Healthcare's Culture Crisis
The Problem: The Risk of Medical Errors
The oft cited and highly touted landmark study, To Err Is Human, illuminated with scientific validity the magnitude of the medical error problem in healthcare. While it changed expectations of what the standard should be, the prevalence of medical errors and the lack of effective institutional programs remains a major challenge. Specifically, research has shown that an understanding of organizational dynamics and the application of teamwork principles and communication protocols are what is required for organizations in high risk industries -- such as aviation, nuclear power, and petrochemicals -- to become "High Reliability Organizations" (HROs), organizations that achieve remarkably consistent records of performance despite highly complex environments. In short, the culture of safety and quality matters, not as a “nice-to-have” but as an influencer, first and foremost, of patients physically surviving and, second, of hospitals financially thriving. For safety culture in healthcare, there is a long way to go.
The Need: Measuring & Improving Culture
Emblematic of the current need is the inability for hospital CEOs – charged with running organizations of high quality and safety – to answer the basic question, “Are we safer?” Or, more pointedly, “Are we safe today, and are we safer than last year?” Without measuring safety culture, hospital leaders cannot manage and improve safety and quality, which are inextricably connected. Indeed, the Joint Commission has recognized research findings and the clinical imperative of measuring patient safety culture and has announced that, as of January 2009, hospitals and healthcare systems should conduct cultural assessments. But, for patient safety, this is only the beginning of the introduction of metrics, a phenomenon that inevitably hits every field of endeavor: from finance to IT to baseball, and so on. For healthcare, the advent, multiplication, and maturation of metrics and the use of resulting analytics has just begun.
The Answer: Scientific Rigor, Disciplined by Clinical Judgment
The answer to the question, “Are we safer?” rests on the ability to draw upon and integrate the scientific rigor of academic research, the practical judgment of clinical expertise, and the scalability and empowerment of technology and operations. Why? Patient safety must be rooted in science, enabling data-driven intervention. Clinical experience is crucial, as knowing how to apply science feasibly to achieve real results is the difference between success and failure. And, finally, infrastructure using the latest in technology to support the accessibility, interpretability, and actionability of the data is paramount. Integrating scientific, clinical, and technology expertise is what Pascal Metrics does.
