- Integrating behavioral and physical healthcare access, addressing physician burnout, and creating safe mHealth patient engagement tools are among the top patient safety issues of 2019, according to the latest rankings from the ECRI Institute.
The annual rankings outline the key issues that will be essential to promote patient safety. And while many of these topics address clinical skills and health IT, others look at how providers interact with their patients.
For example, using mHealth in a judicious way to engage the patient outside of the clinic will be essential for driving outcomes in chronic care management.
Rated as the number four patient safety issue, mHealth use calls into question the habits clinicians develop when prescribing a technology intervention. mHealth has presented a great opportunity for chronic care management and post-discharge recovery by bringing care into the patient’s home. However, there are some issues that healthcare experts are working to overcome.
“Risks of mobile health technology include lack of regulation of new technologies, barriers to ensuring that providers are accurately receiving the data a device collects, and the possibility that a patient is not using the technology correctly or is not using it at all,” the report authors stated.
Part of the equation will be establishing whether an mHealth tool is actually usable, the report noted.
“It’s no use to have a technology that the patient is supposed to use at home if the patient is not going to use it,” said Juuso Leinonen, senior project engineer, Health Devices Group, ECRI Institute.
Organizations must also establish strategies for reporting user error or inactivity to clinicians. Additionally, organizations should train patients in how to use an app when it is assigned as a part of the patient’s chronic disease management plan and ensure that it is the appropriate app for the patient’s condition and lifestyle needs.
Other patient safety topics go into the healthcare facility. For example, breaking down the siloes separating behavioral and physical health will be crucial. The separation of both elements of patient health can have negative consequences, landing it as the fifth patient safety issue, according to the ECRI Institute.
If a clinician treating a patient with a physical ailment is unaware of a certain behavioral health issue, she may react to any issues in a negative manner, impeding the patient-provider relationship and patient care.
But because behavioral and physical health are often treated as two issues, mitigating those issues can be difficult.
A behavioral health issue “is not a broken leg that you can see and feel,” said Nancy Napolitano, BS, patient safety analyst, ECRI Institute. “How do we change our mindset so that everyone belongs here and is treated with dignity and respect?”
To address this challenge, healthcare organizations need to provide better training opportunities for patient-provider communication. These sessions should emphasize patients with behavioral health needs.
For example, organizations can offer certified training courses with internal experts or host community behavioral health first aid classes. Additionally, creating mock situations in which a clinician encounters a patient with a behavioral health need may be helpful.
Organizations may also foster specialist teams to support these needs. Nursing staff could take courses to become integrated behavioral and physical health specialists. Additionally, behavioral health staff could be “on call” to address any needs.
“Working with external resources can improve care coordination and identify ways to develop behavioral health skills and support in non-behavioral-health settings,” the report authors wrote. “Organizations can also reach out to community resources.”
Finally, the report acknowledged the clinician burnout epidemic. Ranked as the third most pressing patient safety issue, burnout is pervasive and indiscriminate, the report authors noted. Because clinicians are often self-critical and face increasing demands from the healthcare system, burnout is a significant problem across the industry.
And while the EHR and other technologies contribute to burnout, the report authors stated that the entire healthcare industry needs to change to accommodate clinician needs.
“Reprioritizing what a clinician needs to do is one way to reduce burnout, but ultimately the system must change,” the authors noted.
“If burnout is to be addressed effectively, organizations must listen to providers’ concerns about workload, performance criteria, and suboptimal resource allocation and fix these problems at a system level,” the report continued. “Moving to a safety culture that rewards and recognizes a job well done is necessary. Leadership must strive to make providers feel they are treated as human beings, whose opinions and abilities are valued, rather than as cogs in a wheel.”
For example, providers will need to spend more time with their patients. This will be a significant patient satisfaction driver while also creating more job satisfaction for providers.
The ECRI Institute patient safety rankings sets out to help healthcare organizations address the challenges they currently face. The Institute determines the key subject areas by reviewing common patient safety events, assessing common patient safety literature, and speaking with industry experts.