Providing Safe, Quality Care. How Are We Doing?

Providing quality patient care continues to be the underpinning of all patient experiences from hospital and long term care, to physician offices and community clinics. Quality, safe patient care impacts patient satisfaction, employee retention, and reimbursement. Have we made any progress since the 2002 publication Across the Quality Chasm? This Institute of Medicine’s (IOM) publication, written in response to the seminal treaty on patient harm titled To Err Is Human: Building a Better Healthcare System, still informs and guides quality initiatives today. The Institute of Medicine continued to bring focus to the patient safety movement with seven more publications highlighting rural health care, healthcare provider competency, communication and interdisciplinary teamwork.

Since 1970, the IOM’s goal, under the US National Academy of Sciences, has been to focus on utilizing evidence based research to make recommendations and provide guidance for the health of the general public as well as advising science policy. Beginning in 1996, the IOM began a healthcare quality initiative that involved three phases. To Err Is Human was published within the end of phase one (1999), bringing to light the challenges for providing quality care, and the devastating impact medical error has on individuals, communities and health care organizations. Across the Quality Chasm, published in 2002, laid the foundation and vision to promote safe quality care through the work of health care policy, and health system involvement. The IOM’s Six Aims of Quality continues to be the template in the ongoing phase three. Quality care should be Safe, Effective, Patient-Centered, Timely, Efficient and Equitable.

So how do we measure up, 17 years after the publication of To Err Is Human? Do we see less medical error and stronger, safer health care models for patient care? A recent report by researchers at Johns Hopkins University states that after an eight year review of data, more than 250,000 deaths in the US per year are due to medical error, and is the third leading cause of death. This increase in deaths is possibly due to the underreporting of medical error.

Great strides continue to be made in areas such as standardization of care and procedures, advancements in technology, and stronger leadership commitment to high reliability organizations.

Hospitals maintain  focus on several crucial areas to reduce error. First, involve the patient in their care by empowering and encouraging them to question, engage and partner with all health care providers in health care decisions. Next, monitor vulnerable populations and strive to eliminate disparities in healthcare. Third, make communication between all members of the health care team essential in all patient interactions. Finally, health care leaders must encourage a culture of safety, allowing all members of the health care team to not only safely report error, but be involved in ongoing safety plans and initiatives. All of these areas assist in becoming high reliability organizations. A highly reliable organization views safety as an ongoing, ever changing strategy to monitoring, reviewing and adjusting safety plans at every level of the organization.

Resources:

Agency for Healthcare Research and Quality. High Reliability. (2017). Retrieved from: https://psnet.ahrq.gov/primers/primer/31/high-reliability

Harvard Business Review. (2016). The Next Wave of Hospital Innovation to Make Patients Safer. Retrieved from: https://hbr.org/2016/08/the-next-wave-of-hospital-innovation-to-make-patients-safer

Institute of Medicine. (2001). Crossing the Quality Chasm: A new Health System for the 21^st Century. Retrieved from: http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf

Johns Hopkins Medicine. (2016). Study Suggests Medical Errors Now Third Leading Cause of Death in the U.S. Retrieved from: https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us

Managed Healthcare Executive. (2017). Four ways to reduce dangerous medical errors at your hospital. Retrieved from: http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/four-ways-reduce-dangerous-medical-errors-your-hospital?page=0,1

 

Written by Katie Cross, MSN, RNC-OB, Part-Time Faculty, Saint Joseph's College