A lack of effective technology is impeding the progress of patient safety, according to a 2018 survey of healthcare professionals. Even though most healthcare organizations claim safety as a priority, serious challenges remain to making a significant impact on patient safety outcomes.
Survey respondents said ineffective information technology and the related lack of real-time warnings for possible harm events were the top barriers to improving patient safety. They cited a number of key obstacles:
1. Lack of resources.
2. Organization structure.
3. Lack of reimbursement for safety measures.
4. Changes in patient population.
This survey of more than 400 healthcare professionals tackles a big question many hospital leaders are asking: Why aren’t we seeing improvements in patient safety despite our efforts?
Technology has become an integral part of healthcare, and as hospital systems work toward improving patient safety, it’s more important than ever. Although the majority of healthcare organizations are focused on patient safety, the results of those efforts are yet to be seen. Better technology could be the key, according to a June 2018 survey by Health Catalyst.
Nearly nine out of 10 respondents to a national survey of physicians, nurses, and healthcare executives say their organizations are successfully improving the safety of patients.
But real problems remain. In order to make further improvements, respondents to the Health Catalyst survey said they need better health information technology to warn clinicians of impending patient harm, as well as more resources and greater organizational focus on the problem.
The need for improvement is compelling. Medical error is one of the leading causes of death in the U.S. While mortality grabs the headlines, non-lethal harm events are even more frequent, occurring at a rate 10 to 20 times higher than lethal events, according to The Journal of Patient Safety. Researchers estimate that one in three hospitalized patients experience preventable harm and over 400,000 individuals die each year from these injuries.
Despite these statistics, confidence in current patient safety efforts is high, according to the online survey of 462 medical, quality, and pharmacy professionals in healthcare organizations of all sizes across the U.S. Seventy-nine percent of survey respondents rated their organizations’ success in improving patient safety as either “somewhat good” or “very good.” Only 11 percent rated their patient safety efforts as “poor,” however, just 9 percent gave their efforts an “excellent” grade.
The survey confirms that serious challenges prevent healthcare organizations from making a significant dent in preventable errors, with 89 percent of respondents seeing room for improvement. However, they identified several key obstacles that prevent them from achieving their patient safety goals. These barriers are listed below in order of percentage:
The lack of effective information technology tops the list of barriers to improving patient safety. This problem ties in closely with another survey finding—that healthcare organizations are almost completely dependent on manual methods of tracking and reporting safety events. According to the survey, the four most common sources of data used for patient safety initiatives are voluntary reporting (selected by 82 percent of respondents), hospital-acquired infection surveys (67 percent), manual audits (58 percent), and retrospective coding (29 percent). Nearly one-third of respondents (28 percent) reported also using trigger tools as a data source for patient safety, which could mean either the manual process of chart review that relies on Institute for Healthcare Improvement (IHI) methodology, or home-grown reports that also follow the IHI methodology.
These standard approaches to manual reporting of hospital safety events have been shown to find less than five percent of all-cause harm. Manual reporting is based on data that is at least 30 days old, and it requires extensive time and resources for data extraction, aggregation, and reporting, resulting in limited root-cause analyses.
“As these survey results confirm, the current approach to using voluntary reporting to monitor patient safety gives healthcare organizations a false sense of tackling the ever-present danger of patient harm,” said Stanley Pestotnik, MS, RPh, Health Catalyst’s Vice President of Patient Safety Products and one of the foremost experts at the intersection of patient safety and harm-reduction technology. “Recent evidence continues to demonstrate that the majority of patient harm goes undetected and that medical injury is the third leading cause of death in the U.S.—evidence that challenges voluntary reporting as an effective patient safety management strategy.”
When asked to name factors that are most influential in driving their patient safety efforts, a majority of survey respondents (51 percent) named regulatory reporting requirements. In second place at 39 percent was financial considerations, such as malpractice claims, value-based contracts, and reduced reimbursement. Respondents cited additional factors:
Determining exactly where to focus patient improvement efforts seems to be a difficult decision for most organizations. When asked to identify the areas where patient safety most needs improvement, survey respondents rated four of the six choices within 3 points of each other. “Inpatient clinical” areas of focus such as length-of-stay, mortality, and readmissions came out on top at 21.6 percent, barely ahead of “operations” (21.1 percent), an area that includes ED wait times and patient instructions at discharge. Two other areas most in need of improvement, according to survey takers were “severity of illness” (19.5 percent) and “outpatient/ambulatory clinical” (18.6 percent). Only “regulatory reporting,” including reporting of hospital-acquired conditions, seemed to require slightly less improvement than other areas, with 15.5 percent of respondents citing that issue. “Other” captured the remaining 3.7 percent of respondents.
“The big picture takeaway from this survey is that although a small portion of respondents felt they have a good handle on their patient safety efforts, the largest portion of respondents still believe that they have room for improvement,” said Valere Lemon, RN, MBA, a senior subject matter expert for Health Catalyst. “Surveilling all-cause harm will aid healthcare organizations in bridging the gap from niche focused improvements to proactive harm identification and broader patient safety improvement interventions.”
In June 2018, Health Catalyst announced the release of the Patient Safety Monitor™ Suite: Surveillance Module, the industry’s first comprehensive patient safety application to use predictive and text analytics combined with concurrent clinician review of data to monitor, detect, predict, and prevent threats to patient safety before harm can occur.
The Surveillance Module quickly identifies patterns of harm and proposes strategies to eliminate patient safety risks and hazards for current and future patients. This potent combination of predictive analytics, text analytics, and near real-time data from multiple sources enables the Patient Safety Monitor Suite to predict harm events and trigger a response while the patient is still in the hospital.
Survey results reflect the opinions of 462 healthcare professionals who responded to an online survey in May and June, 2018. Respondents included 240 physicians, 99 nurses (including 19 chief nursing officers), 38 pharmacists, 14 chief quality officers or directors of quality, and a number of other roles. They work for organizations ranging from some of the nation’s largest academic medical centers to national health insurers and independent physician practices.
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