Patient Safety - and the role of economic incentives
It’s not only U.S. hospitals that are concerned with improving the safety and quality of health care. I recently returned from Malaysia, where there is great interest in creating a safer experience for patients. During my visit, I conducted workshops for 4 hospitals and the Malaysian Ministry of Health.
One of our first activities was to get to know one another, and for me to understand the competitive and regulatory landscape in Malaysia. So I began to ask them questions about reimbursement rates, Never Events, public transparency of safety and quality data, Sentinel Events, and malpractice lawsuits, etc…
What I disscovered about their country is that few of the patient safety “motivators” that exist in the States are present in that country. There is no govermental or regulatory pressure on local hospitals to improve patient safety. They are not concerned about pay for performance, or lower reimbursements for poor safety or quality. They do have malpractice cases, but the “sue anybody for anything” mindset is notably missing. They do not post their safety and quality data for the public to see. In short, there is no economic pressure on the Malaysians to improve patient safety.
Said another way, the lack of an improvement in safety will not put their business at risk.
Yet, there is clearly a national concern over doing a better job for those they serve, and for no other reason than it is the right thing to do.
Financial return on investment for safety activities is a secondary consideration, if it matters at all.
Honestly, I found it very refreshing to have the opportunity to work with medical professionals who want to do the right thing just because it is the right thing, and not because their actions were monetized, provided an ROI, or because they felt threatened by regulatory or economic consequences.
Another refreshing difference from stateside workshops was the number of practicing physicians in the room. In the U.S., it’s rare to see a practicing physician take time away from caring for patients to invest in patient safety improvements. Most of the workshops we do of this type are filled predominantly with nurses and administrators. In Malaysia, over 50% of the participants were physicians who were taking an active role in leading patient safety initiatives in their hospitals.
Having said that, as the workshoip progressed, it became clear that many of the barriers to organizational change that we experience in the States are identical to those in Malyasia. People are people everywhere - all subject to the universal resistant human reactions to change.
The lesson learned here is that no mater what adversity or barrier you are struggling to overcome in your patient safety change initiative, someone, somewhere in the world is experiencing, or has experienced, the same thing. And, that means there is best practice available to overcome your challenge. We just have to find the best practice and learn from others.
My experience in Malaysia proves yet once again that there is very little new under the sun. When we realize that and seek out those who have already walked our journey, we learn and improve much faster.
