Health workers still reluctant to report unsafe acts
In spite of significant efforts over the past two decades to improve healthcare quality and safety, it is widely recognized that there is more work needed to eliminate preventable harm in the U.S. healthcare system. Part of the problem continues to be that healthcare providers are unwilling to speak up about threats to patient safety, according to a new report from the National Association for Healthcare Quality (NAHQ).
“While a strong and just safety culture has been recognized as a key element for improvement, a critical deficit that has not yet been fully addressed is the lack of protective infrastructure to safeguard responsible, accurate reporting of quality and patient safety outcomes and concerns,” according to the report Call to Action: Safeguarding the Integrity of Healthcare Quality and Safety Systems. (The report is available online at http://tinyurl.com/Nahqreport.) “In fact, as attention to creating a culture of safety in healthcare organizations has increased, so have concomitant reports of retaliation and intimidation targeting staff who voice concern about safety and quality deficiencies.”
Some healthcare providers acknowledge that they fear reporting events or conditions that could endanger quality and patient safety, the report notes. Some professionals whose direct responsibilities include the monitoring and reporting of quality and patient safety outcomes have experienced pressure, outright harassment, or even serious legal and licensure challenges when they recognize and report events of concern.
“Only with integrity in reporting can healthcare organizations identify and eliminate the root causes of systemic problems that threaten patient safety,” the report says. “The accelerating implementation of new financial models that tie quality outcomes to payment will raise the stakes associated with quality results. The need will be even greater for a protective infrastructure to safeguard accurate reporting of quality data and patient safety concerns.”
The report builds on concerns in a February 2012 report from the Agency for Healthcare Research and Quality (AHRQ), which found most health professionals are reluctant to report errors because they are afraid of a punitive hospital culture. (That report is available online at http://tinyurl.com/AHRQsurveyreport.) The NAHQ, along with 11 other organizations, is calling on hospitals to incorporate protective policies that encourage better reporting in an honest culture of safety.
The NAHQ report urges hospitals to focus on accountability, such as helping clinicians recognize their responsibility for quality and safety. Hospitals also must protect workers who voice concerns about safety and quality deficiencies and ensure their data and reports are comprehensive, transparent, and accurate.
Hospitals should immediately examine and respond to any concerns, using an attitude of “appreciative inquiry” when looking into quality and safety issues, the report says.
In spite of significant efforts over the past two decades to improve healthcare quality and safety, it is widely recognized that there is more work needed to eliminate preventable harm in the U.S. healthcare system.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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