Three things every hospital should be doing now to improve patient safety

by David Goldsteen, MD, Patient Safety & Quality Healthcare

Improving patient safety has always been a priority for hospitals and health systems, but COVID-19, and the possibility of a second surge in a few weeks or months, is bringing new urgency to these efforts. All hospitals must quickly assess their current safety-related processes, identify optimization opportunities, and implement new approaches that foster a safer environment—not just for patients with COVID-19, but for all patients, staff members, and visitors.

A recent survey of 100 hospital leaders, physicians, pharmacists, and infection preventionists reveals some of the new safety-enhancing approaches that hospitals should consider. In the survey, conducted by healthcare consultancy Sage Growth Partners just prior to the COVID-19 outbreak in the United States, respondents identified their top safety challenges, evaluated their safety performance, and identified their most successful safety improvement approaches.

Here are three of the biggest takeaways:

• Hospital leaders say it’s time to look beyond the EHR for safety support.

As hospitals seek to improve patient safety, they need processes and approaches that enhance their ability to identify, track, and monitor safety problems in real time. The survey found that a growing number of hospitals (29%) are implementing clinical surveillance technology to help accomplish this mission.

Clinical surveillance continuously pulls information from electronic health records and other data sources, analyzes that data, and uses it to produce patient care insights and reports. The technology also issues real-time alerts to healthcare providers (via email, in task lists, or through dedicated notification channels) when potential patient safety problems arise.

Nearly all survey respondents (95%) said clinical surveillance improves patient safety and identified its top benefits as:

1.Identifying and managing safety events

1. Identifying medication errors
2. Identifying opportunities to improve antibiotic use
3. Ensuring safer opioid prescribing

In relation to COVID-19 specifically, clinical surveillance provides many safety-enhancing benefits. These include alerting healthcare providers and infection preventionists to test results in real time, providing outbreak and exposure alerts and investigation tools, assisting with contact tracing, and managing drug shortages.

• Hospitals that use real-time alerts have stronger safety performance.

Real-time alerts provided by clinical surveillance technology ensure physicians, pharmacists, and infection preventionists are notified as soon as potential safety problems are identified or critical information is available, such as that related to medication errors, non-optimal antibiotic or opioid use, or COVID-19 test results.

The survey findings underscore the safety-enhancing benefits of real-time alerts. Respondents who said their organization uses them were much more likely to be satisfied or very satisfied with their hospital’s safety performance. They were also more likely to:

• Say their organization could respond to a viral or disease outbreak immediately
• Say their process for identifying patients at risk for sepsis is very or extremely effective
• Say medication error rates and opioid prescribing rates had fallen in the past year

Real-time alerts also help hospitals optimize medication usage when certain medications are in short supply. With a second COVID-19 surge likely here in the U.S. and in other countries, providing pharmacists with real-time alerts related to medication usage is even more important. For example, if pharmacists receive alerts whenever a necessary medication for COVID-19 patients is ordered for a patient who does not have COVID-19, they can quickly determine whether an alternative medication can be used instead.

• Hospital leaders say safety-event reporting tools are critical to fostering improvement.

Nearly all survey respondents (98%) said a robust safety-event management system—in which safety-event information pertaining to patients, staff members, visitors, security, and housing is collected, assessed, and managed—is important or very important to supporting patient safety initiatives.

Still, only about half of respondents said they use safety-event management tools to support safety improvement efforts, and only 51% said their approach to safety-event reporting is extremely or very effective.

These findings are particularly concerning given the possibility of a second COVID-19 surge. Hospitals that did not have an effective safety-event reporting system during the first wave will have a harder time identifying where they made missteps and how they can improve moving forward.

The urgency with which hospitals must act to improve patient, staff, and visitor safety cannot be overstated. The good news is that hospital leaders report significant benefits from new approaches, which include clinical surveillance, real-time alerts, and robust safety-event reporting solutions. As hospitals seek to improve patient care, they all should begin exploring opportunities to implement these tools.

This article originally appeared in Patient Safety & Quality Healthcare, a Simplify Compliance brand publication. Goldsteen is the cofounder of VigiLanz, and serves as chair and CEO. He is a founder and former chair and CEO of Vascular Science, Inc., purchased by St. Jude Medical. Dr. Goldsteen is a graduate of the University of Minnesota Medical School. He performed his residency in internal medicine at Hennepin County Medical Center in Minneapolis.