Improving Patient Safety and Physician Accountability

The third leading cause of death in the U.S. is medical malpractice, according to a study by Johns Hopkins University. Approximately 251,000 lives are claimed every year due to medical error, preventable deaths that outrank strokes, accidents, or Alzheimer’s. In light of the COVID-19 pandemic and increased strain on healthcare facilities, medical malpractice and negligence are even more of a risk because of physician burnout and the unrelenting demands placed on our healthcare systems.

In order to optimize patient safety, the Department of Health and Human Services’ (HHS) guide identified four key areas healthcare organizations should examine to prevent medical errors. Four common problem areas were found in primary care settings:

• breakdowns in communication
• medication-related errors
• factors influencing incorrect or incomplete diagnosis
• factors related to fragmentation of the healthcare system

By addressing these critical patient care areas, healthcare organizations can improve physician accountability and mitigate risk. Here are some ways that HHS recommends addressing these high-risk areas.

Systems-Based Approaches to Improving Patient Safety

A systems-based approach means that elements required to perform response operations are viewed as interrelated components of a single system. Once elements are viewed as an interrelated system, a standardized set of sequential management steps can be applied to any major undertaking. A systems-based approach to healthcare incident management can be especially helpful during times of crisis. By working under consistent objectives, strategies, and tactics, healthcare entities can trace patterns to mitigate risk. A systems-based approach also creates a culture of safety that not only mitigates risk but also reduces the stigma associated with errors, creates incentives for those reporting errors, and identifies and corrects the contributing system problems.

One way to apply a systems-based approach is to follow the recommendation of the HHS Office of the Assistant Secretary for Preparedness and Response, which encourages applying management methodology to the initial development of an Emergency Operations Plan (EOP).  This may support response strategies and reduce medical malpractice risk during emergencies.

Another example of a system problem is medication-related mistakes such as illegible orders and confusion of medications with similar names or packaging. Medication-related mistakes can be reduced by leveraging technology such as computerized systems that catch medication errors before reaching patients.

No-Blame vs Accountability

A “no-blame” model, referenced in the Institute of Medicine’s (IOM) report To Err is Human, approaches physician accountability as a “no-blame” program rather than one of punitive judgment and blame. Underreporting of medical errors is more common in punitive cultures where physicians fear the consequences of their mistakes.

“No-blame” cultures result in improved physician/patient communication. According to IOM, a traditional blaming culture distracts healthcare organizations from improvement. Instead, IOM recommends that healthcare organizations identify error-prone situations and settings, implement systems that prevent caregivers from committing errors, and catch errors before they cause harm or place patients at risk.

By focusing on accountability to vetted systems versus blame, healthcare organizations can improve patient safety and physician/patient communication and reduce medical errors. Optimized systems leveraging premium technology create a combined model of less blame and increased accountability.

Accountability in Healthcare

An accountability-based system holds individuals responsible for a set of activities and their actions. However, healthcare administrators increasingly find that failures to adhere to safety standards are often due to systemic issues.

Providers may not know what behavior is expected of them, understand the underlying rationale for the behavior, or recognize how behavior is audited. Dysfunctional systems can result in “workarounds” that, if evaluated, could be avoided. When healthcare organizations create efficient, intuitive systems, providers are more likely to follow regulations and quickly identify missteps.

Although healthcare organizations should apply swift disciplinary action to egregious or habitual violations, they should also understand the difference between dysfunctional systems and intentional violations. Finding the right balance between “no-blame” and accountability will prevent medical errors and their consequences for both providers and healthcare organizations. Healthcare organizations can integrate third-party credentialing software as part of their physician accountability and compliance systems.

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Legal and Policy Approaches to Accelerate Enhancement in Patient Safety

Errors in healthcare can be widespread and multifaceted. Therefore, legal and policy approaches to improve patient safety emphasize error detection and reporting programs, new clinical interventions systems development, and safety culture implementation within healthcare organizations. These efforts improve transparency, accountability, and communication and significantly reduce risks.

Third-party technologies improve patient safety and physician accountability with provider credentialing software that continuously monitors primary sources. By using Verisys’ multitude of data sets and database monitoring services, healthcare organizations ensure that physicians and healthcare organizations provide the highest quality of patient care.

Although credentialing can’t solve every system management issue, premium credentialing software can reduce risk significantly by allowing fully vetted providers and healthcare organizations to perform their work with accountability and confidence.

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