Institutional change is undoubtedly hard, but in an industry where people's lives are at risk every second of every day, there is no excuse for not prioritizing and tackling patient safety head on. How quickly is healthcare changing if attention to harm and improvement of patient safety remains so feeble?
A story I wrote in December on the top 10 patient safety issues for healthcare organizations to focus on in 2015 attracted some attention. In his blog "Running a Hospital," Paul Levy, former president and CEO of Beth Israel Deaconess Medical Center in Boston, highlighted the list in his post called "The worst of the top ten lists."
Items on the list included healthcare-associated infections, hand hygiene and medication errors — topics that are hardly novel to any healthcare professional, but nonetheless remain clinical quality issues in today's hospitals. Mr. Levy said the list "prompts discouragement" because it "documents the failure of leadership by all too many boards of trustees, senior administrators and chiefs of clinical service in America's hospitals."
The 10 issues I included in the list were recommended by or confirmed by industry professionals. Taking a step back, the list does appear discouraging, especially since a number of items seem so elementary.
Hand hygiene?
Appropriate use of antibiotics?
If you work in healthcare, you've likely seen the numbers: In 2013, the Journal of Patient Safety reported up to 440,000 patients die each year from preventable medical errors, making it the third leading cause of death in the United States.
To be fair, HHS released new figures in December showing a 17 percent decline in hospital-acquired conditions from 2010 to 2013, resulting in 50,000 fewer patient deaths and 800,000 fewer incidents of harm. Any progress is good progress, but the rate of this particular progress — 50,000 fewer patient deaths of the 1.32 million deaths estimated to occur in that time — seems fractional.
Now, I've never worked in a clinical setting. I'm aware of the pressures and strain of day-to-day operations in healthcare, but I don't have the first-hand experience of working in a trauma bay where I'm sure scrubbing under my nail beds is not my main priority. That said, as a healthcare reporter, I continuously research the industry, speak with healthcare professionals weekly and write about the issues daily, all of which objectively informs my perception.
And the perception I have of the healthcare industry is one wrought with contradiction. Hospital executives, physicians and staff claim their No. 1 priority is the patient. It's upheld as the universal truth. But in this industry, talk seems oh-so-cheap because 440,000 deaths from preventable errors don't relay the message of "safety as a priority." If hospitals and health systems truly hold patient safety as a main concern, there is no excuse for such a figure.
When will leaders actually make purposeful moves toward addressing these issues and tangibly demonstrate their commitment to the patient?
I developed a fear of stepping into a hospital only a couple of weeks after I started writing about healthcare — not because I hope to remain in good health, but because if I were to undergo a surgical procedure, my main concern would be of the surgeon operating on the wrong side of my body and developing a life-threatening infection through a ventilator. A tad dramatic? Maybe. Out of the realm of possibility? Not so much.
Everybody talks about preventable errors, hand hygiene, health IT-related issues and medication errors, but from my perspective as a healthcare writer, too little progress is being made for how much coverage these issues receive.
I mean how many ways, and how many times, can clinicians be told and reminded to wash their hands?
Fixing patient safety issues and addressing these concerns, some argue, requires a cultural shift. That's hard and takes time. Meanwhile, that very top 10 assignment I wrote in December was all too easy. I wish crafting a list of the top patient safety issues was excruciatingly difficult. I wish it took weeks. But it's no secret that the issues for 2015 largely mirror those for 2014, and they likely reflect those for 2013 and 2012. Dare I say it's likely these same issues will be on future patient safety issue lists for 2016 and 2017 and beyond?
Time is going quickly, and these safety concerns aren't budging.
We're dealing with issues that are solvable. The majority of professionals I talk to in this job mention how fast the industry is changing, yet the needle remains stagnant when it comes to improving patient safety, infection control and clinical quality. Maybe instead of investing so heavily in hospital redesigns, rebrandings, and mergers and acquisitions, healthcare organizations can direct these resources toward the foundational patient safety issues they face.
So where does that leave us?
One of the main pillars of journalism is objectivity in reporting. Journalists are not to involve themselves with the stories they write. I apologize now to the professor of my ethics and communication class, because in this case, I would be remiss to not get involved.
I don't want to include hand hygiene on future lists of patient safety issues. I don't want to include medication errors. I don't want to keep writing about HAIs.
It's a new year, so let's develop a new focus on the most basic tenet of healthcare: caring for the patient. Re-visit my list of the top 10 patient safety issues for 2015 and push those to the top of your resolutions.
And this year, I hope to write a different story — one void of discouraging repetitiveness.
We owe that progress to the patients.