NAHQ’s “Call to Action” – promoting integrity and accountability in healthcare

January 12th, 2015

Back in February, we wrote about the disturbing results of AHRQ’s Hospital Survey on Patient Safety Culture – specifically, that only 44% of respondents said their facility had a “nonpunitive response to error.”

Now, the National Association for Healthcare Quality has stepped up with an important new report – “Call to Action: Safeguarding the Integrity of Healthcare Quality and Safety Systems.” (Here’s a link to the PDF.)

It’s a tremendously impressive – and timely -- piece of work, created with input from eleven other organizations, including the AMA, the ANA, The Joint Commission, and the American Society for Healthcare Risk Management.

It’s plain that healthcare organizations can’t improve patient safety if they don’t know what the problems are. Unfortunately, according to the report, “Some professionals whose direct responsibilities include the monitoring and reporting of quality and patient safety outcomes have experienced pressure, outright harassment, or even experienced serious legal and licensure challenges when they recognize and report events of concern.”

How foolish does someone have to be to try to silence the very people who could improve the quality of care at a facility – and reduce its liability risks in the process? But it happens anyway, all too often.

So what’s NAHQ calling for? These are the report’s “actionable components”:

• Establish accountability for the integrity of quality and safety systems.
• Protect those who report quality and safety findings.
• Report quality and safety data accurately.
• Respond to quality and safety concerns with robust improvement.

There’s more to it than that, of course, and I urge you to read the whole report. I couldn’t find much to disagree with, and if some of the recommended actions are easier said than done, well that’s to be expected, isn’t it? Culture change is hard, and it requires structure and a clear commitment from the top of the organization. And even if you get it right, it’s likely to take some time before staff actually believe they’ll be protected if they come forward with something serious.

It’s worth the effort, though. I just hope those organizations that most need to hear NAHQ’s call actually have their ears open.