Small reforms that can significantly improve patient safety in the hospital – part 2

In our previous blog post on hospital safety, we introduced five reforms that one surgeon believes will significantly reduce medical errors and improve patient safety if implemented. This post will explore these recommendations in more detail.

Online dashboards

All hospitals should have an online informational “dashboard” that reports information that can help patients make informed choices about where to go for hospital care. The dashboard should include statistics for surgical complications, patient readmissions, infection, the number and types of surgeries performed, and patient satisfaction scores. People get performance information on restaurants, cars and many other consumer items. Why should hospitals be any different?

Safety culture scores

A hospital culture that promotes safety makes for a better, safer, hospital. Employees at all levels should be encouraged to speak up rather than remain silent because they fear for their jobs. After all, who knows better whether a hospital is safe than its employees? This can only happen when all personnel see themselves as part of a team; studies have shown that when hospital employees do not view their colleagues as partners, outcomes – and patients — suffer.

Cameras

Nothing keeps doctors on their toes better than the knowledge that they are being filmed. Having procedures filmed and preserved encourages physicians to follow evidence- based guidelines and established best practices. Videotaping and reviewing common procedures such as colonoscopies, cardiac catheterizations, arthroscopic surgery and others will promote peer-based quality improvement. One study showed that when hand-washing stations were filmed, compliance with standard hand-0washing procedures improved dramatically.

Open notes

Dictating notes during the patient visit so the patient can hear improves accuracy. If the doctor is recording the details of the patient exam and conversation incorrectly, the patient has a chance to correct it. Even if this is not practical, having notes available for a patient to review later provides an opportunity to correct errors in the patient record.

No more gagging

Although some hospitals and clinics have adopted some of these improvements, there are signs of backward movement as well. For example, patients are often asked to sign non-disclosure orders that promise never to say anything bad about their treatment online or elsewhere. And if you do suffer the consequences of a medical error and sue a hospital or doctor, you will almost certainly be required to not say anything about the injury as a condition of your settlement. Patients need more transparency, not less. This will allow hospitals to compete on safety as well as parking and anecdotal reputation.

Source: Wall Street Journal, “How to stop hospitals from killing us,” Sep. 21, 2012.