The industry strives for ‘zero harm’, but remains unprepared for today’s complex challenges

Saturday, August 31 2019

Anne Marie Benedicto

"Zero harm” is a healthcare rallying cry with roots that stretch back to the Hippocratic oath—and it’s one that still resonates with providers today.
Yet despite the prominence of this universal goal, a recent Joint Commission Center for Transforming Healthcare survey found as many as 1.98 million healthcare workers don’t feel they have the tools and training to help their organizations reach zero harm.
In fact, of those surveyed, fewer than half strongly agreed they have the resources needed to safely care for patients.
We’re at a tipping point. A growing number of people with increasingly complex needs are entering an environment where caregivers are being asked to do more with less. As the healthcare policy debate plays out in national headlines, courtrooms and capitol buildings, our clinicians at bedsides are looking for direction—and support.
When people seek care, they expect to start healing and get well. Yet daily there are documented cases of errors and unsafe conditions in care settings across the country—a critical problem for an industry built on the mantra of “first, do no harm”:

  • On any given day, about 1 out of 31 hospital patients has a healthcare-associated infection.
  • 94 wrong-site surgeries were reported to the Joint Commission in 2018.
  • Each year, as many as 1 million patients fall in U.S. hospitals.

Clearly, healthcare today requires dramatic improvement. The industry is not struggling because people need to work harder or be smarter; our medical centers are filled with intelligent, dedicated people who are giving their all to every patient. Healthcare is built on making life better, but so many systems and facilities are applying the same bandages, pulling worn-smooth “improvement” levers and expecting different results.

To truly make a difference and forge a new path toward a successful future, we must start by acknowledging that the system we set up no longer works for the challenges we face in 2019 over resources, care complexity and technology. Addressing these systemic issues won’t take a tweak here and a new checklist there. It will take wholesale change and a commitment to adopting and training workers on high-reliability healthcare principles, putting data-driven tools to work—and cultivating a safety culture to sustain these practices.

We’ve long known that high-reliability science, focused on consistent excellence in quality and safety maintained over long periods, can have an unparalleled impact on patients. Commitment to this approach must extend far beyond clinical staff. Foundational change has to start at the top, with leaders fully committing to the goal of zero harm and to making the kinds of changes needed to support and achieve this goal.

This level of leadership support—setting the expectation that zero harm is the top organizational priority—is critical to success. But despite the importance, there’s an overwhelming perception that leaders are far from committed. In fact, nearly 8 out of 10 healthcare professionals cited a lack of leadership (77%) and absence of organizational investment (79%) as barriers to healthcare excellence.

As an industry, we can no longer live in the gray area between today’s healthcare reality and the unclear landscape of tomorrow. It’s time to start equipping our caregivers with the right tools and building the high-reliability system that will help us succeed for the patients we serve, with “zero harm” at the center as the priority. The pursuit of zero harm transforms organizations so that the focus on excellence in patient care is supported by a focus on excellence throughout an organization’s infrastructure. After all, safe healthcare facilities are ones with strong financial performance, engaged teams and visionary leaders.

When we think about what comes before “first, do no harm” and develop the systems that set up our caregivers for success, we can truly live out our promise of zero harm—and make a lasting impact.

Modern Healthcare Op-ed Commentary: Healthcare remains unprepared for today’s complex challenges.