|Four Patient Safety Trends|
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.
Patient advocacy. In
2020, there will be two primary forces at play in patient advocacy, Benedicto
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,"
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.
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,"
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."
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
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.
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."
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
from "Four Patient
Safety Trends for 2020," HealthLeaders, by Christopher
Cheney, Jan. 8, 2020.