One hospital safety expert, who admits she'd be scared to be admitted to a hospital, explains what needs to change to make hospitals safer.

Marie Thibault

It's not often you hear someone extolling the virtues of airlines. But Paula Wilson, president of the Joint Commission International (JCI), wonders why hospitals can't be more like airlines in terms of safety. She told an audience at the New York Health Forum "Future Is Now: The Era of Mobile Health" on May 21 that she gets on planes without trepidation, but would be scared to go to a hospital. 

Wilson knows what she's talking about when it comes to hospital safety. JCI accredits health care organizations around the world and advises hospitals on best practices. She notes that in three-and-a-half years, there were 120 "Sentinel events" recorded as a result of something going wrong with or bad use of technology. Sentinel events are defined by JCI as "an unexpected occurrence involving death or serious physical or psychological injury or the risk thereof." What's more, Wilson added, there were likely more such events and near misses that weren't reported.

So what can hospitals do to become safer, or more specifically, reach what Wilson terms "zero harm"? Wilson detailed three things that must change within the area of hospital technology in order to achieve a higher level of safety:

1) A Safety Culture

Wilson wants healthcare workers to be more like engineers, because "engineers tend to be obsessed with failure." Calling healthcare professionals "far too optimistic," she urges healthcare organizations to become "mindful of all opportunities for failure of your systems and processes." 

By thinking more about how things could go wrong and reporting any mistakes or problems, Wilson believes hospitals can become safer, more reliable organizations. "We are encouraging safety culture in order to be a more safe organization around technology, creating a collective mindfulness around all of the things that could happen around technology," she says. 

To achieve this, hospital staff needs to feel supported and should understand that improving safety is the highest priority. "A safety culture is one in which not only do people feel comfortable reporting a near miss or mistake, but they are actively congratulated, encouraged, and praised for bringing those mistakes forward because that's how you can actually correct the problem," says Wilson.

2) Process Improvement

It is important to make sure that when the hospital adopts a new technology, that everyone learns how to use it and that the same technology is used across the entire organization, Wilson says. "Here, as an organization is adopting a new technology, we really encourage standardization and redundancy, so that the processes of using machines across the organization—and it's gotten way more complicated now because of all the mergers and acquisitions going on in healthcare, the vendors are going to vary by site—how do you get standardization across all of your care sites when different people are using different equipment, different types of technology? We are even seeing in those mergers and acquisitions, that they're not all on the same EHR base . . . all of that creates great risk," she says.

Making sure that technology is kept up to date and that the users were part of the decision to buy the technology is important. Wilson says, "One of the key things that we see throughout the literature and the evidence around using technology, is to involving the front line staff as you make choices about what vendors to use, what technology to use, what devices to use. The front line users have to be engaged. . ." 

3) Leadership Engagement

Wilson explains that when the top brass makes it clear that they care about safety issues, everyone else within the organization is likely to make it a priority as well. "If the leadership team is not engaged around these issues, you'll probably have a much higher risk for more errors, more near misses, and serious harm from technology . . . When the whole organization understands that the chief executive and the key team there is looking at the safety metrics around the safe adoption of technology, there tends to be much more attention paid to this on a day-to-day basis." 

Marie Thibault is the associate editor at MD+DI. Reach her at [email protected] and on Twitter @medtechmarie. 

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