Call to Action: Safeguarding the Integrity of Healthcare Quality and Safety Systems

It is widely recognized that there is more work needed to eliminate preventable harm in the U.S. health care system. While a strong and just safety culture has been recognized as a key element for improvement, a critical deficit that has not yet been fully addressed is the lack of protective infrastructure to safeguard responsible, accurate reporting of quality and patient safety outcomes and concerns. In fact, as attention to creating a culture of safety in health care organizations has increased, so have concomitant reports of retaliation and intimidation targeting staff who voice concern about safety and quality deficiencies.

It is widely recognized that there is more work needed to eliminate preventable harm in the U.S. health care system. While a strong and just safety culture has been recognized as a key element for improvement, a critical deficit that has not yet been fully addressed is the lack of protective infrastructure to safeguard responsible, accurate reporting of quality and patient safety outcomes and concerns. In fact, as attention to creating a culture of safety in health care organizations has increased, so have concomitant reports of retaliation and intimidation targeting staff who voice concern about safety and quality deficiencies.

Some health care providers acknowledge that they fear reporting events or conditions that could endanger quality and patient safety. Some professionals whose direct responsibilities include the monitoring and reporting of quality and patient safety outcomes have experienced pressure, harassment or even serious legal and licensure challenges when they recognize and report events of concern. Only with integrity in reporting can health care organizations identify and eliminate the root causes of systemic problems that threaten patient safety.

The accelerating implementation of new financial models that tie quality outcomes to payment will raise the stakes associated with quality results. The need will be even greater for a protective infrastructure to safeguard accurate reporting of quality data and patient safety concerns.

Meaningful and measurable improvement in patient outcomes, safety, quality of care, patient experience; and transparency of quality and safety data can be attained only with impeccable accuracy and trustworthy reporting.

This call has four 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; and
  • Respond to quality and safety concerns with robust improvement.

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