By Matt Phillion
A new report from Sage Growth Partners LLC, Leading Through Change: Because Patients Deserve More, pulls together insights from industry leaders in hospitals, health systems, non-profit organizations, and technology companies to offer perspectives on patient safety challenges, improvement opportunities, and ways healthcare organizations can advance positive change.
“Nationally, we believe wonderful changes can come from the safety community,” says Hayley Burgess, PharmD, MBA, BCPP, CPPS, one of the experts featured in the report and chief operating and chief clinical officer for VigiLanz, a clinical surveillance company. “We’re aware of the need to improve patient safety, and we’re making that a priority. Those of us who have been health system leaders know this intimately because we know the struggles that hospitals and ambulatory care settings have in protecting the patient, understanding clinical outcomes and safety event data, and collecting that data in a valuable way.”
Contributors to the report offer the evidence and science behind these factors to back up these concerns—none of which are new, Burgess notes. Initiatives launched 15 or 20 years ago to address patient safety and the “chasm of care” have led to incremental improvements in areas such as healthcare-associated infections, medication management, pressure ulcers, and falls—the common events patient safety professionals know so well.
“Healthcare leaders know what the best practices are and an opportunity still exists in the execution of those best practices,” Burgess says.
The pandemic had a profound impact on the public’s awareness of patient safety in many ways, from highlighting safety issues encountered by patients to healthcare professional burnout culminating in leaving the profession.
“Post-pandemic, we took a step back to understand the current climate,” says Burgess. “Healthcare professionals are leaving in droves: they’re at retirement age, or they’re just burned out. New graduates are entering the healthcare field and innovations in technology can streamline their workflows to support harm prevention and early care interventions.”
Complex systems like medication management can’t be taught overnight. It can be overwhelming to think about from a human factors perspective.”
“If patients receive on average 100 doses of medication during their stay, how can we believe we can get it right every time without best practices, checklists, and supporting technology?” she says. “Technology integrated into the workflow to assist staff with monitoring patients is one higher order safety strategy. For example, utilizing electronic surveillance to prompt staff to preempt and intervene to prevent and avert patient harm events.”
“We saw the recent PCAST report put an emphasis back on patient safety, and I personally feel there’s momentum. There are conversations happening that will bring accountability measures across the board,” says Burgess. “As we gain alignment nationally, and as some of those key performance indicators become part of reimbursement, we’re going to see change.”
The PCAST report indicates that the government is serious about taking care of people as they seek medical care, Burgess says, and that “it’s time to put dollars and metrics behind that, and electronic surveillance technology is able to inform the measurement strategy and provide clinical outcomes insight.”
What has improved
Perhaps the biggest gain in patient safety in the past decade has been improved transparency. More organizations are focusing on patient safety and encouraging it on the front lines.
“Thinking about when the next event is going to happen, knowing what keeps you up at night—that’s the first step in major change,” says Burgess. “You can’t fix what you don’t know about, and leadership presence on patient care units demonstrates commitment to a culture of safety to better understand what is happening on the front lines.”
The technology has leapt forward as well in terms of clinical surveillance and reporting, focusing on evidence-based medicine and implementing the technology to ensure it happens and matures over time.
“The transparency component is really important,” says Stephanie Kovalick, partner and chief strategy officer with Sage Growth Partners LLC. “Just measuring advancements is a huge step forward.”
Kovalick also points to access as an area where patient safety should turn its eye.
“We have to look at both workforce shortages and burnout and lack of access—people who can’t get in to see a provider,” she says. “We have this access problem, a workforce shortage problem, and we have technology such as surveillance and infection prevention that has been underutilized all these years. There’s never been a better time to start implementing technology to help overburdened staff with tasks they can’t do themselves.”
The new generation coming in is inherently tech-savvy, Kovalick notes, and that’s an advantage for the future.
“We’ve had this little bump in the road, maybe a big bump, but now we have this opportunity to push forward with new staff, greater transparency, and new technology solutions,” she says.
Technology that works together
Something to be aware of as we turn to new and emerging technologies to help with access and staffing shortage is interoperability, says Burgess.
“Being able to utilize software and synergistic tech with the EHR can help close patient safety gaps,” she says. “Creating a workflow utilizing electronic surveillance software with the EHR gets ahead of harm to help protect both patients and the healthcare team. EHRs are terrific for traditional documentation and billing, and there is rich data within those systems, but it’s still a real challenge taking technologies that uncover problems and really putting them into that workflow.”
Kovalick notes this is a national problem. Work is being done to move toward interoperability because many technologies collide with an inability to work together within the EHR. To overcome this barrier, healthcare workers by necessity work across multiple systems or screens.
“There’s a tendency for hospitals and health systems to look to the EHR to solve all problems, but the EHR is really a clinical documentation tool, not a patient safety reporting system,” says Kovalick. “We’re asking the EHR to do too much, and there’s a bit of danger putting all your eggs in one basket. We need to be looking outside to augment and solve specific challenges around patient safety, and these need to be a front and center tenant of the solution you’re using, not ancillary.”
This is really a change management issue, Kovalick notes.
“Healthcare really struggles to change unless it’s forced to with urgency, like the pandemic,” she says. “How do you keep that urgency front and center? How do we leverage technology alongside so many priorities in healthcare today?”
“We depend on frontline clinicians to carry out critical tasks, and often all at the same time,” says Burgess. “That’s where this interplay with the EHR and workflow efficiency is so important. Technology such as clinical surveillance software can be used to alert clinicians to intervene before an event occurs, and to quickly report near misses and safety events.”
The right clinical surveillance technology in tandem with the EHR does make a difference, Burgess says.
“From my experience as a health system leader, clinical surveillance on the pharmacy side doubled the productivity of my pharmacists and expedited their workflow. They were able to have twice as many clinical interventions to improve patient care in a given day,” she says.
These advancements need to particularly focus on nursing, Burgess notes.
“Nurses are the largest population of healthcare providers. They’re the ones on the front lines, closest to patients, and today probably have the worst workflows in healthcare,” she says. “The industry is wildly inefficient and we need to provide them with a more streamlined process to assist them with knowing what’s the most important thing to do for this patient in this moment without going to multiple places: the right information for the right clinician at the right time.”
Interoperability enables not just the exchange of data but the matching of data and how it flows for the individual patient.
“A lot of the technology exists today,” says Kovalick. “They offer better workflows. When you look at nurses in particular, they’re expected to do countless tasks an hour—a ridiculous number—and you can use technology to let them operate at a higher level. The question isn’t does the tech exist, but why does a health system not adopt them?”
This is why interoperability is such a key concept. Systems and hospitals can be inclined to rely on technology they have already invested in but as the technology grows more complex, it’s too big an ask for a single vendor or tool to solve every issue. Where is patient safety headed? Will we reach the level of technological interoperability to keep pace with an overburdened workforce?
“I think we’ll get there,” says Kovalick. “I’d love to see us get to the point where patient safety is not third on a list of priorities, but rather where you don’t have to think about patient safety as a priority because it’s an overarching goal in your people, processes, and technology to put patient safety first.”
“Investing in synergistic technology in conjunction with EHRs to help clinicians prioritize their workflow by providing the right information to them at the right time prevents harm, improves safety, and is simply a good return on investment,” says Burgess. I am hopeful that this report will assist healthcare leaders to evaluate clinical and safety gaps in their system and thoughtfully invest resources in patient safety efforts to improve clinical outcomes and reduced harm.”
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at firstname.lastname@example.org.