So, the AIG survey of hospital executives and risk managers reveals a disturbing pciture that might explain some reasons patient safety problems still exist in the hospital industry.  Here are the highlights:

According to hospital executives and risk managers, the largest barrier to patient safety is lack of teamwork, negative culture and poor communication in their hospitals (42% C-Suite; 55% Risk Managers). The main problems include the following:

  • The perception that nurses fear retribution if they discuss patient safety (26% C-Suite, 29% Risk Managers);
  • Documentation burdens (69% C-Suite, 60% Risk Managers);
  • The number of patient “handoffs” among hospital staff (56% C-Suite, 61% Risk Managers); and
  • The quality of coordination and communication between departments at their hospitals (59% of C-Suite executives, 69% of Risk Managers).

Another big problem: inconsistent perceptions of who is “responsible for” patient safety and who “owns” it. 98% of both C-Suite executives and Risk Managers agreed that “every staff member in my hospital is responsible for patient safety.” But, 52% of C-Suite executives and 51% of the Risk Managers believe that nurses “own” it.  Inexplicably, executives see nursing staff turnover as one of the least influential items on overall hospital risk even though they place the onus of patient safety on nurses.

More problems:

  • 75% of C-Suite executives see reporting of quality metrics as beneficial to safety, but, 20% see negative impacts as a result of having to report these metrics.
  • 84% of C-Suite executives and 88% of Risk Managers think their hospitals effectively use technology to improve patient safety, 59% of C-Suite executive and 53% of Risk Managers think it takes clinical staff away from patient care.
  • 23% of C-Suite executives and 24% of Risk Managers think their hospital is more focused on driving publicly reported metrics instead of actually improving patient safety. Most hospital leaders think the public is not smart enough to understand patient safety measures (83% of C-Suite executives and 89% of Risk Managers).

Obviously, the hospital industry still has a long, long way to go solve these fundamental problems that result in needless injury and death in the hospital setting. Most of the problems outlined here have been identified in the literature for many years.  Yet, there still is little by way of improvement since the groundbreaking Institute of Medicine study showing at least 98,000 people die needlessly in hospitals each year due to medical and nursing malpractice. Sadly, the hospitals are no closer to dropping the secrecy that protects the industry and acts as the largest impediment to real patient safety improvements.

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