Frontiers of Health Services Management - Spring 2014 - (Page 27)

Patient Safety Conclusion The drive to deliver high-value healthcare to all has begun. While our goals Jos e p h R . B e ta nc ourt * 27 F E A T U R E Patient safety has drawn the most attention and energy among healthcare leaders and professionals over the past ten years. We have made great progress in this area, but we still have much to do, especially concerning the safety of minority patients. Although we know that many errors experienced by minorities are due to communications issues, little attention is paid to effectively identifying and preventing medical errors in patients with limited English proficiency. Medication reconciliation, discharge instructions, informed consent, and pre/peri/postoperative instructions, for example, have been identified as high-risk scenarios that can lead to medical errors, risk management issues, and situations that have dire financial consequences (Betancourt et al. 2012). As the work in patient safety expands, healthcare organizations must establish a culture of accountability around safety for diverse populations. Such a culture entails training all healthcare professionals- especially those who interact routinely with minority and vulnerable populations-to recognize and report near-misses and errors, institutionalizing systems that capture the demographics of patients who have experienced near-misses or errors, and identifying the root causes of these adverse events. (For more information on building a culture of accountability that ensures the safety of all patients, refer to the collaborative work of the Disparities Solutions Center, the Mongan Institute for Health Policy, Abt Associates, and the Agency for Healthcare Research and Quality [Betancourt et al. 2012].) seem clear-to ensure access to highquality healthcare for all, and to do so cost-effectively-the new structures for delivery, such as ACOs and PCMHs, and the tactics required to make these structures successful remain works in progress and a great experiment. Given this environment, healthcare organizations will look for quick wins, or areas of focus that potentially provide high returns on investment-high-value targets. Successful leaders will quickly identify these high-value targets and deploy systems and tactics to achieve them. For some areas, proven models can be deployed; for others, similar models transferred from other industries can work; and still others may need complete innovation and a new set of models. As healthcare leaders make difficult choices, they should consider the realities of healthcare equity. First, racial and ethnic disparities in healthcare persist and are a clear sign of poor-quality, lowvalue healthcare. Second, the root causes of these disparities are complex, but a well-developed set of evidence-based approaches is available to help leaders address healthcare inequity. There is no need to reinvent the wheel. Unequal Treatment provides a clear blueprint, and myriad other guides share insight on building systems and implementing tactics for eliminating or minimizing disparities (see, e.g., Disparities Solutions Center 2013). Valuable lessons can be learned from early adopters of these strategies. Third, some observers argue that efforts to address racial and ethnic disparities in healthcare are simply too costly in these financially challenging times and that no strong business case can be made for such an effort now. This viewpoint centers on the perception that addressing

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Spring 2014

Frontiers of Health Services Management - Spring 2014
Contents
Editorial
Baylor Health Care System’s Journey to Provide Equitable Care
In Pursuit of High-Value Healthcare: The Case for Improving Quality and Acheiving Equity in a Time of Healthcare Transformation
Ending Healthcare Disparities: An Urgent Priority and a Growing Possibility
Expanding the Evidence Base for Health Equity
A Historical Perspective on Disparities as Context for Our Work Ahead

Frontiers of Health Services Management - Spring 2014