National Association for Healthcare Quality (NAHQ) Issues 'Call to Action' for Enhancing Health Care Quality and Patient Safety

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National Association for Healthcare Quality

Oct 16, 2012, 02:30 ET

CHICAGO, Oct. 16, 2012 /PRNewswire/ -- To enhance overall quality of care, strengthen patient safety protection, and minimize costly medical errors, health care provider organizations should expect all clinical staff to be accountable for achieving meaningful quality improvements and reporting potential safety risks. This allows health care professionals to feel empowered and protected when reporting concerns about potential risks and adverse events, according to the National Association of Healthcare Quality (NAHQ) www.nahq.org in its "Call to Action: Safeguarding the Integrity of Healthcare Quality and Safety Systems" issued today.

"A strong safety culture is essential for any health care organization to maintain effective quality monitoring processes and ultimately preserve the integrity of health care quality and patient safety systems," said Susan Goodwin, MSN RN, NAHQ Immediate Past President and assistant vice president, HCA in Nashville. "Without a strong safety culture, frontline providers and management may fail to identify a concerning pattern of performance or a single event or may hesitate to report them.

"In any given situation where quality or patient safety is called into question, the process by which an issue is raised is considered as important as the query itself. Not every concern about patient safety or quality of patient care will ultimately be deemed valid, but every reported concern deserves serious consideration. A culture that encourages such disclosures is critical to improved patient care," said Goodwin.

NAHQ's "Call to Action" provides detailed recommendations adopting best practices to enhance provider institution quality, improve ongoing safety reporting, and protect staff. NAHQ collaborated with several national health care professional organizations in developing the recommendations, including the American College of Physician Executives, American Health Information Management Association, American Medical Association, American Nurses Association, American Organization of Nurse Executives, American Society for Healthcare Risk Management, National Association Medical Staff Services, National Association of Public Hospitals and Health Systems, National Patient Safety Foundation and The Joint Commission.

"We are calling on U.S. healthcare organizations to build on their achievements to ensure the integrity of quality evaluation and measurement by fostering even stronger safety cultures and processes," said Cynthia Barnard, MBA, the NAHQ volunteer responsible for leading the work on the paper and director, quality strategies, Northwestern Memorial Hospital, Chicago. "It is not only good medical practice but also good business, especially as accountable care organizations, which tie reimbursements to quality measures, are becoming more prevalent in the market."

Recognizing the importance of optimal safety and quality management, many health insurers are linking payments to quality outcomes and will withhold reimbursement for hospital-acquired conditions. "We hope this action by payer groups helps eliminate incentives in health care organizations that impede efforts to improve patient safety and quality," said Barnard. "It certainly raises the stakes for reporting less than optimal outcomes."

While studies show that more than 85% of those who report concerns about performance or misconduct in health care facilities have a positive experience, there is room for improvement in this industry. The Institute for Safe Medication Practices has reported that 40 percent of clinicians either keep quiet or remain passive after witnessing an improper patient care event to avoid possible reprisals. In a 2010 straw poll of NAHQ members in leadership positions, three in four respondents said they personally experienced an incident of ethical and professional concern related to reporting quality or safety concerns.

NAHQ's members are healthcare quality professionals (HQPs) who conduct thorough and objective reviews of a provider organization's overall quality and safety. They evaluate and investigate potential quality problems and report them to appropriate management. To be effective in this role, they must be assured protection. The same holds true for those in other roles that encompass responsibility for quality and patient safety, such as an organization's executive administrators, chief medical officer, chief nursing officer, other clinical leadership, risk manager, medical staff services professional, and health information management professional, to name just a few. Each must be supported and protected in performing their patient safety and healthcare quality oversight roles without undue or inappropriate pressure to suppress or withhold reporting of concerns.

In the Call to Action, NAHQ offers several practical recommendations to assure the integrity of quality processes within a health care institution is maintained. They are:

Create a focus on accountability for quality and safety as part of a strong and just culture: Educate employees continually about expectations for timely reporting of quality and safety concerns. Publicize ethical responses to errors and 'good catches' through management praise, peer recognition and other techniques. Benchmark regularly by comparing the organization's performance in responding to quality and safety concerns with peer organizations. Consider engaging patients and families to report their concerns and ideas.
Ensure that protective structures are in place to encourage reporting of quality and safety concerns: Establish explicit policies that support error reporting and penalize reprisals in response to reporting. Respond, counsel and discipline as needed to ensure that egregious violators of policies regarding error reporting are not permitted to work or practice in the organization.
Ensure comprehensive, transparent, accurate data collection and reporting to internal and external oversight bodies: Establish quality improvements so that data collected are applied to foster improvements in patient outcome. Set policies that protect data integrity, and communicate to clinicians any identified gaps in patient care processes.
Ensure effective responses to quality and safety concerns: Immediately investigate and respond to any adverse event, complaint or concern. Implement effective actions plans to address vulnerabilities and gaps in quality and safety processes.
Foster teamwork and open communication and ensure effective oversight.

About NAHQ

Founded in 1976, the National Association for Healthcare Quality (NAHQ) represents more than 10,000 quality and patient safety professionals working in healthcare settings both nationally and internationally. NAHQ provides education, leadership development opportunities, and resources to support quality professionals. More than 40 NAHQ state affiliates provide education and networking at the local level.

Quality and patient safety professionals are an integral part of the success of today's modern healthcare system. They impact every aspect of the healthcare process in facilities large and small, from major metropolitan health centers to local long-term care facilities.

Healthcare quality professionals ensure their facility meets specific requirements set forth by accrediting bodies for healthcare organizations and programs, such as The Joint Commission and Centers for Medicare & Medicaid Services.

For more information, visit www.NAHQ.org.

SOURCE National Association for Healthcare Quality