Patient Safety Tools Designed to Minimize Risks from System Mergers and Acquisitions

A new set of tools was released last week to help protect patients from safety risks caused by health system mergers, acquisitions, and affiliations. Ariadne Labs and CRICO/Risk Management Foundation of the Harvard Medical Institutions released a set of patient safety tools designed to help clinical leaders identify safety risks and prevent potential harm.

A paper examining public safety risks during health system expansion was published in JAMA by Ariadne Labs public health researchers Susan Haas, an OB-GYN and visiting scientist at the Harvard T.H. Chan School of Public Health; Atul Gawande, a professor of the Harvard T.H. Chan School of Public Health, surgeon at Brigham and Women’s Hospital, and executive director of Ariadne Labs; and CRICO President and CEO Mark Reynolds.

The paper identified three ways that patient safety can be compromised by differences between merged hospitals in terms of clinical capacities, patient populations, protocols, staffing structures, and cultures. The issues include:

• New settings for physicians. When physicians are assigned to new sites, they may receive little or no orientation, which requires them to deal with new infrastructure, processes, teams, and clinical culture.
• New patient populations. Significant gaps in care may result if facilities are not prepared for increases in patient volume or the introduction of new patient demographics or medical conditions.
• Unfamiliar infrastructure. Routine tasks can become challenging for clinicians because of changes due to the affiliation in supplies, equipment, formularies, protocols, and information systems.

The tools, which can be downloaded from the Ariadne Labs site, include guiding principles for system expansion, a user’s manual, a series of discussion guides, and a joint clinical integration guide.