Quality and Patient Safety: The Team Approach

Most people don’t foresee the need for treatment at a hospital or an outpatient facility when plotting points on a life map. The experience is usually the result of an unforeseen illness, a downturn in a condition, or an emergency, such as a car accident. Regardless of the reason, however, many patients have less-than-ideal treatment outcomes. While medical facilities and providers understandably bear most of the responsibility for quality and patient safety, patients can also play a role.

The Problem


Within the medical community, a discussion of ways to fix quality and patient safety issues, and in turn boost outcomes and lower costs, is often a finger-pointing exercise. According to top organizations, providers should embark on a team approach that involves clinicians, administrators and board leaders who focus on relationship-based care.

Achieving improvements involves three areas:

  • Culture is important in any healthcare organization. Everyone must work as part of a team, feel safe to speak up, and be subject to accountability. In after-the-fact, wrong-site surgery reviews, as many as 80 percent of interviewees revealed they knew an incision had been made at the wrong site, yet said nothing.
  • Healthcare (clinical) analytics involves studying and being aware of the significance of important data.
  • Content refers to concepts like shared baselines and the practice of evidence-based medicine.
  • What exactly needs fixing?

    According to the Centers for Disease Control and Prevention (CDC), on any day, around 1 in every 25 patients in a U.S. hospital suffers from a minimum of 1 healthcare-associated infection (HAI). In 2011, U.S. acute care hospitals had an estimated 722,000 HAIs. Approximately 75,000 HAI patients died while hospitalized. More than half of recorded HAIs developed outside an ICU.


    Direct hospital costs for U.S. HAIs have fallen between $35.7 billion and $70 billion a year. This is more than half the annual budget of $70 billion to run the U.S. Department of Education.

    Unfortunately, HAIs are not the only quality and patient safety issues. Among others cited by the American Hospital Association report Zeroing in on the Triple Aim are central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP), adverse drug events (ADEs), falls and fall-related injuries, and early elective deliveries (EEDs) of babies.

    What Providers Can Do

    Cultural changes and the skillful use of analytics require time to evolve. However, the Agency for Healthcare Research and Quality cites 10 important steps hospitals can implement now to promote quality and patient safety:

    • Take steps to prevent CLABSIs
    • Revamp discharges to reduce the number of preventable readmissions
    • Create a protocol to help prevent venous thromboembolisms
    • Provide patient education on blood thinner use
    • Put limits on medical residents’ shift durations
    • Evaluate consulting a Patient Safety Organization (PSO) for suggestions
    • Follow evidence-based principles of hospital design
    • Collect and use metrics on the facility’s patient safety culture
    • Improve rapid-response systems and teams
    • Follow a safe protocol when inserting chest tubes

    Patient Tips


    An HAI takes is name from a disorder that develops in a hospital. Unfortunately, HAIs also develop outside hospitals. They can occur any place where patients receive medical care. Some of the most common include:

    • Outpatient clinics
    • Dialysis centers
    • Rehabilitation hospitals
    • Long-term care facilities

    Fostering quality and patient safety, along with the financial savings that accompany them, requires a team effort. The best team consists of healthcare providers, visitors, and patients themselves.

    According to the CDC, safe patients are those who are informed, empowered, and prepared. Following these 10 suggestions will help individuals stay safe when receiving medical care:

    • Be sure to tell providers about safety concerns.
    • Ask providers and visitors to clean their hands if you don’t see them doing so.
    • Ask if a central line or a urinary catheter is still necessary or can be removed.
    • Insist on new needles or syringes each time an injection or procedure is necessary.
    • Be vigilant about medications by following directions on packaging and revealing other drugs taken.
    • Practice the smart use of antibiotics by taking them only when necessary.
    • Ask about exactly what to do to prepare for surgery to avoid a surgical site infection.
    • Report signs of C. diff. such as diarrhea.
    • Learn the signs of skin infections, such as redness, drainage, or pain.
    • Get a flu shot if possible to prevent illness.