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Patient Safety Efforts Need Engaged Leaders

By Tinker Ready  
   March 09, 2017

It makes sense that hospitals make sure everyone, from the CEO to the staff who handle waste disposal, be aware of and on board with efforts to protect patients from harm. Several tools enable hospitals and health system to gauge and monitor staff attitudes when it comes to safety.

Other Patient Safety Studies
Recent studies correlating patient safety culture measures with other quality metrics have had both positive and negative results.

One study, published in the BMJ Quality and Safety Journal, looked for a link between patient safety scores and two common hospitals acquired infections: central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). It didn't find one.

Jennifer Meddings, MD, is an assistant professor at of the University of Michigan Medical School and lead author of the study. Infection rates improved, she says, but safety scores didn't.

Meddings' findings suggest that the safety culture measure she used, the widely used Hospital Survey on Patient Safety Culture (HSOPS), may not be adequately measuring safety, since surveys like this one take up time that could otherwise be used for patient care, hospitals need to be sure they are valid, she says.

"If you can't correlate this survey with important clinical outcomes, perhaps you should be spending more time on discrete tasks at the bedside," Meddings says.

Jeff Brady, MD, is the director of Center for Quality Improvement and Patient Safety at the Agency for Health Quality Research (AHRQ). Academics and researchers working with his agency developed and vetted the HSOPS survey and are currently working on a revision, which will be tested at 40 hospitals starting next month.

Brady says the HSOPS is a well-vetted tool that has been key to improving safety. Each organization needs to understand its own unique culture, and the survey allows them to do that, he said.

"You figure out what areas you do well in, and you figure out areas where there might be opportunities for improvement and you take the next step by focusing on those areas," Brady said.

He notes that many of the "Tenets of Patients Safety Culture" in the Joint Commission Sentinel Every Alert are also in the HOSPS survey.

In his view, leadership's role is to attend to all of those necessary steps. "Know what your culture is and make sure it's optimalized for safety and quality."

Tinker Ready is a contributing writer at HealthLeaders Media.

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