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5 Patient-Centered Strategies to Improve Patient Safety

Healthcare professionals can help improve patient safety through patient-centered care strategies and incorporating the patient as part of the care team.

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- Patient safety is a key aspect of patient-centered care and is tied to the patient experience and health outcomes.

However, all too often healthcare professionals view patient safety and patient-centered care as two different issues. Clinicians sometimes view patient safety as a part of their clinical care, and do not incorporate safety into their patient experience initiatives.

Additionally, clinicians often leave patients out of patient safety protocol, despite evidence that patients can support safety initiatives.

Properly engaging patients, driving patient satisfaction, and listening to patients are critical to supporting patient safety initiatives. Likewise, clinicians must make sure patients and their caregivers are knowledgeable about their care and can help prevent medical errors from falling through the cracks.

Below, PatientEngagementHIT.com outlines how clinicians can incorporate patient-centered strategies into patient safety programs.

Allow patients access to EHR data, clinician notes

Facilitating patient access to health information and clinician notes is an effective method for preventing medical record misinformation. When patients can look at their EHR data, they can spot inaccuracies in medication history or prescription errors.

In a recent OpenNotes study, researchers found that patient access to clinician notes help improve patient safety.

Researchers introduced a feedback tool to 41 physicians who had already adopted OpenNotes. Between August 2014 and August 2015, 6,225 patients had access to the feedback tool.

Forty-four percent of participating patients looked at their clinician notes, and about 8 percent of patients used the feedback tool.

Of the patients who used the feedback tool, 23 percent reported safety concerns, usually pertaining to medication errors or misreported pre-existing health conditions.

Sixty-four percent of these reports were flagged as confirmed or possible concerns, and 57 percent of reports turned into eventual medical record revisions.

“Our findings add to a growing literature suggesting that patients can help identify mistakes,” said lead author Sigall Bell, MD. “We were struck that nearly all patients and care partners in the study found the feedback tool valuable. What that indicates to us is that patients are eager to help their health care teams ‘get it right.’”

Care for hospital environment

Ensuring hospital cleanliness is a clear-cut method for preventing adverse patient safety events. Facility staff should make sure all areas in the hospital or office are sanitary to protect patients from hospital-acquired conditions (HACs).

Although HACs have gone down in recent years, they still present a significant healthcare issue. In 2011 -  the most recent year for which the CDC has published statistics - HACs killed nearly 75,000 patients, highlighting the need for continued improvements.

However, caring for the hospital environment goes beyond cleanliness. According to a report from the American Hospital Association, hospital administrators should enforce quiet hours and be attentive to lighting to ensure patients get the proper rest necessary for recovery.

Administrators can also implement convenient times for waking patients for various procedures, being careful not to disrupt the recovery process for the sake of tests that providers can potentially conduct at a later time.

Create a safe patient experience

Building a positive patient experience is about more than simply making the patient happy. Ensuring patient safety and that the patient does not experience preventable harms are equally important to the patient experience.

“When we say patient experience, it’s not in addition to quality, it’s not if we have time after we’ve gotten care right,” said Deirdre Mylod, PhD, Executive Director of the Institute for Innovation and Senior Vice President of Research and Analytics at Press Ganey. “Patient experience is that safety and quality. It is what patients think of their care. It’s how efficient and effective care is.”

Mylod stated that clinicians should deliver patient-centered and attentive care to ensure a safe and positive patient experience. For example, nurses should be quick to react to nurse call lights, and other clinicians should make sure they are circulating rooms to meet patient needs.

“[Clinicians] can go in on an hourly basis to make sure that patients have what they need, to make sure that things are in reach, if they need to go to the bathroom, what their pain is like,” Mylod explained. “It proactively meets patient needs so they don’t need to push the call button.”

Healthcare professionals should also stay attentive to procedure protocol, another key aspect to delivering a quality patient experience.

In his role as Johns Hopkins Medicine Vice President of Patient Safety and Quality, Peter Pronovost, MD, PhD, helped developed patient safety checklists to ensure adverse safety events do not mar the patient experience.

“Patients are at risk of dozens or hundreds of harms, and those harms vary by each diagnosis or procedure,” said Pronovost, who says patient safety and patient satisfaction go hand-in-hand.

“For too long, we separated the quality of care and the experience of being cared for as two separate things,” he noted. “In reality, I think most care providers said, ‘my job is to cure and those other things – well, they’re someone else’s job.’”

Instead, healthcare professionals must ensure that both patient safety and patient experience are top priority. Patients cannot have a positive experience without safety.

Create simple and timely appointment scheduling

Creating a simple appointment scheduling process is key for ensuring patients receive care in a timely fashion. When patients cannot access necessary treatment, they may become increasingly sick while waiting for an appointment.

Healthcare organizations must implement quality appointment scheduling protocol that keeps appointment wait times at a minimum. In a past interview, Irene Vergules, a medical call center consultant, maintained that facility administrators should assess patient population preferences to determine what kind of demand the organization faces.

“Know what your customers are expecting in terms of access, and then work to make those things happen,” Vergules explained. “Make those availabilities available. Look at your schedule. Make sure that your providers are seeing patients. Make sure that anyone who calls can actually get an appointment, that they don’t have to be squeezed in or kind of worked in to get an appointment.”

When patients face long wait times, they also run the risk of seeking care from the inappropriate provider. For example, patients who cannot receive a primary care appointment for pneumonia symptoms may go to the emergency department when that may not have been the best access point.

Encourage family and caregiver engagement

Promoting family and caregiver engagement can likewise support patient safety by adding yet another set of eyes looking for inaccuracies in patient care.

Planetree Director of Research Jill Harrison, PhD, pointed out that having a family member present at the patient’s bedside is one of the best patient safety drivers.

“When a patient is in the hospital, they need an extra set of eyes and ears to understand things,” Harrison explained. “Having a family member by their bedside after surgery is one of the greatest things a family member can do in terms of safety.”

With family members at the bedside, clinicians should explain to both them and the patient medication and care directions, ensuring that patients get the proper care to facilitate recovery.

Additionally, clinicians should ask family members about the role they will play in a patient’s at-home recovery. More often than not, hospitals discharge patients into family member care, making it critical that family members know how to perform simple healthcare tasks to make sure the patient is safe while out of the hospital.

“Planetree has a program that allows people to say that they want help with wound changes, or help ambulate their loved one, or help check a tracheotomy if the patient has one,” Harrison said. “Caregivers go through a training program with the nursing staff and learn how to provide that care so that when patients get out of the hospital setting their family members are ready to take that all on.”

Ultimately, incorporating patient-centered strategies for patient safety is about making the patient a partner in healthcare. Allowing the patient to guide safety initiatives through data access helps clinicians ensure all care is accurate. Furthermore, patient input allows clinicians to implement strategies that will meet patient needs and alleviate any potential harm.