Survey: Progress on Patient Safety Slowed by Ineffective Technology, Healthcare Professionals Say
SALT LAKE CITY, July 19, 2018 – Nearly nine out of 10 respondents to a national survey of physicians, nurses and healthcare executives say their organizations are successfully improving the safety of patients. But real problems remain, and to make further improvements, respondents to the Health Catalyst survey said they need better health information technology to warn clinicians of impending patient harm, as well as more resources and greater organizational focus on the problem.
The need for improvement is compelling. Medical error is one of the leading causes of death in the U.S. While mortality grabs the headlines, non-lethal harm events are even more frequent, occurring at a rate 10 to 20 times higher than lethal events, according to The Journal of Patient Safety.
Despite the dismal statistics, confidence in current patient safety efforts is high, according to the online survey of 462 medical, quality and pharmacy professionals in healthcare organizations of all sizes across the U.S. Seventy-nine percent of survey respondents rated their organizations’ success in improving patient safety either “somewhat good” or “very good.” Only 11 percent rated their patient safety efforts as “poor.” However, on the opposite end of the scale, just 9 percent gave their efforts an “excellent” grade.
Top Barriers to Improving Patient Safety
With 89 percent of survey takers still seeing room for improvement, the survey confirms that serious challenges prevent healthcare organizations from making a significant dent in preventable errors. Respondents identified several key obstacles that prevent them from achieving their patient safety goals, ranked here according to the percentage of respondents that selected them:
- “Ineffective information technology (data quality, patient matching, reporting)” and the related “lack of real-time warnings for possible harm events,” which requires technology – 30 percent
- “Lack of resources” including staffing and budget – 27 percent
- “Organization structure, culture or priorities” – 19 percent
- “Lack of reimbursement for safety initiatives” – 10 percent
- “Changes in patient population and practice setting” – 9 percent
- “Other” – 6 percent
Over-reliance on voluntary, manual reporting
Organizations’ lack of effective information technology for patient safety is tied to a related finding from the survey – that healthcare organizations of all types are almost completely dependent on manual methods of tracking and reporting safety events. According to the survey, the four most common sources of data used for patient safety initiatives are voluntary reporting (selected by 82 percent of respondents), hospital-acquired infection surveys (67 percent), manual audits (58 percent), and retrospective coding (29 percent). Nearly one-third of respondents (28 percent) reported also using trigger tools as a data source for patient safety, which could mean either the manual process of chart review that relies on Institute for Healthcare Improvement methodology, or home grown reports that also follow the IHI methodology.
These standard approaches to manual reporting of hospital safety events have been shown to find less than 5 percent of all-cause harm. Manual reporting is based on data that is at least 30 days old, and it requires extensive time and resources for data extraction, aggregation, and reporting, resulting in limited root-cause analyses.
“As these survey results confirm, the current approach to using voluntary reporting to monitor patient safety gives health care organizations a false sense of tackling the ever-present danger of patient harm,” said Stanley Pestotnik, MS, RPh, Health Catalyst’s Vice President of Patient Safety Products and one of the foremost experts at the intersection of patient safety and harm-reduction technology. “Recent evidence continues to demonstrate that the majority of patient harm goes undetected and that medical injury is the third leading cause of death in the US—evidence that challenges voluntary reporting as an effective patient safety management strategy.”
Regulatory reporting requirements help
When asked to name all of the factors that are most influential in driving their patient safety efforts, a majority of survey respondents (51 percent) named regulatory reporting as an influencing factor. Coming in second at 39 percent was “financial considerations” such as malpractice claims, value-based contracts and reduced reimbursement. Most of the other choices fell in the mid-range:
- Published accreditations and designations – 34 percent
- Patient satisfaction scores – 33 percent
- Data-driven organizational priorities – 29 percent
- Performance against safety measures – 27 percent
- Brand recognition, market competition – 16 percent
- Stakeholder interests – 11 percent
- Other – 5 percent
Areas most in need of improvement: All of them
Determining exactly where to focus patient improvement efforts seems to be a difficult decision for most organizations. When asked to identify the areas where patient safety most needs improvement, survey takers rated four of the six choices within 3 points of each other. “Inpatient clinical” areas of focus such as length-of-stay, mortality and readmissions came out on top at 21.6 percent, barely ahead of “operations” (21.1 percent), an area that includes ED wait times and patient instructions at discharge. Two other areas most in need of improvement, according to survey takers, were “severity of illness” (19.5 percent), “outpatient/ambulatory clinical” (18.6 percent).
Only “regulatory reporting,” including reporting of hospital-acquired conditions, seemed to require slightly less improvement than other areas, with 15.5 percent of respondents citing it. “Other” captured the remaining 3.7 percent of respondents.
“The big picture takeaway from this survey is that although a small portion of respondents felt they have a good handle on their patient safety efforts, the largest portion of respondents still believe that they have room for improvement,” said Valere Lemon, RN, MBA, a senior subject matter expert for Health Catalyst. “Surveilling all-cause harm will aid healthcare organizations in bridging the gap from niche focused improvements to proactive harm identification and broader patient safety improvement interventions.”
New Patient Safety Technology Introduced
Health Catalyst last week announced the release of the Patient Safety Monitor™ Suite: Surveillance Module, the industry’s first comprehensive patient safety application to use predictive and text analytics combined with concurrent clinician review of data to monitor, detect, predict and prevent threats to patient safety before harm can occur.
The Surveillance Module quickly identifies patterns of harm and proposes strategies to eliminate patient safety risks and hazards for current and future patients. This potent combination of predictive analytics, text analytics and near real-time data from multiple sources enables the Patient Safety Monitor Suite to predict harm events and trigger a response while the patient is still in the hospital.
Survey results reflect the opinions of 462 healthcare professionals who responded to an online survey in May and June, 2018. Respondents included 240 physicians, 99 nurses including 19 chief nursing officers, 38 pharmacists, 14 chief quality officers or directors of quality, and a number of other roles. They work for organizations ranging from some of the nation’s largest academic medical centers to national health insurers and independent physician practices.
About Health Catalyst
Health Catalyst is a next-generation data, analytics, and decision-support company, committed to being a catalyst for massive, sustained improvements in healthcare outcomes. We are the leaders in a new era of advanced predictive analytics for population health and value-based care with a suite of machine learning-driven solutions, decades of outcomes improvement expertise, and an unparalleled ability to unleash and integrate data from across the healthcare ecosystem. Our Health Catalyst Data Operating System (DOS™)—a next-generation data warehouse and application development platform powered by data from more than 100 million patients, and encompassing over 1 trillion facts—helps improve quality, add efficiency and lower costs for organizations ranging from the largest US health system to forward-thinking physician practices. Our technology and professional services can help you keep patients engaged and healthy in their homes, communities, and workplaces, and we can help you optimize care delivery to those patients when it becomes necessary. We are grateful to be recognized by Fortune, Gallup, Glassdoor, Modern Healthcare and a host of others as a Best Place to Work in technology and healthcare. Visit www.healthcatalyst.com and follow us on Twitter, LinkedIn and Facebook.