Gauging Patient Safety Programs

In response to evidence that adverse medical events are widespread, patient safety programs have emerged and proliferated worldwide in recent years. Patient safety may be considered a new and distinct healthcare discipline. It emphasizes the reporting, analysis, and prevention of medical errors that can lead to adverse healthcare events. While this is a useful generic definition, it takes on different meanings for each healthcare discipline. When patient safety programs were studied, it was found that many are generic and may be inappropriately focused and researched. In planning a patient safety program, the basis of patient safety programs for all disciplines will have similarities. But each discipline will require nuances specific to the discipline since the goals, objectives, and requirements of each are unique. Furthermore, each discipline will have its own preferred outcomes that may change over time as new data become available and service providers become more knowledgeable of ways to increase the likelihood of desired outcomes. J Allied Health 2013; 42(3):182-186.WHILE ADVERSE healthcare events are a leading cause of death and injury in the US, over the last two decades many countries began reporting staggering numbers. It became evident that healthcare errors, both of commission and omission, were impacting 1 in every 10 patients around the world. The World Health Organization cited patient safety as an endemic concern.1 In its report, the Institute of Medicine has defined six critical areas for the care of patients: care should be safe, effective, patient centered, timely, efficient, and equitable.2 The Agency for Healthcare Research and Quality (AHRQ) has defined patient safety as "a discipline that applies safety science methods toward the goal of achieving a trustworthy system of health care delivery."3 As a result, patient safety is emerging as a distinct healthcare discipline supported by a developing scientific framework. There is a growing body of literature that is informing the science of patient safety.4An expanding literature includes methods for assessing patient safety5 as well as promoting advanced education for healthcare leaders, such as the American Hospital Association Patient Safety Leadership Fellows program. This literature contributes to patient safety by applying lessons learned from business and industry, and from NASA to nuclear engineering. It is augmented by the adoption of innovative technologies, education of both providers and consumers, improving error reporting systems, and developing new models of economic incentives. The purpose of this paper is to examine what may be the structure or anatomy of a well-functioning patient safety program for differing healthcare disciplines.BackgroundIt is reported that the United States spends more financial resources on healthcare than any other country in the world.6 Healthcare services in the United States are expensive, with an estimated 16.2% of the gross domestic product spent on healthcare.6 Furthermore, services in many cases may be inadequate, inappropriate, and at times dangerous. The Commonwealth Fund reports that the United States "consistently underperforms on most dimensions of performance." These dimensions include access to care, coordination of care, efficiency of service, equity, and patient safety.8 The report goes on to note that at the same time that increasing numbers of Americans are in need of primary care services, major health worker shortages exist. These shortages include physicians, nurses, mid-level providers, medical laboratory scientists, pharmacists, and public health workers. Many of them provide services in rural areas where 20% of the nation's population lives, as well as in areas designated as medically underserved.Along with health worker shortages, the way services are provided is experiencing a significant shift. This shiftis from a model of providing services within a clinic or hospital, to one where services are provided in many different venues: outpatient clinics, community health centers, specialty practices, community pharmacies, and by telemedicine. …