Why It Matters
Economic uncertainty may distract leaders from focusing on workforce and patient safety.
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What Worries Safety Leaders Around the Globe

By Derek Feeley | Wednesday, October 30, 2019

Almost no matter where you are in the world today, you’re experiencing the effects of economic uncertainty. I’ve traveled to several regions across the globe in the last few months, and I haven’t met a single health care leader who doesn’t have some fears about the future.

While these apprehensions are understandable — and I have concerns of my own — I worry about how they will influence global efforts to improve health and health care. From what I have seen, the biggest threat the economic climate poses to patient safety is the diversion of leaders’ attention. It’s easy to get consumed with the struggle to make sense of our economic and financial environment. In focusing on this uncertainty, however, we risk turning our attention away from keeping our patients and workforce free from harm.

What Leaders Can Do

We can’t afford to get distracted by things that are completely out of our control. There’s very little that an individual clinician, clinical team leader, or health care chief executive can do about the macroeconomic environment in which they operate. What we can do, however, is accept the complexity of the situation and turn our attention to addressing the issues we can control.

The three areas health care leaders from Asia to the United States tell me they find most challenging are the keys to keeping safety front and center in turbulent times:

  • Safety culture — Regardless of where you are, if you are a leader who wants to be serious about patient safety, you must prioritize your safety culture. Do people feel free to speak up when they see actions and behaviors that can lead to harm? Does everyone in your organization understand how they contribute to a strong safety culture, whether they’re a nurse, physician, or housekeeper? There are resources available to help, including Leading a Culture of Safety: A Blueprint for Success, a tool to help leaders assess and advance their organization’s culture of safety.
  • Care coordination — When resources are tight and the future feels uncertain, it’s important to make sure there’s coordination and collaboration at every level to minimize wasted efforts or resources. Is your organization improving care coordination at the patient level and at the system level? How is your system centering itself around the needs of the patient? The key is to maximize the learning opportunities from everyone’s patient safety efforts. For example, a number of organizations use safety huddles to increase communication, with some teams finding these briefings have contributed to more efficient flow and decreased mortality.
  • Listening to patients — Almost every patient I talk to acknowledges that their doctors, nurses, and allied health professionals are trying to do the best job they can. But patients also tell me, “Oh, the nurse just seemed so busy” or “I didn’t want to bother the doctor.” We shouldn’t assume that if patients (or their loved ones) had anything to say they would say it without our prompting. Let’s make it easier for patients and family members to express their concerns, share important information, and ask questions by inviting them into a dialogue. “What questions do you have? What can we review?” As Susan Edgman-Levitan — one of the people who first recommended we ask patients “What matters to you?” in addition to “What’s the matter?” — has noted, engaging patients may be easier said than done, but it can be done.

We know the kind of gains that can be made from rigorous and disciplined attention to implementing known patient safety practices. There have been many examples of success, but progress has been too slow and too fragmented.


LEARN MORE: IHI National Forum


With this in mind, IHI has been convening a National Steering Committee for Patient Safety for a little over a year with representatives from 27 organizations. Members from the health care, policy, regulatory, and advocacy communities have been working together to develop ways to renew energy and focus on patient safety. The Committee’s goal is to release a national action plan in 2020.

Why do we need a national action plan? Because there’s power in the efforts of the many. Broad collaboration across all our health systems has the potential to keep our patients much safer than a series of disjointed efforts. As we face economic uncertainty across the globe, it’s a good time to remember that — in addition to many of the same worries — we also share a common dedication to keeping patients and the health care workforce safe.

Editor’s note: Look for more from IHI President and CEO Derek Feeley (@DerekFeeleyIHI) on leadership, innovation, and improvement in health and health care in the “Line of Sight” series on IHI.org.

Leadership and Patient Safety sessions are part of IHI’s National Forum this December.

(Having difficulty watching this video? Watch on YouTube.)

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