Maximizing patient safety is a top priority for hospital C-Suite executives and risk managers in the United States, but lack of teamwork, negative culture and poor communication will present barriers to patient safety in the future according to a new survey commissioned by American International Group (AIG) in consultation with patient safety expert Martin Makary, MD, MPH.
The results revealed a tension between what hospital leaders perceive as their number one priority in 2013, patient safety (64 percent C-Suite and 62 percent risk managers), and their No. 1 threat, failing to maximize financial sustainability (60 percent C-Suite and 62 percent risk managers). While nearly all respondents (96 percent of C-Suite and risk managers) say their hospital has a culture of patient safety, one-third (33 percent of C-suite and 37 percent of risk managers) acknowledge that their hospital needs to undergo major changes to maintain that culture in the future.
This study is designed to better understand what drives patient safety, the barriers our healthcare system must overcome to achieve it, and what can be done to help keep hospitals safer over the next three to five years, says Russell Johnston, Casualty Product Line Executive, AIG U.S. and Canada.
A majority of respondents said the largest barrier to patient safety is lack of teamwork, negative culture and poor communication (42 percent C-Suite; 55 percent risk managers). The main communication and coordination problems cited include:
The perception that nurses fear retribution if they discuss patient safety (26 percent C-Suite, 29 percent risk managers);
Documentation burdens (69 percent C-Suite, 60 percent risk managers);
The number of patient handoffs among hospital staff (56 percent C-Suite, 61 percent risk managers); and
The quality of coordination and communication between departments at their hospitals (59 percent of C-Suite executives, 69 percent of risk managers).
Who Owns Patient Safety?
The study also revealed inconsistent perceptions of who is responsible for patient safety and who owns it. Virtually all hospital executives (98 percent of both C-Suite executives and risk managers) agree that every staff member in my hospital is responsible for patient safety. But half of both C-Suite executives and risk managers (52 percent and 51 percent, respectively) believe that nurses own it. Interestingly, executives see nursing staff turnover as one of the least influential items on overall hospital risk, including patient safety, regardless of the fact that they place the onus of patient safety on nurses.
Technology, Regulation, and Metrics
Further complicating the situation, the introduction of new technology, regulation, metrics, and patient education aimed at helping patient safety are sometimes perceived has having the opposite effect:
Three-quarters (75 percent) of C-Suite executives see reporting of quality metrics as beneficial to safety, yet 1 in 5 (20 percent) sees negative impacts on other areas of quality as a result of having to report these metrics.
While most (84 percent of C-Suite executive and 88 percent of risk managers) agree their hospital effectively uses technology to improve patient safety, more than half (59 percent of C-Suite executive and 53 percent of risk managers) say it takes clinical staff away from patient care.
One in four executives (23 percent of C-Suite executives and 24 percent of risk managers) admit that their hospital is more focused on driving publicly reported metrics rather than truly impacting patient safety. Also, most hospital leaders agree the public does not understand how to interpret publicly reported patient safety metrics (83 percent of C-Suite executives and 89 percent of risk managers).
Given that nearly half of every dollar spent on healthcare costs is related to a medical error, improvements in patient safety will provide a quick return on investment, says Emily Rhinehart, RN, MPH vice president and division manager for healthcare risk consulting at AIG.
Source: American International Group (AIG)