Make Your Own Patient Safety Murder Board!

I’ve said many times — each time based on credible evidence — that patient care in the U.S. isn’t safe and isn’t getting any safer because healthcare executives don’t make patient safety their top priority despite all the rhetoric to the contrary. It’s like college football coaches saying they put the health and safety of their players first above all else right before the next injury or hazing scandal hits the headlines. You can even read one of my latest screeds on the topic, “Scared Healthy.”

Three seemingly unrelated events happened over the past several weeks that, when you connect them together like on a murder board in a crime show, point to the lack of healthcare leadership as the top patient safety suspect.

First, a new study in the British Medical Journal, or BMJ, estimated that diagnostic errors result in 795,00 adverse patient events, or serious harms, each year in the U.S. The researchers defined serious harms as permanent injury or death. Fifteen diagnoses accounted for about 51% of the instances of serious harm with the top five being stroke, sepsis, pneumonia, venous thromboembolism and lung cancer.

We know, at least according to this study, where the patient safety hot spots are and, as a result, where to focus the industry’s patient safety resources to save the most lives for the fewest dollars. Or, as the researchers put it: “So the problem may be more tractable than previously imagined.”

Second, The Joint Commission (TJC) said that it was eliminating more than 200 performance standards across eight of its accreditation programs for healthcare providers, including hospitals, effective Aug. 27. The move will “streamline requirements and make them as efficient and impactful on patient safety and quality as possible,” TJC said. That’s on top of the 168 performance standards that TJC eliminated last December.

“When we announced the first tranche of eliminated and revised standards in December 2022, hospital leadership and direct care providers alike were extremely supportive of the news that Joint Commission standards would be fewer but more meaningful,” said Jonathan Perlin, M.D., TJC’s president and CEO, in a statement. “After such positive feedback, we are pleased to extend additional relief to our accredited organizations outside the hospital setting — especially as this is where patients most frequently receive care.”

This raises all kinds of questions. Where did the 368+ performance standards come from? Someone at some point thought the standards were a good idea. Were they just busy work and/or duplication with other standards? How will taking them away improve quality and safety? Did they have any effect? Did they make care worse? Either way, it sounds like healthcare executives are pretty happy to have fewer patient safety rules to follow.

Third is this 31-page info brief from International Data Corporation (IDC) and Redox on health system health IT spending priorities this year and in 2024. The report is based on a survey of 205 clinical and clinical IT leaders.

Ranked by the percentage of respondents who cited one of 19 priorities in their “top five most important goals,” here are the top five initiatives health system clinical and clinical IT leaders intend to spend their IT budgets on:

• Digital transformation (53%)
• Cost reduction (35%)
• Improving quality of care (31%)
• Improving patient safety (31%)
• Using data as a strategic asset (30%)

Less than one-third of clinical and clinical IT leaders cited improving the quality and safety of patient care as a health IT spending priority. Again, that’s clinical and clinical IT leaders — you know, the people who at least on paper are in charge of making care safer and more effective. Turns out, they’re more interested in cutting costs.

A tell of what these clinical and clinical IT leaders really think of patients as customers is where they ranked improving end-user experience. It finished at 16%, number 18 out of 19 choices.

More deaths and injuries despite knowing where to dig. Fewer rules of questionable value to follow. And misplaced and misguided health IT spending priorities. It’s time to get out the pushpins and yarn.

Thanks for reading.