Patient Safety — Does Your Community Believe You?

The views, opinions or positions expressed by the author and those providing comments are theirs alone, and do not necessarily reflect the views, opinions, positions or strategies of Becker's Hospital Review.

If not, nurses unions will be happy to take advantage.

Much has been written about the patient safety issues confronting healthcare and the challenges healthcare providers face, not only for enhancing patient health, but doing so at the safest levels possible. During the last ten years, there has been a monumental focus on eliminating patient care errors through better process and reporting. Clearly, all the initiatives have resulted in better healthcare across the nation. As the delivery of healthcare advances technologically and increases in sophistication, the need to enhance patient safety efforts will also increase. Hospitals and care providers are up to the challenge, but there is one major component that has not been addressed: Do the communities that hospitals serve believe that patient safety has improved? In many cases, the answer is no.

Healthcare providers have always faced a key dilemma: How much of the organization's resources should be focused on improving safety, instead of promoting to the community its high level of safe care? Conventional wisdom would say that if hospitals actually provide a safe care environment, that would be clear to the community and there would be an overall belief that the hospital is safe. Most of the community perception develops due to a lack of negative care events, or at least a lack of knowledge of negative events. A hospital's reputation for safe, compassionate, excellent care is its most valuable intangible asset — its good will. Even though it is so valuable, typically very few resources are allocated to ensure that the public perceives that the hospital provides a safe care environment.

Hospital marketing budgets have increased during the last few years as the competition for patients has increased. There have been a number of very effective ad campaigns to increase the reputation of hospitals and to try to gain or maintain their patient base. Few marketing efforts, though, focus on patient safety. Most provide an overall positive picture of the hospital to enhance the communities' general perception. Safety discussions are even avoided because of the fear that highlighting safety does not diminish the communities' concerns but may actually raise questions.

The California Nurses Association and the newly minted National Nurses United (a handful of state nursing associations with the CNA in the lead), believe that the majority of communities have negative perceptions of patient safety in their hospitals, and that provides an excellent opportunity for the unions. In several recent cases, union leaders have been determined to use public disclosure of isolated unsafe care environments as a way to tarnish hospital reputations and to gain them bargaining leverage, or to force hospitals to allow unions to more easily organize nurses. Recent negative campaigns in California, New York, Massachusetts, Minnesota, Florida, and Michigan have all focused on unsafe patient care environments, even in highly prestigious and awarded healthcare facilities.

These unions have money, are motivated and are willing to embellish the facts to create a horrific picture for the community overall, as well as for future hospital patients, physicians and employees. The combination of money — in some cases tens of millions of dollars — and motivation can frequently make up for the unions' sometimes heavy handed and less polished approaches. The unions, though, continue to become more skillful in how and where they attack. Unions are maximizing the use of social media and turning nurses into union agents that look for everyday issues and create clandestine video footage of a leaking pipe in a patient room, a patient in a soiled bed, an infected surgical site or off-handed remarks by hospital executives. These tactics have become the norm, even if they violate hospital policy and federal law.


News outlets have become much more competitive, and they fear that a video may go viral without the local newspaper, radio or television station being aware. This fear of becoming irrelevant has resulted in the willingness of these traditional media outlets to publish or air unsubstantiated reports before any research is made as to the legitimacy of the claims. The media, then, could become, a complicit partner in the union's attempt to diminish the public's view of the hospital.

Just the threat of a well funded public attack can be sufficient for hospitals to alter their positions and make decisions which are not in the best interest of the future of the hospital or the community at large. The ground is fertile for patient safety attacks because, in most cases, little has been done to build a community attitude that the hospital is a safe place to receive care.

The nurses unions are particularly adept at painting a picture that the registered nurse is the only person in the hospital truly concerned about the safety of the patients. Their message conveys that physicians and hospital executives have all sold out to financial gain at the expense of the patient. The word 'corporate' has become especially derogatory, and the recent protests against Wall Street and banks has helped feed community perception that the hospital leadership and historical caretakers — the physicians — can no longer be trusted to ensure a safe care environment.

Although these union tactics are not new, the level of attack and the current social and political environment have created a much more receptive audience. Many in the community no longer see the hospital as a community asset, like schools and parks, but more like a big business with greater concern for financial success than for the public good.  

What can hospitals do?
With this whirlwind of union activity, what can hospitals do to diminish the impact and effectiveness of these patient safety attacks? Simply put, hospital leadership needs to take back the patient safety mantle from the union and promote to the public that the top priority of the hospital is to provide safe care. If the community at large trusts that hospital leadership and physicians are foremost concerned about patient safety, then the union attacks can simply be diminished by exposing them as negotiating tactics that do not truly reflect the state of care at the hospital. If the first real public discussion about safety is in response to a union attack, the battle is already lost.

A well funded, long-term and carefully orchestrated campaign to mold the community perception of patient safety should be a top priority. Having care givers, physicians, and nurses speak of the commitment by hospital leadership for patient safety, and providing examples of such, should be at the core of any public campaign. Including discussions in the campaign about the everyday issues that arise in the delivery of today's high-tech, sophisticated care, and how those issues are addressed, helps give credibility that the hospital has processes and resources in place to respond when a problem happens. Being open to managing the community's perception of care issues in healthcare limits the union's effectiveness in showing isolated incidents as being the norm for the hospital.

Simply having a program is not enough. A patient advocacy program should be publicly promoted and reinforce that patients have someone to go to with concerns. The program should illustrate that it is not just nurses looking out for patients, but all of hospital leadership. Focusing on safety and patient advocacy may not be as glamorous as a media campaign on the most recent cancer treatment innovation, but it will help place the hospital in a position to fend off the union’s attacks with relative ease. The time to act is now because the patient safety attacks are sure to increase over the next two years as the California Nurses Association spreads its tactics across the nation by bringing more and more state nursing associations under the umbrella of the National Nurses United. The areas that have historically seen themselves as immune from union activity will likely be the least prepared and, as a result, will become the new battleground for the CNA and other union attacks on patient safety.

Kevin Haeberle is Senior Vice President and Senior Advisor in the HR Consulting service line of Integrated Healthcare Strategies. Mr. Haeberle may be contacted by calling 800.821.8481 or emailing Kevin.Haeberle@IHStrategies.com.

More Articles from IHS:

Average Hospital General Counsel Salaries Rise to 57% of CEO Salaries
New York Hospital CEO Salaries 29% Higher Than National Market

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars