The final word: Where is the patient’s voice in patient safety?

Sunday, September 01, 2013 12:46 PM
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Think About It Colorado

Brian G. Dwinnell, MD, FACP

There has never been a time when we have experienced more change in our profession than we are experiencing today. Some have chosen to welcome this change; others would prefer to have all their teeth removed devoid of anesthesia. However, even the majority of those who see the changing landscape as ripe with possibilities have failed to seize the opportunity to collaborate with those experiencing the health care we deliver, breaking down the proprietary walls that inhibit our progress in safety and quality. Certainly other industries have learned to partner with their customers. I resist referring to our patients as consumers because it diminishes the inherent altruism associated with the delivery of care, which is a value we should never relinquish. But is it not the ultimate irony that we fail to value the contributions of the individuals for whom we strive to help? We seem to emphasize patient-centered care, yet we continually marginalize what patients can contribute to the care they receive.

One could offer many theories regarding our lack of efforts at partnering with patients. Fear is certainly a barrier, whether it is related to liability or perhaps the perceived potential loss of autonomy. Some of the fear may be rational, as there are examples of activated patients or advocacy groups that may convey a tone of accusation. However the mounting evidence of the effectiveness of the concept of full disclosure should provide adequate rebuttal. True patient safety efforts focus on system improvements rather than identifying a guilty party.

Process improvement in complex systems requires the participation of each key stakeholder. Improving the culture of patient safety is certainly no exception, but we have failed to capture the voice of perhaps the most crucial stakeholder. We must overcome the perceived lack of alignment of key stakeholders and look for opportunities to collaborate. It is reasonable to expect that major delivery systems, insurers, providers, and the patients we serve may have incongruent goals at times. Surely we can all align around the desire for good outcomes for patients. Even the most cynical argument cannot convince me that this is a value we don’t all share.

Think About It Colorado (TAIC) is a coalition of knowledgeable leaders from health care, patient advocacy and business communities dedicated to promoting statewide awareness of the needs and opportunities for safer health care. TAIC also serves as the bridge across diverse health care organizations by bringing all partners together to enhance a culture of safety. A strong, genuine partnership between patients and providers can be a significant step toward better health care safety.

We talk about transparency, but now is the time to walk the walk. Think About It Colorado includes tools and resources to help physicians engage patients in safer care. We need to share our shortcomings with our patients and work collaboratively to prevent errors, or at least address the systems that led to the errors they experienced. Let’s invite our patients to participate in longitudinal quality and safety improvement. Go to ThinkAboutItColorado.org to learn more. If we are going to redevelop systems and processes, isn’t it logical for those experiencing these processes to be involved in their development?

Brian Dwinnell, MD, FACP is the Director of Graduate Medical Education and Medical Staff President-Elect with Presbyterian-St. Luke’s Medical Center in Denver and is an Associate Professor of Medicine at the University of Colorado. He is also a member of the Think About It Colorado Board of Advisors and a member of the Colorado Medical Society.


Posted in: Colorado Medicine | Final Word | Initiatives | Patient Safety and Professional Accountability
 

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