Have you read the September AARP Bulletin? The lead article has a huge front page headline: "Warning! How the Healthcare System Can Harm You." The author informs the readers-all 38 million of them-that 250,000 people die each year from medical errors as reported by a Johns Hopkins researcher, unfortunately true. And then he tells them "how to fight back." My interpretation is that the public sees the healthcare experience as a fight for their lives. We have to do better than this in our care environments.
The author's advice is sound; in fact, most of it is what we consider best nursing practices: hand washing, patient identification before medication administration, speaking up (aka patient engagement), repeating back instructions, and medication reconciliation. This list is eerily similar to the National Patient Safety Goals. Why are they still goals? They should be embedded practices by now.
Several other approaches were suggested, one being to check on various websites "that could save your life," such as http://medicare.gov/hospitalcompare and http://hospitalsafetyscore.org. Our organizations spend a lot of time ensuring that the data driving these comparisons are accurate, arguing the validity of the scoring systems, and sometimes making excuses for not hitting benchmarks. We're painfully aware of the nurse-sensitive indicators that we haven't yet nailed: falls, pressure ulcers, and infections. Many of us have achieved great results, even zero incidents. Why not all of us?
Here's an often discussed issue for clinicians and a piece of advice from AARP: Have someone accompany the patient during hospital stays and physician visits. Despite the evidence on open visitation and the obvious risk mitigation from another set of eyes and ears, we still struggle with it. Security concerns, clinical time management, lack of space, and privacy for overnight caregivers in semiprivate rooms-all get in the way of doing the right thing for patients. This is simply not good.
The AARP article also instructs its readers to "look for signs of a safe hospital," meaning visible information on infection rates, unrestricted visiting hours, and noting how nurses and physicians interact. The last one is incredibly insightful to me. We all know that true collaboration makes for improved patient outcomes, never mind an improved practice environment for our staff. How are we demonstrating this to our patients? And, more important, if collaboration is lacking, is it on our radar as leaders? It should be.
Even truer is a section on clinical burnout, clearly identifying that a low quality of work-life balance compromises patient safety. What's AARP's advice to readers on how to counteract their clinicians' burnout? Be respectful and not obnoxious because the patient's relationship with healthcare providers is the "cheapest medical insurance you can buy." We can't argue that burnout and unhealthy work environments don't have negative effects or that respectful, relationship-based care doesn't has positive results.
AARP gives sage advice to 38 million people on how to fight back against the threat of medical errors. Much of it is what we know to be evidence-based practice. We can't let our guard down, despite recent advances in improving patient safety indicators. The public may trust nurses, but not our healthcare systems. As nurse leaders, we know there's still much work to do. Our patients have been cautioned to fight, and we must keep fighting for them.
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