The Quality-Cost Connection: Develop a patient safety management system
The Quality-Cost Connection: Develop a patient safety management system
Know the right questions to ask
By Patrice Spath, RHIT
Brown-Spath Associates
Forest Grove, OR
Every health care facility should have some type of patient safety management (PSM) system in place. Some programs are more formal than others. While there is no ideal model to follow, there are fundamental questions that organizations need to address: "Are all the elements of an effective patient safety program in place?" "Are the elements integrated?" "Do actual patient care practices conform with safety goals?" And perhaps the most important: "If the patient safety director left tomorrow, would the program continue to function effectively?"
This is the first in a series of three articles on the essential elements of a PSM system. The building blocks of an effective program are presented along with self-assessment tools. The questions can be used to identify to what extent your PSM system conforms to the generally agreed upon fundamentals of an effective program.
The checklists have been developed primarily to improve your understanding of critical PSM elements and raise awareness.
The elements incorporated into the checklists have been drawn from a number of sources and tailored to the unique needs of health care organizations. When you have completed the checklist, there are many different actions you can take depending on the results.
Hopefully the self-assessment process will provide some ideas for actions. If a task group or committee completes the checklist, get them together again to review the results and discuss next steps.
The PSM system promotes continual improvement in all elements of performance that affect patient safety in a health care environment. The core elements of the program are illustrated in the chart. These elements are connected in much the same way as the "Plan, Do, Check, Act" cycle of continuous improvement. While different organizations may use different terms, all the essential elements must be present in some form.
In this installment, we’ll explore the policy-setting phase. The PSM system derives its goals from the organization’s patient safety policy. It is established by the board of trustees and other top leaders, documented, and widely communicated throughout the organization. The policy should include a commitment to continual improvement, patient injury prevention, regulatory/accreditation compliance, and a management framework.
In this table, is a series of questions to identify to what extent your patient safety policy measures up to an ideal approach. Policy elements are organized in the format of a simple questionnaire with a four-part scoring system. Add your organization’s score for each question in the space provided. Begin by reading the description for score 0 to determine if the situation described therein accurately reflects the situation in your organization. If not, then proceed to the row and make the same decision. Eventually, move on to the last row and ask the same questions. In this way, you build progressively on your understanding of what the highest score of "3" means.
The questions can be used to better understand the PSM policy-setting phase and to judge the effectiveness of your current initiative. The scores are designed to be useful as tools, not grades per se. Use the results to discuss how your organization’s PSM policy needs to be strengthened. A "perfect score" (i.e., every question received a score of 3) would, if responded to thoroughly and honestly, indicate that your organization has all of the requisite policy elements for an effective PSM system.
In next month’s column, the phases of planning/commitment and implementation/operation action will be described. The accompanying self-assessment tools will aid your organization in determining strengths and weaknesses for these PSM elements.
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