Infection Control

Blog spotlight: Create patient safety solutions that are right for you

Patient Safety Monitor Insider, May 16, 2012

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Editor’s note: Columnist Catherine Hinz, MHA, works as a leader in patient safety at HealthEast Care System in St. Paul, MN. Hinz previously worked at PatientSafe Solutions, Inc. Hinz has also completed a patient safety internship with the Agency for Healthcare Research and Quality. The following is an excerpt of her monthly column, which can be found in its entirety in Patient Safety Monitor Journal.

Patient safety has long stood on a variety of tenets, some of which have formed the process and basis for how professionals (both leaders and clinicians) conduct improvement work. Some of these are well-known and accepted: Patient safety is a right. A high level of patient safety performance is nonnegotiable. Quality, risk, and patient safety are inseparable. A healthy culture is at the core of ideal patient safety performance.

I agree with all of these; however, there are two tenets of the patient safety movement that, while I believe do exist, I am beginning to question more as my leadership perspective evolves: that organizations do not compete over patient safety, and that sharing best practices is one of the best ways to improve across units, systems, and organizations.

Let’s first talk about competition. Historically, organizations have not experienced the shortage of resources, restricted access to capital, and flat patient volumes they are experiencing now. Therefore, the competition among organizations has never been fiercer. The uncertainty of health reform, organizational structure, and new regulations adds a layer of complexity that also has not been seen before. Regardless of the final outcome of health reform, it is certain that reimbursement will, more often than not, pit peers against each other in races of efficiency, cost reduction, and quality.

It is a certainty, then, that competition will reign even in the realm of patient safety. Organizations will discover new and better ways to avoid adverse events and near misses, and they will be incentivized in many cases not to advertise the mechanics of how they did it-no matter how ­helpful sharing these best ­practices might be for other, lagging organizations and the communities they serve. As it does now, safer care will improve reputations thanks to public reporting and greater consumerism in healthcare choices, but it will also potentially allow hospitals to retain or collect additional payment, creating more competition.

The market forces are providing the right environment for competition to be a strong contributing factor in the race for improved patient safety and zero harm, but not necessarily toward sharing practices; therefore, the idea that we should not compete in all things patient safety might not be the best path forward.

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