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Quality First

August 1, 2007
by Charlene Marietti
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Patient safety and quality of care improvement goals unify caregivers in all types of healthcare provider organizations

Since the release of the Institute of Medicine' landmark report "To Err is Human" in 1999, care provider organizations have made incredible progress, mobilizing behind the tightly linked goals of improvements in quality of care delivery and patient safety initiatives. It's a slow process, but when members of the Healthcare Informatics Research Panel were recently asked to identify the most important factor driving patient safety initiatives at their organizations, nearly half of the more than 400 respondents, representing a diverse group of care provider organizations, said it was to improve quality of care delivery. A distant second was compliance with regulatory requirements and mandates.

The IOM report was a turning point. Accrediting organizations, public-private partnerships, Fortune 500 employers, professional groups and government-backed quality improvement organizations were quick to bring resources, leadership, commitment and strategies to bear in the effort to improve safety in the nation's healthcare system. Today, thankfully, it doesn't matter how researchers calculated or how accurate the estimate was for that first report. One death from any type of error is one death too many.

Leaders in the medical community have also stepped forward, mounting an aggressive campaign aimed at matching the achievement of the airline industry, which transformed from seeing growing numbers of midair collisions more than 50 years ago into one noted for safety. Physicians such as Donald Berwick, M.D., president and CEO of the Institute for Healthcare Improvement (IHI), have made it a mission to help care provider organizations improve their safety records. In 2006, data released by that group suggests that the number of deaths attributed to medical errors in the 1999 IOM report was, indeed, wrong. It was too low. Now, after claiming between 115,000 and 149,000 saved lives in 18 months through its "100,000 Lives Campaign," the IHI leads a "5 Million Lives Campaign."

Many healthcare institutions have a quality improvement program and/or patient safety committee to help improve safety records — and public relations in a time of increased transparency and public reporting. C-suite executives and clinical professionals head most patient safety programs, say those surveyed, and most answer to board members who are keenly interested in patient safety. Improved outcomes are not only a point of pride: achievements translate into higher ratings from accrediting and quality improvement organizations and offer a competitive advantage within the community.

Like others across the country, these organizations are investing in technology to enhance patient safety efforts. Adoption for safety-related technology applications such as bar coding, radio frequency identification, computer-based provider order entry and e-prescribing have yet to reach a majority, but it shouldn't be long before they do. Although only five of the 15 patient safety technologies surveyed — documentation at the point-of-care, standardized order sets, electronic medical record, automated medication cabinets, and smart medical devices — are currently in use at most facilities, most care providers have plans to implement nearly all of them. It can't be soon enough.