Institute for Healthcare Improvement's Tejal Gandhi on building a culture of patient safety in hospitals and at home

The IHI Chief Clinical and Safety Officer discusses what it takes to make a real dent in patient safety issues plaguing hospitals today.

When the National Patient Safety Foundation and the Institute for Healthcare Improvement merged in May, its leadership sought to create a stronger voice for patient safety. They discussed the work they were doing in the safety space and realized their efforts were complementary -- not duplicative.

So for the last six months, the now single patient safety group has been concentrating on consolidating and implementing initiatives to further its mission, according to IHI Chief Clinical and Safety Officer Tejal Gandhi.

IHI/National Patient Safety Foundation is working within four main buckets: the advancement of safety as a public health issue, establishing a workforce with a culture of patient safety, leadership education and building best practices tools, explained Gandhi.

Creating a culture of safety

The industry is still not where it needs to be in talking about safety.

“We need to focus on improvement,” Gandhi said, “instead of punishment.”

To begin making a real dent in patient safety, it’s crucial to engage leaders and board members to foster a culture of safety within an organization. These tools help organizations improve care outcomes while creating a fair and just culture around patient safety.

In May, IHI/National Patient Safety Foundation drafted key steps for leaders to begin making that shift. Included in the necessary elements are the need for a designated safety officer who reports to the CEO and is tasked with driving the safety mission.

Hospitals should also create a reporting system, along with simulations of both possible adverse events and reenactments of adverse events that have happened at their organization.

Leadership should also conduct safety briefings and involve patients in safety initiatives, among others. Gandhi explained that while there has been significant advancements in patient safety in the last few years, there’s still a long way to go.

“Twenty years ago when I started, people didn’t even know there was an issue with errors and harm,” said Gandhi. “We’ve made a lot of advancement in patient safety over the years.”

Focusing on what matters most

For Gandhi, the most drastic changes can be seen in education and training of nurses and physicians, which never happened before. Not only that, but hospitals have also created safety teams that add a human element not seen before in healthcare.

“We’ve made progress in medical errors, infections, readmissions have seen significant reduction,” said Gandhi. “It’s not that we’ve not made a lot of improvement, but we still have a long way to go.”

The issues vary by settings, but “one of the biggest issues is that we don’t know enough about the settings outside of hospitals,” explained Gandhi. More effort is needed to determine patient risk at home, after care.

However, the continued healthcare debate and the dramatic changes posed in Congress is serving as a distraction for the industry.

“Our biggest challenges that hospital leaders are really putting a lot their attention into those issues, as it affects reimbursement,” said Gandhi. “I can see why it’s on the mind of leaders -- but we want to make sure to help them keep their focus.”

“There are so many competing issues,” she continued. “How do we keep their eyes on the core issues?”

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