staffing at healthcare organizations is a key element of patient safety, and health systems, hospitals and physician practices need to step up efforts to care for caregivers, Benedicto says. "This is an ongoing trend because we are already seeing clinician shortages. We are not recruiting and retaining enough medical staff members to meet the demand."
She also stressed how healthcare organization leaders must shape work environments in ways that ease stress on staff members. For example, clinicians often struggle to find equipment or supplies such as medication pumps. It may be a small inconvenience, but repeated occurrences can add frustration and danger to an already stressful day. "The solution to this challenge is to put the proper systems in place, such as supply chain management, that make it easier for staff members to do their work."
3. High reliability. Falls with injury represent an example of a persistent patient safety problem that is actually a missed high-reliability opportunity, Benedicto says. "Often, an organization will target falls every couple of years, saying that their fall rates are unacceptable. They come up with a solution, put it in place, it lasts for a few months, then the old practices creep back."
There needs to be an understanding that persistent problems in healthcare persist because they are complex, and they require structured and sustained solutions, she says. "The use of highly reliable process tools is necessary to get to zero harm. It's not just a matter of picking the easiest solution and putting it in place. It's a matter of stepping back and figuring out why the problem is happening, finding out why it is persisting, looking at the contributing factors, then developing solutions."
4. Surgery center safety
Surgery centers need to adopt patient safety protocols that have become common at hospitals. With increasing numbers of procedures shifting from the hospital setting to ambulatory surgery centers, improving safety at these centers will be a top concern in 2020, Benedicto predicts.
"If patients can get care in less complicated settings, then those options should be pursued. However, this opportunity comes with a risk. Many surgical centers do not have the same levels of protection that hospitals have. For example, more and more spine surgeries are happening in surgical centers, and those centers may not know what to do when there is a serious complication."
"Over the past decade, hospitals have been investing in process improvement and improvement methodologies, so they could make their care as safe as possible. That same type of trend needs to happen in other settings of care such as surgery centers, Benedicto says. "Achieving zero harm not only requires embracing high reliability as a goal, it means making sure that resources are in place to get to that goal—stronger improvement skills, stronger safety culture, and leadership commitment to zero harm."