The Industrialization of Patient Safety

Posted on June 1, 2011


I really wanted to get through an entire day without becoming miffed at a bunch of bureaucrats, but that didn’t happen.  Today I saw a headline that reminded me that too often, bureaucrats care more about protecting the organization than about the people they are supposed to serve – unless, of course, there’s money in it. 

The Baltimore Sun reported over the weekend that Johns Hopkins just received a $10 million donation to open a new institute aimed at studying the problem of preventable medical harm. The donation comes from C. Michael Armstrong, chairman of their board of trustees. Okay, first, a big thank you to Mr. Armstrong for the donation. But that’s the end of my kudos.

The bureaucrats strike again! First they industrialized healthcare and we all know the result: 1 in every 3 people admitted to a hospital in the United States is harmed by the care they receive, and 1000 patients are killed each day. Healthcare bureaucrats have set their sites on patient safety advocacy, turning the study of patient safety into a cottage industry – just one more revenue stream to add to their bottom line. 

Hospitals are first to line up for grants to study this problem and first to send out PR teams with a message of, Hey, no need to pay attention to this anymore; we’ve got it covered. Does anyone else see a conflict in trusting hospitals who are legally allowed to profit from inflicting avoidable pain and death on their patients, to also get paid to study the problem?

Here’s another question: Does anyone seriously believe we need one more study on the causes of preventable medical harm? What is this new institute going to tell us that we don’t already know? Hasn’t the Joint Commission covered this? What about the presitigious Leapfrog Group for Patient Safety? What about RWJF, or Harvard, or any one of a dozen other organizations that have been there, done that before Johns Hopkins? And yet, here we have another announcement. One more study. One more new program to fund and maintain. Another giant hospital gift. I guess we’re expected to applaud politely and wish them well in their humanitarian work.

I’m sorry. I just can’t do that today. I’m all out of polite applause. This is the simple formula for ending preventable medical deaths and injuries in our nation’s hospitals. If you’re a hospital CEO or board member, pay attention:

1) Give a damn about the patients you serve. Don’t just say you do.

2) Staff your facility with competent, qualified professionals – enough of them to handle the patient load – and then get out of their way and let them do their jobs.

3) If someone on your payroll makes a mistake, you eat the cost. No more profiting from your mistakes. 

4) Publicize the mistakes. All of them. In cases where giving a damn about your patients doesn’t motivate you, honest publicity about adverse events will provide the leverage needed for policy change.

Hospitals should not be allowed to profit from the study of the very problem they are creating, any more than the cigarette industry is allowed to profit from the harm its products cause its paying customers. Yes, I am drawing a comparison here because I believe it fits.  The healthcare industry and big tobacco are peas in a pod. There are far more similarities than differences in their business models and in the attitudes they share about their customers and if you find that comparison offensive, get over it. Do a little research into their histories and I think you’ll draw the same conclusion.

I’m waiting for the day when we stop rewarding hospitals with grants for studing the misery they inflict on the public. Instead, we should be leveling heavy fines to help pay for the ruined lives their shoddy care has created.

While we’re on the subject, let’s clear up one more thing: True patient safety advocates are not hospital employees working under the umbrella of the Risk Manager and the hospital legal team, so let’s stop calling them advocates. Let’s call them by their true function – Front Line Defense, there to coerce families and patients when harm does occur.  

If we are to make true progress in this fight for safe quality patient care, we need independent patient safety advocates working with patients in every hospital in the USA – working on behalf of the patients, not the hospital.