Intro to Quality – Part 2: “S” is for Safe

Last month, we looked at the Institute of Medicine’s STEEEP acronym, which stands for care that is Safe, Timely, Effective, Efficient, Equitable, and Patient-Centered. Safer care is the first pillar.

Safety goes far beyond “trying” to keep patients safe. The Institute for Healthcare Improvement (IHI) explains it this way:

“This means much more than the ancient maxim ‘First, do no harm,’ which makes it the individual caregiver’s responsibility to somehow try extra hard to be more careful (a requirement modern human factors theory has shown to be unproductive). Instead, the aim means that safety must be a property of the system. No one should ever be harmed by health care again.”

This requires that healthcare practices assess a multitude of different areas. As patients, we should be aware of our healthcare providers’ track record in these areas, too, when possible:

• Healthcare acquired infections – sometimes infections occur after procedures, operations, or hospitalizations. The industry is working hard at reducing this number to zero.

• Handoff communications: One of the most challenging areas to make reliable, handoff communications between providers, hospitals, and specialists is critical to ensure safe care and prevent errors.

• Medication errors: These are often the result of poor handoffs, poor communication, missed alerts (see alarm fatigue below), or overworked staff. While these appear to be “people problems” they are actually the results of systems that aren’t setup to support people in reducing errors and increasing accuracy.

• Diagnosis errors/delays: Any error or delay in diagnosis has the potential to cause patient harm and slow the healing process by delaying appropriate treatment or intervention. Even worse, misdiagnoses have the potential to cause more harm and increase cost by forcing patient to go through unnecessary tests, procedures, and medication regimes.

• Alarm fatigue: EMRs are notorious for creating so many pop-ups, alerts, and alarms, that sometimes it’s easy to dismiss the ones that truly keep patients safe. The EMR industry knows this and is working toward solutions.

Next month, we’ll look at timely care. Please e-mail with questions in the meantime.