How We Elevate the Quality and Safety of Patient Care
Patient Safety Patient safety is not a project. It is an ongoing effort to constantly improve how we deliver care with minimal opportunity for error.
From their unique corners in the health care industry, two established voices weigh in on where they see the most room for improving patient well-being—and more.
What innovations in health care connectivity are increasing the quality of patient safety?
Frank Federico: There are many new and recent innovations in connectivity that have helped elevate the quality and safety of patient care. Technology has improved health care access in regions that are underserved or lack specialists. Remote monitoring for ICU patients has ushered in the opportunity to add a second set of eyes on patients, who are now able to carry on with daily life while being monitored remotely.
Patients managing chronic disease are using text messages to share morning blood sugar levels and blood pressure readings with their care teams; and the creation of online communities for patients to share and support each other when dealing with a chronic disease are offering new and exciting opportunities for improved patient experience. The ability to connect and have real-time response (or close to real-time) helps care teams address symptoms or issues before they become serious, which can potentially minimize harm or a hospitalization. As with implementing any innovation, it is critical that health care organizations ensure the proper culture, processes and systems are in place to support the intended goal of the technology.
“...patient safety is not a project. It is an ongoing effort to constantly improve how we deliver care with minimal opportunity for error.”
Kristin Hagen: Patient safety innovation is often thought of in terms of hardware, software and big data, but it must also include the breakthroughs in how care providers, patients and certified medical scribes use the technology. We see the patient-centric care inherent in the concept of precision medicine as the best way to ensure patient safety. When providers and patients are working toward prevention and wellness as a team, with complete information on both sides, one of the results will be greater patient safety.
Where can the medical community most improve patient safety?
FF: The medical community must adopt the mindset that patient safety is not a project. It is an ongoing effort to constantly improve how we deliver care with minimal opportunity for error. In the absence of error, it is the persistent effort to minimize all forms of patient harm. We have addressed significant contributors to harm, such as central line infections, ventilator-associated infections and more. However, we have not built robust systems that allow for the spread and sustainability of the success within hospitals and across hospitals.
We have only begun to touch on safety in other care settings, such as the physician’s office and skilled nursing facilities. In addition, the transition of patients across all of these settings, including the patient’s own home, must be improved at every opportunity. The medical community has the most important role to play in all of this; and so long as we engage with patients and families, understand what matters most to them, and design care around those needs, we’ll move the needle toward better, safer patient care.
KH: Health care teams are overburdened and overworked. Among the more than 1,200 comments that were received regarding the proposed rule for Medicare and CHIP Reauthorization Act, many focused on the burdens clinicians endure because of computerized provider order entry (CPOE), which is critical to improving the quality of patient safety.
A new analysis of a nationwide survey of physicians shows that CPOE and electronic health record use are major sources of burnout for physicians. Using certified medical scribes is the key to eliminating this problem. The clinical documentation and practice efficiencies certified scribes provide have been shown to ease the clerical burdens of CPOE, and give physicians back the time and attention they need focus on their patients toward patient-centric health care.
“The electronic health record acts as a conduit and mechanism to improve patient safety and a platform for advanced care...”
How does the health care industry prioritize patient safety?
FF: We have had to raise awareness of patient safety both within health care and outside of health care, to address the most dangerous issues. Now that we understand how to approach many of the challenges, we must consider the impact that safety has on all dimensions of quality and the impact that other dimensions like equity, efficiency and patient centeredness have on patient safety. That should be our priority.
Developing safer care that in turn decreases efficiency, timeliness or equity is not our goal. We should be focusing on all aspects of quality as they interact with each other. Patient safety should have the same high level of priority as access, effectiveness, efficiency and payment reform. We should consider inequitable, untimely or disrespectful care as a form of patient harm, just as we should consider overuse and underuse of care as a form of patient harm.
There is still much work to be done, but with the proper prioritization on a whole-systems approach, we can get closer to delivering the safest, most reliable care across the continuum.
KH: By ensuring that all health care team members (and that includes the patient) have a complete picture of the health and history of each patient. The electronic health record acts as a conduit and mechanism to improve patient safety and a platform for advanced care and long-term research into what works best for patients. Certified scribes are a key element. Having fully credentialed medical scribe specialists on staff is not only a requirement for meaningful use of CPOE to meet federal requirements, it also reduces risks in the health care system and increases patient safety.