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Safety Is Central To Our "New Normal"
In this new miniseries director of patient safety Iona Thraen examines our safety and quality improvement efforts through the clarifying lens of our coronavirus response. Part 1 focuses on patient-centered care and patient safety and proves just how much patient safety is embedded in our culture.
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was recently asked about how much patient safety and quality improvement I’ve seen during the COVID-19 pandemic. I’ve had two opposing responses. 

On the one hand, many of the patient safety and quality improvement efforts (past, present, and future) have been put on hold during the past 10 to 12 weeks due to our necessary focus on the coronavirus. 

On the other hand, our response to the coronavirus has given us a single-minded focus on safety and quality in dramatic and important ways. In fact, I have seen more patient safety and quality improvement efforts over the last few months than, possibly, over the past year. 

The coronavirus provides a clarifying lens

COVID-19 and the work we are doing to respond to its demands has provided us with a once-in-a-lifetime opportunity. It has given us fresh eyes with which to observe patient safety, quality and patient-centeredness in action. Improvement is more embedded throughout the organization than ever before; COVID-19 is the ultimate applied clinical and operational use case.

What improvement looks like today

To Err is Human, the groundbreaking work that brought medical error to the forefront, was published in 2001. That same year the state of Utah began to require reporting on what were then called sentinel events—an event that results in death or serious harm to a patient. Since then, multiple systems have evolved to identify patient experiences as well as patient safety events. 

Some have wondered if improved patient experiences and patient safety are simply delegated to one group within the organization. My experience suggests otherwise: patient safety has attached itself to the soul of the organization.  Here are just a few examples over the last few months.

Finances. Gordon Crabtree used the SAFE (S – Safety, A – Action, F – Financial, E – Everyone) framework to guide our organizational finances. 

Crisis standards. Russel Vinik demonstrated patient-centeredness by applying the Crisis Standards of Care principle uniformly to all hospitalized patients, and not only narrowly to special cases.

Ambulatory settings. Richard Olrandi and Sam Finlayson focused on sound processes to safely dial up ambulatory services and resume elective surgery.

Behavioral health. Jim Ashworth opened our eyes to the impact of COVID-19 on mental health and UNI’s unique strategies for dealing with social distancing, isolation, and the well-being of psychiatric patients.

Orthopaedics. Pat Greis showed us how patient safety, not money, convenience, or preference, are guiding how patients are selected and procedures are conducted.

Virtual care. Maia Hightower leads virtual care that highlights safety, convenience, access, and importantly, patient-centeredness.

There are, of course, many more examples. All of them demonstrate that patient-centeredness and patient safety are embedded in our organizational psyche. I see it everywhere. And while we shouldn’t rest on our laurels, we can take time to congratulate ourselves. In the face of unprecedented changes, we are changing too—and our patients are better for it.

Contributor

Iona Thraen

Director, Patient Safety, University of Utah Health