By Aparna Gupta, DNP, FACHE, CPHQ, CRNP
Safety in healthcare is a cure-all – yet how many of us put
safety front and center? From wearing seat belts, to washing hands, to crossing
the street, the mechanism of safety is (mostly) well entrenched in all of us.
Yet when it comes to identifying safety risks, reporting adverse events, or
keeping patients and clinicians safe, we are prone to miss the point. The Institute
of Medicine has established six domains
of healthcare quality – safe, effective, patient centered, timely, efficient,
and equitable care .
The first domain is safety. Delivering safe care means that
adequate assessments have been done in a consistent, efficient, and equitable
manner and that the right patient is receiving care in the right way, at the
right time. Which also means that medical waste (unnecessary intervention) is
avoided and patient outcomes including the experience of care are optimized. In
other words, we accomplish the triple aim – maximize the patient experience of
care, quality, reduce cost and enhance outcomes.
But wait, there’s more. What about clinician safety? Our
interdisciplinary team members that are in the patients’ homes are exposed to a
plethora of risk, the most recent being demonstrated during the COVID pandemic.
While these are unsung superheroes, we need to focus on the safety of our staff.
Not only physical safety, but psychological safety as well. As much as we need
to ensure our staff are protected and feel safe to report any security incidents
for their selves, we also need to ensure that the organization nurtures a just
culture, whereby staff can “say something” when they “see something”.
It is well known that organizations that focus on a just
culture see higher rates of “near miss” reporting – events that could have
harmed the patient but didn’t reach the patient just yet. When these
organizations make it safe and non-punitive for staff to report near misses, we
see better workflows, higher standards of care and better communication between
the interdisciplinary team (IDT).
Communication plays a big role in ensuring safety both
for staff and patients. When the IDT talks to each other
and shares important information at the right time and in the right way, the
coordination of care reaches a new horizon. Safety tools like SBAR become the language that keeps care focused on the patient and the family.
As we celebrate Patient Safety Awareness Week, I cannot help but think of James Reasons Swiss Cheese Model (BMC Health Serv Res. 2005; 5: 71.) which explains how complex functions like taking care of a human being can be simplified when the whole team gets a say, has input, and works together to put patients’ safety first. Let’s keep our patients, our communities and ourselves safe by working together, trusting each other, and leaning on one another. Happy Patient Safety Awareness Week 2023!
About the author:
Aparna Gupta is the Vice President of Quality with National
Hospice and Palliative Care Organization. Aparna is a board-certified adult
nurse practitioner and has served in various roles ranging from executive
leadership, operations, and clinical care delivery across healthcare. She holds
a national certification in healthcare quality and is a Fellow with the
American College of Healthcare Executives.