Patient safety Featured

7:00pm EDT November 24, 2006

While patient safety has always been important, the issue took on even more significance in the health care field in the late 1990s when the Institute of Medicine issued an alarming report regarding medical errors that lead to thousands of unnecessary patient injuries and deaths each year. That report led to the creation of new patient safety standards as well as specific action plans for health care organizations to follow in order to achieve those standards.

Patient safety has come a long way in the last decade or so; not only to the benefit of patients, but also to the benefit of helping to maintain health care costs, according to Cathy M. Ceccio, executive vice president and COO at Akron General Medical Center.

“Many health care organizations have really gone the extra mile to take practical, measurable steps to hardwire patient safety practices into their culture,” she says. “The result has been more emphasis on patient safety and outcomes than ever before.”

Smart Business spoke with Ceccio about the changes in patient safety standards and how patients benefit from those changes.

How do health care organizations monitor their patient safety measures?

A number of third-party organizations can help health care providers assess and improve their patient safety standards, including an organization called the Leapfrog Group. Leapfrog — a collaboration of large employers and health care purchasing consortiums that have an interest in patient safety — was initially created to address concerns about the cost of care. It found that the lack of good patient safety measures and systems were key factors in escalating costs. Through initial research, it identified three key patient safety initiatives: utilizing a computerized physician order entry system, evidenced-based hospital referrals, and 24/7 staffing by critical-care-trained physicians in intensive care units.

In addition, Leapfrog embraced 27 other safe practices identified by the National Quality Forum, including very practical measures such as having nurses read back verbal orders and ensuring that all medical personnel use standard abbreviations.

How have patient safety standards changed over the years?

Leapfrog and other patient safety organizations were influenced by the 1999 Institute of Medicine report called ‘To Err is Human.’ The report concluded that if we just implemented some basic changes in patient care, tens of thousands of lives — if not more — could be saved.

Patient safety has really moved from a global awareness issue to a very practical issue. The standards have more teeth to them now because tactics and an action plan were identified for each of the standards. It’s one thing to have awareness, but awareness is not the answer. You must have an action-oriented approach. As a result, patient safety today is more practical, more measurable and very data driven.

How can employers be sure that the hospitals included in their medical plans meet or exceed patient safety standards?

Many hospitals will put quality and patient safety information directly on their Web site, including Leapfrog and other quality indicators. It’s also very common for hospitals to include important patient safety information in their brochures or information about various procedures that are provided to patients. It’s a good indicator when a hospital makes an effort to educate its patients not only on what they need to know, but why such things are important and the reasons that safety precautions are in place.

Employers should look for designations from organizations that focus on patient safety like Leapfrog and the Joint Commission on Accredited Healthcare Organizations. This information should be visible on hospital and health care organizations’ Web sites, promotional materials and patient information materials.

How do patients benefit from patient safety standards?

A lot of very pragmatic and practical steps happen when an organization really embraces patient safety. One of the actions we take involves ‘red rules,’ which are rules that you adhere to, no matter what. For example, you never do anything with, to, or for a patient without having two ways to properly identify that patient. Other very practical patient safety tactics include creating and utilizing a structured way for any clinician to update a physician on a patient’s status and standardizing the use of abbreviations to reduce confusion in interpreting physicians’ orders. They may sound simple, but these types of actions help an organization to really hardwire safety practices into their culture.

CATHY M. CECCIO is executive vice president and COO at Akron General Medical Center, which recently was named as one of the top 50 acute-care hospitals in the country for meeting patient safety and quality standards. Reach her at (330) 344-1019 or