7 Pillars to a Safer Healthcare System

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Carolyn M. Clancy, MD, director of the Agency for Healthcare Research and Quality, discussed the seven pillars to a safer healthcare system in a recent column published on the agency's website.

The seven pillars, which focus on transparency and empathy in the wake of adverse events, are as follows:

•    Report near-misses and other adverse events.
•    Take corrective action steps to prevent future incidents from happening again.
•    Communicate errors to patients.  
•    Apologize and waive hospital and physicians' fees.
•    Bridge systemic gaps that contribute to adverse events.
•    Collect data and measure performance to determine whether improvements have been made.
•    Educate and train staff on patient safety.

The University of Illinois Hospital in Chicago adopted the pillars in 2006 and within two years reported several improvements, including better processes and protocols. In fact, the adoption of the pillars was so successful, AHRQ is piloting University of Illinois Hospital's transparency program in 10 Chicago-area hospitals. Although the agency is a year away from reporting full results, two-year outcomes indicate positive trends, including increased communication and transparency by hospital staff.

"The seven pillars process works because it spells out and follows steps that we know make a lasting difference in building a safer health system," Dr. Clancy said. "Reporting, communicating, creating a culture of learning and other improvements move us closer to identifying and fixing patient safety gaps, rather than simply assigning blame."

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