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Employers Role in Patient Safety

Uncomfortable-ShoesHealth premiums paid by employers and their employees are profoundly impacted by health costs, especially when the care was inappropriately delivered.

Since the release of Heartland Health Research Institute’s Silently Harmed white papers, a number of employers have inquired about how they can influence patient safety practices in the hospitals that serve their communities.

To be clear, there are no easy answers. Employers are deservedly frustrated with the perceived leverage they have to influence necessary progress on this issue that dually impacts costs, and most importantly, lives. When it comes to patient safety, there appears to be just enough self-interest group regulation that precludes the public from igniting a patient revolution.

It has been said that revolutions never happen in comfortable shoes – and so it goes with healthcare.

Healthy organizations require healthy employees. From the employer perspective, ‘patient safety’ should be equally balanced with two other initiatives: affordability and high-quality outcomes. This ‘holy trinity’ of value – cost, quality and safety – serve as the cohesive bond for all payers – government, carriers and employers. Armed with the right information, employers can play a proactive role in changing the healthcare delivery landscape that is currently going through a seismic evolution (if not a revolution). In fact, now is the time for employers to inject their influence to a mammoth industry that requires major disruption.

Employers, assisted by carriers, can begin to craft health plans that reward safety practices and discourage (or penalize) non-compliance, urging hospital boards to make patient safety a priority. This can be done by insisting that providers implement safety measures that demonstrate adherence to patient safety cultures. By leveraging this new role, employers can educate their employees on how they can engage more effectively with their healthcare partners to receive better care. Distributing patient safety literature to employees and family members can serve as important reminders for patients to proactively seek care from providers who have proven to give the right care at the right time. Visiting the National Patient Safety Foundation website can be a great first step to increase awareness about patient safety issues. There are many other organizations promoting quality and safety measures, such as The Leapfrog Group, which cleverly includes a ‘hidden surcharge calculator‘ for Leapfrog members to calculate their average annual hidden hospital surcharge resulting from medical errors.

Iowa is served by very capable and well-intentioned providers. But the question is not as much about the people who care for us, rather, the ‘systems’ in which they operate. Due largely to self-interest concerns, medicine is unable to regulate itself voluntarily – it needs a push from those who have much at stake – employers and other purchasers.

Employers can and must promote patient safety measures when purchasing health coverage. There is no better time than now for this to happen.

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  1. Thanks for making this important point. Bad safety is never a good bargain, so it’s critical to incorporate safety into a value strategy. Two other good resources: Consumer Reports offers ratings including safety. And Leapfrog offers the Hospital Safety Score, a letter grade rating hospitals on safety.

  2. Anne Kinzel says

    David: Nice piece. I only have one caveat. WHen you say employers can influence the safety climate I think you have to be careful. The US financing systems has employers of vastly different size and complexity responsible for purchasing health care coverage for their employees. It would seem that only a small number of very large employers willl have the wherewithal to engage in safety-related purchasing. While those employers employ the vast majority of covered employees, it still leaves a sizable number of employers with no ability to impact the system. This may help explain why their is such underperformance in safety.

    • Anne, Even smaller employers can give employees information on the relative safety of hospitals and health systems in their community, and educate them to use that data in decisionmaking. The difference between a hospital with a Hospital Safety Score of “A” and one with a “C” is dramatic in terms of lives lost and expenses by purchasers.

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