Underlying problems in healthcare safety

Most healthcare organizations use core metrics such as near events, medication errors, hand-washing, hand-off communications, falls, hospital acquired infections, diagnostic errors and discharge practices, to gauge safety performance.

However, there are some underlying issues contributing to some of the most pressing safety problems. Items to consider:

1) Assumed Failure - Based on past experience, many healthcare leaders plan for a certain number of medical errors, injuries or other incidents. Instead, they should build a shared voice around the belief that all errors, injuries and incidents harming patients or the workforce are preventable. Assuming that there will be failures in the systems or in the humans running the systems is a dangerous mindset contributing to high levels of harm and error.

2)Silo-ed Safety - Most healthcare organizations have safety silos with little or no shared learning and resources. Patient safety efforts and worker safety efforts are rarely integrated and this hinders the progress of a reliable safety culture. An overall safety strategy can be built to offer benefits for every part of the organization by blending the knowledge base, the tools and direct experience of passionate safety team members from patient care and occupational health.

3)Inferred Safety - A highly safe organization supports a bold and consistent voice about how hazard identification and prevention is not optional. Safety messaging is heartfelt, authentic and enthusiastic. Many organizations have safety hidden within their values of integrity and trust or believe it's well covered with a once-a-year safety video for all staff. Safety must be boldly supported in words and actions at every level of the organization. Training must be engaging and constant. Senior leaders must model the importance in their actions and recognize great safety efforts.

4)Non-Safe Rewards & Compensation - If you believe what gets rewarded gets repeated, then a new look must be taken at the bonus and salary structures in hospitals. Although most hospitals have compensation programs that connect with financial results, patient satisfaction scores and some quality scores, very few have extensive leader compensation tied to never events, medical error events and worker injuries. When an organization can offer up avoidable deaths, wrong site surgeries and dozens of infections in one year and the C-suite continues to receive a full salary and bonus, unsafe thinking is present.

Diane Stover-Hopkins is principal consultant for DuPont Sustainable Solutions - Healthcare, and can be reached at diane.hopkins@mail3.dupont.com. For more info: www.safepeoplesafepatients.com.


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