All healthcare services are rooted in one core assumption...that those in charge of the caring do no harm. This fundamental premise is emphasized during clinical training, as well as during graduation ceremonies for nurses and other medical and clinical personnel.
However, somewhere between graduation and working as a caregiver, a new assumption begins to take shape. Healthcare is a complex, high-risk industry. As a result, some clinicians begin to assume that there will be some unintended, unpreventable harm to patients and staff in the course of diagnosis, treatment or rehabilitation. Acceptance of inevitable human error is the first step toward complacency.
This assumption that some degree of patient sacrifice and suffering is unavoidable seems to come from a perceived lack of control by individuals in the care chain. "Assumed harm" stems from paradigms such as medicine is just as much of an art as a science, patients are all different, staff members are all different, and overall healthcare as an industry is just too complex and different. These thoughts can lead to costly and life-altering mistakes for healthcare organizations and their patients
One solution is to dare to believe that every single act of harm to a patient or staff member is preventable. This way of thinking needs to be embraced first by upper management and then to every employee in a healthcare organization. This shows true leadership in a high-risk industry. Believing that prevention of harm in every case is possible is the first step toward real change. It may surprise many healthcare workers to know that hospitals and healthcare as an industry have higher worker injury rates than the construction or mining industries. The Institute for Healthcare Improvement estimates over 120,000+ deaths are due to medical errors. In June 2015, Modern Healthcare reported that OSHA declared back and arm injury rates to nurses as an epidemic and now hospitals can face fines of $7,000-$70,000 for failure to implement recommended safe practices. Clearly, a change in behavior is critical.
Once bigger thinking is in place, it's time to identify a new trusted path. Institute for Healthcare Improvement (IHI) Founder Don Berwick made a profound statement in 2013. He said, "Ultimately, by far the greatest benefit to patient safety will be achieved by increasing the skills and knowledge of the many rather than penalizing the very few." This quote frames the path to be around cultural enhancement through effective risk factor and safety education.
Dramatic lessons on how to move to harm-free, safer healthcare can be found in other high-risk industries such as the chemical industry. OSHA legislation in the 1970s forced these complex and high-hazard manufacturing companies to move beyond a compliance-only commitment to safety. They needed to exceed the standard, not only as a good business strategy, but also because it was the right thing to do.
As focus on outcomes and transparency drive future priorities in healthcare, high-performing organizations will take the time to develop a comprehensive safety strategy that integrates patient and staff safety efforts. Reliable safety and hazard-identification systems are needed to support the ultimate promise that no harm is done in the process of caring. As the healthcare industry continues to struggle with high injury and error rates, deeper understanding of out-of-industry lessons may lead to an industry-wide belief that all incidents are preventable. A daring new leadership imperative is that safety should become the overall guiding priority for all decisions, investments and alignments. Those in the honorable position of leading and managing healthcare entities need to thoughtfully plan to leave behind a safety legacy that will impact their organization and its patients for generations to come. We must dare to believe.
Diane Stover-Hopkins is Principal Consultant for DuPont Sustainable Solutions- Healthcare and can be reached at diane.hopkins@mail3.dupont.com
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