Top patient safety pain points and where to focus improvement efforts

Begin by eliminating the false sense of safety that manual reporting produces and, from there, target these key areas.
By Bernie Monegain
08:37 AM
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Many healthcare organizations are working to improve patient safety but serious challenges remain.

Medical errors are among the leading causes of death in the U.S. and non-lethal harm occurs even more frequently – at a rate 10 to 20 times higher than deaths, according to The Journal of Patient Safety

A big part of the problem is the fact that determining exactly where to focus patient improvement efforts is a difficult, if not a daunting decision for most organizations.  

Let’s take a look at what needs improvement and some areas hospitals should address. 

Patient safety obstacles

Analytics vendor Health Catalyst on Thursday published the results of research outlining common hurdles in the way of patient safety efforts. 

It’s worth pausing here to note that Health Catalyst just last week announced a patient safety app -- and as is often the case with vendor research and reports, readers should consider the findings aware that they support the company’s efforts to sell products or services. 

[Also: EHRs can improve patient safety - if they're optimized well]

The research found that obstacles to patient safety include ineffective IT (such as early or real-time warning system for adverse events), lack of staffing and budgetary resources, organizational culture, competing priorities, changes in population or practice settings and the bottom line reality that hospitals do not get directly reimbursed for patient safety initiatives. 

Organizations’ lack of effective information technology for patient safety is tied to a related finding from the survey – that even in the digital age, healthcare providers of all types are almost completely dependent on manual methods of tracking and reporting safety events.

A false sense of patient safety 

Standard approaches to manual reporting of hospital safety events have been shown to find less than 5 percent of all-cause harm, Health Catalyst noted. Moreover, manual reporting is based on data that is at least 30 days old, and it requires extensive time and resources for data extraction, aggregation, and reporting, resulting in limited root-cause analyses.

“Recent evidence continues to demonstrate that the majority of patient harm goes undetected – evidence that challenges voluntary reporting as an effective patient safety management strategy,”  said Stanley Pestotnik, Health Catalyst vice president of patient safety products. “The current approach to using voluntary reporting to monitor patient safety gives healthcare organizations a false sense of tackling the ever-present danger of patient harm.” 

Illustrating that false sense, researchers found that 79 percent of the 462 medical, quality and pharmacy professional survey participants rated their success in improving patient safety either “somewhat good” or “very good,” while 11 percent rated their patient safety efforts as “poor,” and 9 percent gave their efforts an “excellent” grade.

Where to focus patient safety efforts 

Now that manual reporting has been tied to delusions of success, what can hospitals do to actually improve patient safety? Plenty, in fact.

Valere Lemon, a senior subject matter expert for Health Catalyst, suggested that surveilling “all-cause harm” would help bridge the gap from niche-focused improvements to proactive harm identification, which would result in broader patient safety improvements.  

Further, when asked to identify the areas where patient safety most needs improvement, survey takers rated the top four as inpatient clinical, operations, severity-of-illness and outpatient/ambulatory clinical. 

In addition to homing in on those key areas, respondents listed the factors that are most influential in driving patient safety efforts: regulatory reporting led the pack, followed by financial considerations (value-based contracts, reduce reimbursement and malpractice among those), accreditations and designations, patient satisfaction scores, data-driven organizational priorities, performance against safety measures, and brand recognition for market competition, among others. 

“The big picture is that although a small portion of respondents felt they have a good handle on their patient safety efforts, most still believe they have room for improvement,” Lemon said. 

Twitter: @Bernie_HITN
Email the writer: bernie.monegain@himssmedia.com