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blog 3 measured 090919

Healthcare organizations are certainly not lacking data. We measure everything and anything that can move over time. We measure employee attendance, physician engagement, hand hygiene, blood-borne pathogen exposure, time to answer a call light, equipment downtime, number of falls, and the list goes on.

However, the ability to measure and review data doesn’t mean we’re always measuring the right things. Likewise, just because we are measuring something, there is no promise that it will magically improve without some form of managed effort.

The convergence of myriad data points and quality measures are now integral factors in healthcare’s shift from fee-for-service to value-based care payment models, as well as patient safety. To reiterate the latter point, patient safety is also an important component of value-based care models that are part of the Quality Payment Program (QPP), which is where we find the Merit-based Incentive Payment System (MIPS).

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The intersection of patient safety and value-based care.
MIPS is the latest iteration of the volume-to-value payment shift, which the Centers for Medicare and Medicaid Services (CMS) intends to result in the end of fee-for-service by the first half of the next decade. The common theme for quality healthcare, MIPS, patient safety, and value-based care is data. Understanding and using the data will determine the success of value-based care and, more importantly, the revenue streams of hospitals, clinics, physicians, and ACOs.

Measurement, and the resulting data, can help us manage and assess progress in important areas such as quality and safety. A less explored data point that can significantly impact and strengthen quality and safety of care is culture data. It’s also now being used in many new and innovative ways to strengthen organizational sustainability.

The links among organizational culture, safety, and quality are nothing new. Many industries have generated high-reliability outcomes by addressing culture change. By controlling an organization’s ability to change and respond, culture has an incredible impact on organizational success. As management expert Edgar Schein wrote, “Culture determines and limits strategy.”

Patient Safety Culture

One approach to understanding an organization’s current state of patient safety is to collect data around specific adverse events, near-misses, and unsafe conditions. This data reflects a reality that’s known by front-line staff but is often difficult to fully capture. Many organizations have been collecting this data for a long period of time, but consider the quantity and quality of the patient safety data collected in the past at your own organization.

Challenges in collecting “good” data include:

  • Lack of education about what to report;
  • Lack of education about how to report, including inefficient reporting processes;
  • Lack of prioritization to report a mistake, near-miss, or unsafe condition; or
  • Staff members who are fearful to report a mistake.

An artificially low number of reports can be interpreted several ways. Most often it generates a false sense of security for leaders who assume all is well. The Institute of Medicine’s report To Err is Human addressed this false reality and implemented a paradigm shift by encouraging leaders to study mistakes and respond to them proactively rather than reactively. This encouraged the development of safety science and corresponding changes in culture.

“Culture,” in its simplest form, consists of the attitudes, beliefs, and perceptions of a collective group of people. It shapes their behaviors, decisions, and choices, and is therefore a complicated but highly influential component of the safety equation. “Patient safety culture” is the extent to which an organization’s culture supports and promotes patient safety.

How healthy is your patient safety culture?
Understanding employees’ attitudes and perceptions helps leaders as they seek new talent and work to retain talented staff. Candidates are attracted to work environments that demonstrate shared accountability, trust, and transparency. Safety programs based on the science of safety, data-driven outcomes, strong leadership, and a supportive culture will move healthcare organizations forward in a progressively demanding and competitive environment.

Patient safety words

Patient safety culture can be measured by determining what is rewarded, supported, expected, and accepted in an organization as it relates to patient safety. The selection of a measurement tool is important and should not be selected at random. The Agency for Healthcare Research and Quality’s Surveys on Patient Safety™ (SOPS™) are the most recognized in the world for the validity, benchmark data, and diverse usage. There are multiple surveys for various healthcare organizations including hospitals, surgery centers, nursing homes, and pharmacies. Each survey is designed to assess several areas, such as:

  • Teamwork;
  • Communication openness;
  • Continuous improvement;
  • Leadership support for patient safety;
  • Feedback and communication about error;
  • Staffing;
  • Hand-offs;
  • Response to errors; and,
  • Patient safety grade.

Find the AHRQ’s patient safety culture assessment tools here. Or check out the Center’s survey administration options.

Why CPS and Primaris?
The Center for Patient Safety administers the surveys as a way to ensure anonymity and provide the most valid data. Reports provide structured data in the form of next steps and include benchmark results so you can compare your organization to other organizations.

If your organization recently administered the SOPS™, are they participating in the national database? If your survey is administered by CPS, the data is submitted for you. Contributing to the national compare database keeps benchmarks relevant and valuable.

For more information about patient safety’s crucial intersection with value-based care and the need for accurate, reliable, timely, and actionable data, download Primaris’s tip sheet, How Healthy is Your Health Care Data.”

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