How to keep patient and staff safety first

What are the oft-quoted words that sit at the foundation of delivering care? Ancient Greek physician Hippocrates’ “first, do no harm.”

As healthcare providers, we work every day to uphold the principles behind those words. However, medicine is a mix of rapidly advancing science, complex regulations, a lot of “players,” a need for effective and timely communication and, well, a bit of diagnostic art.

The highly regarded Institute for Healthcare Improvement (IHI) annually sponsors Patient Safety Awareness Week (this year March 8-14) to help encourage everyone to learn more about how to improve the safety of our healthcare system — for the health and well-being of not only patients, but our workforce that cares for them. Since the RxLive team works as an extended yet coordinated part of our provider partners, it’s a role we take very seriously…especially since medication errors and adverse drug events (ADEs) have been shown to cause nearly 700,000 Emergency Department visits and 100,000 hospitalizations each year.

A clinical pharmacist’s fresh set of eyes and ears during a patient counseling session on comprehensive medication management — playing a bit of “Nancy Drew” across their providers and pharmacies — can deliver a huge “gotcha” that can help stop adverse medication interactions which could be harmful, unnecessary and financially costly. I love it when I or others on our pharmacist and care-coordination teams can help patients and providers in that way.

Adverse medical events still a major killer

While there’s been significant progress made in patient safety over the last 20-plus years, current estimates still make medical harm a leading cause of death worldwide. 

The World Health Organization (WHO) estimates that 2.6 million people die each year in hospitals in low- and middle-income areas. But it’s not “just” within the acute-care setting with its multiple handoffs between shift personnel, electronic information systems, departments and more. WHO reports some 40% of patients experience harm in ambulatory and primary care settings, with about 80% of it being preventable.

So we all can continue to do more…for our patients, our colleagues and our families as well. After all, each of us interacts with the healthcare system in various ways and times throughout our life. Thus, we all have a role to play in advancing safe healthcare. Like reducing the risk of heart disease, cancer, HIV and others, we must consider ourselves part of a broad team that considers safety a public health crisis (PDF) that requires a coordinated public health response.

Tools you can use

First, of course, you should encourage the use of integrated information systems and standard processes across your own organization and between you and other organizations which you refer patients to. Data — turned into actionable information — and best-practice processes are key to determining trends (good and bad) and areas where updated processes, tools or a staff education refresh would have dramatic effects.

IHI offers a number of patient safety tools and resources, as well as ways your organization can get involved. These are a mixture of studies, videos and audios, Patient Safety Awareness Week free patient and staff educational materials for download. The not-for-profit Center for Patient Safety (CPS) is joining IHI’s 2020 safety campaign, and also has a valuable free toolkit available for download.

CPS suggests these tips to expand safety awareness:

  • Download the PSAW Toolkit.
  • Plan an event or several events to recognize patient safety efforts at your organization.
  • Make it fun! Come up with a theme for the week or each day, watch videos, take quizzes and play games to identify areas of safety concern or that enable everyone in your organization to get involved.
  • Assess your employee culture using a patient safety culture survey that launches during Patient Safety Awareness Week. The additional campaign awareness can help achieve a strong response rate.

IHI webinar with Don Berwick, MD et al. — Tuesday, March 10, 12-1 p.m. Eastern. Free with pre-registration.

The critical balance between risk and benefit

I agree with Robert Shmerling, MD, faculty editor of Harvard Medical School’s Harvard Health Publishing:

“The fact is that when difficult, real-time decisions must be made, it’s hard to apply the ‘first, do no harm’ dictum because estimates of risk and benefit are so uncertain and prone to error.

“But it IS a reminder that we need high-quality research to help us better understand the balance of risk and benefit for the tests and treatments we recommend. Ultimately, it’s also a reminder that doctors should neither overestimate their capacity to heal, nor underestimate their capacity to cause harm.”

National Patient Safety Awareness Week is a great time for that reminder, for all of us. 

Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.