A recent meeting of the Council on Patient Safety in Women's Health Care highlighted healthcare culture change and patient engagement as key to better patient safety.
Wantagh, NY, August 7, 2014 (Newswire.com) - On July 14 - 15 the latest Council on Patient Safety in Women's Health Care meeting was held in Washington DC under the auspices of the American Congress of Obstetricians and Gynecologists. PULSE of NY was represented by Dr. Leslie Farrington.
Farrington, an Ob/Gyn specialist for almost 30 years and a Board member of PULSE, says she experienced “an epiphany” at the council meeting: a breakthrough in understanding two key factors that can slow the runaway increase in patient deaths from medical error that we have seen in the United States in recent years.
"We should think about how to put the hearts back in health care, and underline the importance of patient education in the initiatives to improve outcomes."
Dr. Leslie Farrington
The first is to change a certain culture within parts of the medical system: a whole complex of stereotypes and subtle attitudes that converge to deprive patients’ of optimal care.
The second is to change the patient. Few of us really have high “health literacy” — a thorough understanding of the basics of safe care and the will to insist on them.
The groundbreaking report To Err is Human was published in 1998. Despite implementation of many of its recommendations for improving patient safety, the rate of preventable patient deaths in the US has at least doubled and possibly quadrupled in the 15 years since the report’s publication. We are moving quickly in the wrong direction.
“We will not get the results we desire from protocols and initiatives if we do not have a culture change among clinicians working at the bedside and in the clinics,” says Farrington. “We need a culture of respect and compassion for all colleagues regardless of title, degree, rank or status in the medical team. We need a culture of respect and compassion for all patients regardless of level of education, socioeconomic status, race, religion, abilities, sexual orientation and country of origin. Maybe then we can decrease the racial disparities we see in morbidity and mortality.”
Farrington cites her own African-American heritage as crucial to understanding the last point. Rates of mortality in childbirth are much higher among African-American women than among Caucasian women, and, she says, many of her white colleagues are at a loss to understand why. Her reply? “Any woman in my family can tell you why: they are viewed by a largely white medical establishment as somehow ‘other.’ If medical difficulties arise, there is less a feeling of ‘There but for the grace of God go I’ than there may be when the patients are of the same race or ethnic background.”
“Financial pressures, time constraints, burnout, fear of litigation, intolerance and prejudice have undermined the efforts to improve safety and quality,” Farrington says. “I have heard the grumbling of docs and nurses when a new checklist, protocol, or patient-centered idea is handed down from the department head. I have heard the complaints of providers who say their patients are anxious, demanding or noncompliant (instead of citing their low health literacy or mistrust of the doctor). And not washing hands is just one example how time is "saved" by busy staff.
The other half of the equation is patient engagement. When members of the public learn as much about accessing health care and understanding their conditions and risk factors as they know about food shopping or eating out at a restaurant, they will become what Farrington calls “I-Patients”: Informed and Involved and empowered to say to that resident who is about to change their surgical dressing, "Doc, would you please wash your hands? I would feel much safer."
“The July 2014 meeting of the Council on Patient Safety in Women's Health Care,” she says, “has inspired me to maximize my own efforts in empowering consumers in my community. Listening to the speakers at the meeting with their obvious passion for saving lives and preventing harm gave me hope for the future in women's health care.”
Farrington sums up: ”We should think about how to put the hearts back in health care, and underline the importance of patient education in the initiatives to improve outcomes.”