Why provider quality, risk departments need to work closely
In healthcare organizations, both of these areas have skin in the game to provide safer care and reduce instances of medical errors.
In healthcare, safer care can only be achieved with buy-in from across the organization. Risk mitigation begins with a collaborative and cohesive approach between functions to gather hard data to be turned into insights to inform leadership’s decision-making process.
Risk mitigation is executed by clinicians who closely adhere to policy changes put in place to prevent future harm.
Most healthcare organizations have a handle on collecting data. To be effective, organizations must be able to collect and view data holistically, bridging gaps between departments and consolidating data to produce meaningful insights. Providing clear and digestible insights to key decision-makers enables them to address immediate issues in policies and processes and have the information they need to make proactive changes to prevent future issues.
Preventing risk and being proactive
Information coordination is a key part of reducing risk, improving patient satisfaction, and preventing future incidents from occurring. Patient safety software have the potential to link files and produce data for better information coordination.
Here's one example – a patient is admitted into the hospital for a normal labor and delivery, but develops moderate hypotension and is treated with intravenous medication. Shortly after that, the patient’s blood pressure increases, causing a clinical deterioration and the need for an emergency c-section. During the safety huddle the following morning, it is learned that the high blood pressure was likely triggered by a medication error.
The use of an integrated solution enables the organization to identify and capture the adverse event, analyze it with built-in tools and suggest risk reduction policies. It also can also initiate prescribed protocols while communicating with the patient and family, and implement immediate peer support for the clinicians.
When the incident is identified, staff can submit an incident and then trigger a root cause analysis. After risks are identified and analyzed, this information can be used to create and manage new policies. With data captured and a new policy in place around this event, an organization is better equipped to get ahead and prevent similar events from happening in the future.
In this scenario, the medication error was identified during a safety huddle, and the pharmacy team was able to immediately implement a medication change in the dispensing solution, along with an organization-level alert to all staff notifying them of the change, thereby stopping a similar medication error from happening to another patient. By having a connected organization, it not only stopped another harm event, but it was able to openly communicate with the patient and family and provide much needed support for the clinicians who were involved.
The financial impact of collaboration
Collaboration between risk and quality teams is critical to providing high-quality healthcare. Without it, the financial and reputational implications for healthcare organizations can be astronomical.
A 2006 report from the Institute of Medcine indicates that 1.5 million injuries or deaths occur as a result of errors in prescribing, administering and dispensing medications each year in the United States. Leading healthcare economist Adam E. Block writes that, “based on projections of medical errors, actuarial estimates of costs for hospitals, and the potential reductions in costs due to known, evidence-based interventions, the total potential savings for the four major types of medical errors is $4,832,802 per 100,000 admissions, or a total of almost $48,328 for every 1,000 hospital admissions per year.”
Beyond the enormous operating costs associated with lower quality healthcare, organizations are financially incentivized to avoid medical errors. There have also been an increase in federal payment initiatives linked to healthcare quality, such as value-based purchasing provisions that exclude the costs associated with hospital-acquired conditions and financial penalties associated with high rates of patient readmission within 30 days of the patient being discharged for the treatment of specific conditions. These factors are encouraging organizations’ quality and risk departments to partner together.
Efforts to enhance quality improvement have resulted in a need for collaboration between quality and risk teams across the continuum of care. Some of these initiatives include “The Leapfrog Group's public hospital reporting initiatives to assist healthcare purchasers, the National Quality Forum's (NQF) serious reportable events and recommendations of safe practices for healthcare organizations, and the National Committee for Quality Assurance's (NCQA) quality measures (called the Healthcare Effectiveness Data and Information Set, or HEDIS) for managed care.”
The future of team collaboration
The relationship between risk and quality in healthcare will continue to have an impact on how organizations effectively support their patient safety and quality initiatives. The benefits of this collaboration are numerous, but some of the most notable pluses include:
- • Improved patient outcomes. When quality and risk teams work together, they can more effectively identify potential problems and develop solutions that improve patient outcomes.
- • Increased efficiencies. By collaborating, both quality and risk professionals can focus on their unique functions within an organization while also supporting each other's work. This collaboration can lead to increased efficiency and efficacy overall.
- • Safer patient care. One of the most important benefits of collaboration between quality and risk teams is that it can help make patient care safer. By working together, these teams can support each other's work and improve patient outcomes.