Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Value-Based Care News

How a Cultural Transformation Can Advance Patient Safety

“You can be the best surgeon in the world, practicing at the best hospital in the world. But if you commit a safety error ... your being the best is irrelevant.”

By Jacqueline DiChiara

- Everyone makes mistakes. But what happens when an innocent mistake sends someone to the grave? Hundreds of thousands of patients reportedly die annually because of avoidable medical errors. How many more need to die before the healthcare industry wakes up and takes action?

revenue cycle management patient engagement press ganey

“With more than 400,000 deaths annually in the United States attributable to health care errors, a focus on health care safety is a strategic, professional and ethical priority,” write James Merlino, MD, Press Ganey President and Chief Medical Officer of the Strategic Consulting Division, and Gary Yates, MD, Manager Partner at Strategic Consulting within a new research paper on the reduction of safety events.

“The value of effective and compassionate care delivered by highly qualified providers is diminished if a patient is harmed because of a serious safety event. If a preventable error leads to patient death, the care has no value, and everyone suffers," they state.

The authors list 4 top strategies to help healthcare entities both transform culture and advance patient safety:

  • Committing to a zero harm events goal
  • Understanding the interdependency between safety, quality and patient-centricity
  • Leveraging data and transparency to identify performance gaps and drive improvement
  • Creating and sustaining a culture that supports caregivers in their mission to provide empathic, high-quality, highly reliable care

“If a patient experiences a serious safety event or is harmed by a medical error, his or her overall experience will be negatively impacted, despite the highest quality of care,” said Merlino within a press release.

READ MORE: Preparing Providers for the Healthcare Consumerism Shift

“The time has come for the industry as a whole to embrace zero tolerance for patient harm. Organizations must commit to transformation and embrace new ideas to ensure the delivery of safe, compassionate, high-quality care.”

Why capturing a patient’s true voice is imperative

Understanding how critical elements of patient experience are interrelated is a key to success, says Merlino in an exclusive interview with

“Revenue cycle is impacted positively when organizations successfully integrate safety, quality, and service," he asserts. "This trifold combination reduces the cost of execution and improves outcomes.” 

Investment in strategies and tactics, Merlino says, must be associated with the synergistic benefits of all three of these elements. Merlino uses many different types of surveys to help capture the true voice of the patient.

READ MORE: Lean Primary Care Improves Physician Productivity, Costs

“Typically – if you’re looking at the inpatient environment, for example – there’ll be what’s called the HCAHPS questions, which is the CMS mandater inpatient survey. And we have a block of customized questions which help organizations get a better granularity understanding of the inpatient environment.” 

“There’s a standard survey and then a customized survey which helps to get more granular detail.  We have that type of setup for various areas, including inpatient, ambulatory environment, ambulatory surgery, medical practice environment, emergency medicine department, home health, pediatrics, and psychiatry.” 

“We also do sentiment analysis where we’re able to analyze the comments and determine if it’s positive, negative, or neutral.  And then do some groupings for them to provide a much more detailed drill down.”

Merlino says patients’ survey commentary is then sent to clients’ providers verbatim, as transparency efforts are the key to improving.

“We recommend clients be very transparent with their business units on comments and distribute them in a regular fashion so managers and leaders can use them as an improvement tool.” 

READ MORE: 52% of Practices Use Various Reminders to Stop Patient No-Shows

“Categorizing comments and getting them out to people so they can use them as improvement tools is very important. I remind administrators it’s not you saying things about your organization, your physicians, or your nurses. It’s what your customers and patients are saying.”

Preventable hospital errors the third leading cause of death

“About 440,000 people in the United States die annually from preventable hospital errors. It is the third leading cause of death in the United States, which should shock us.” 

“Senior citizens – people over 65, which by today’s standards is really not that old – have a 25 percent chance of injury, harm, or death from preventable hospital errors. That’s 1 in 4. The numbers are staggering.”

Merlino says medical errors occur because of human factors and process factors. Human factors include a lack of training and a failure to pay attention. Regarding process standards, Merlino says the healthcare industry still lacks homogenous process standards. What is imperative as a greater next step of sorts is collecting transparent metrics that are important to patients regarding safety, quality, and service, says Merlino.

“We’re human, we make mistakes, we are fatigued and stressed, and maybe we’re not keeping up to date with standards," he asserts.

“Getting data collected in a consistent fashion so everybody is recording the same information and being transparent about it, so we have a way to compare organizations against each other and understand what the benchmarks should be is a first step.”

Achieving zero harm with a spotlight on culture

The healthcare industry also has to work on making culture a focus, adds Merlino.

“Culture is where patient experience has played an incredible role as healthcare organizations have worked to retool their cultures to be more patient-centric.” 

“Evidence demonstrates when healthcare workers come to work more engaged, more satisfied – wrapped around this idea of patient centricity – they care more and are more likely to provide safer, high quality care.”

We have to standardize. We have to dig deeper and really get to the root causes – the problems that lead to serious harm. And then we have to take those learnings and put them back into the organization so we can help prevent harm events from occurring in the future.”

Merlino says there must be an industry-wide commitment for zero harm. Helping people understand their priorities, he asserts, will help to transform the healthcare industry.

“You can be the best surgeon in the world, practicing at the best hospital in the world. But if you commit a safety error because you were careless and a patient has a complication and dies, your being the best is irrelevant.”


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