The board members of the National Patient Safety Foundation's Lucian Leape Institute are making the case for healthcare to label some practices as "must do" and hold clinicians responsible for not following through on them.
The argument was laid out in a Health Affairs blog post by Robert Wachter, MD, a member of the Lucian Leape Institute board.
Currently, most of the industry operates under a "no blame" mantra, meaning when a medical mistake is made, organizations blame the system and work to change it so the mistake doesn't happen again.
While that mindset "remains the correct reaction to most mistakes, it is not the appropriate response when clinicians are disruptive, incompetent or willfully choose to ignore evidence-based safety rules," Dr. Wachter wrote.
In other words, Lucian Leape Institute board members want to require clinicians to follow "certain well-established safety practices." As a jumping off point, they propose two practices be labeled as "must do" immediately: hand hygiene and influenza vaccination for healthcare workers.
"Our hope is that the creation and dissemination of a 'must do' list will drive more professionalism than enforcement," Dr. Wachter wrote, but the board recognizes that enforcement may well be necessary. "Leaders must hold clinicians accountable by setting up effective monitoring and disciplinary systems," he continued.
That could include writing "must do" policy expectations into bylaws, but organizations also need to be willing to fire clinicians who refuse to follow the protocol.
In addition to hospitals taking action, the blog post urged accreditors like the Joint Commission and payers like CMS to adopt these practices into their standards.
Read the full blog post here.