How do we really know if the strategies we put in place will create a safer healthcare system–today and in the future?
A willingness to ask these hard questions is an excellent first step in creating a safety culture, and we certainly have no shortage of patient safety data to support analysis of patient safety issues. But, what’s missing is an effective and simple approach to “unlock” the mysteries of patient safety–a way to measure and monitor patient harm.
The measurement and monitoring of safety is far from straightforward. Quite the contrary. It’s incredibly difficult to measure how, and if, healthcare systems are making patients safer. Take, for example, patient harm due to “falls” (the most common patient safety event reported in most countries, and the highest volume of events in BC PSLS). How do we measure if fall prevention strategies are making a difference?
The Health Foundation, an independent organization in the UK, conducts comprehensive research and evaluation about patient safety and quality. In 2013, Professor Charles Vincent and colleagues published The measurement and monitoring of safety, which describes the fundamental components of safety and lays the groundwork for a new way of thinking about patient safety.
Recommendations in the report are meant to apply to all healthcare settings and we believe may serve as a useful and practical resource for healthcare providers across BC in their daily efforts to improve and measure harm.
“Framework” for the measurement and monitoring of safety
The five dimensions shown in the diagram below provide a clear framework for healthcare providers to assess patient safety on a number of different levels. In local contexts, this means looking at what’s happening on a day-to-day basis, discussing patient safety openly and integrating lessons learned:
- Past harm – encompass both psychological and physical measures
- Reliability – measures of behaviour, processes and systems
- Sensitivity to operations – monitoring safety on an hourly or daily basis
- Anticipation and preparedness – ability to anticipate and be prepared for problems
- Integration and learning – ability to respond to, and improve from, safety information
– Used with permission by The Health Foundation
We invite healthcare leaders to explore these concepts and actively pursue opportunities for improvement. Begin by initiating (or participating in) conversations about safety. Such conversations liberate and empower healthcare staff, allowing them to feel comfortable discussing safety issues without any blame or fear of punishment.
We’ll do our part, too. Here at BC PSLS Central Office, we are starting to explore ways in which we can analyze and present our data, in combination with data from other sources, to build and present a more comprehensive, robust view of patient safety in keeping with the framework recommended by Vincent and colleagues. Better measurement and monitoring will help us answer the questions posed above and focus our efforts with confidence that they will make our healthcare system safer.
More patient safety resources from The Health Foundation:
- For a deep dive into the 5 dimensions and framework, watch this video of Professor Charles Vincent talking about the report in detail and answering questions
- This patient safety timeline is a fascinating, visual representation of significant patient safety milestones over the past 150 years
- The measurement and monitoring of safety (summary report)
- The measurement and monitoring of safety (full report)