More on Community Benefit

Barriers to patient safety still exist

Study shows tension between C-suite and risk managers over patient safety

According to a recently commissioned study by American International Group (AIG), an international insurance company, significant barriers to patient safety still exist in healthcare.

The study surveyed 250 hospital administrators and 100 risk managers in hospitals across the U.S.  

[See also: Patient safety project reduces infections by 40 percent, saves $34M]

A majority of respondents said the largest barrier to patient safety is lack of teamwork, negative culture and poor communication (42 percent C-suite; 55 percent risk managers). The results also revealed a tension between what hospital leaders perceive as their number one priority in 2013, patient safety (64 percent C-suite and 62 percent risk managers), and their number one threat, failing to maximize financial sustainability (60 percent C-suite and 62 percent Risk Managers).

"Given that nearly half of every dollar spent on healthcare costs is related to a medical error, improvements in patient safety will provide a quick return on investment," said Emily Rhinehart, RN, vice president and division manager for healthcare risk consulting, AIG.

That’s easier said than done said Peter Pronovost, MD, PhD, senior vice president of patient safety and quality and director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine.

“We’re now over a decade since To Err Is Human was published and the sad reality is there’s very little empiric data that we’ve made progress on a national scale,” Pronovost said. “We’ve had pockets of success, but arguably one of the only national success stories is our work on reducing infections in the intensive care unit. If we say what can we learn from that, well, that effort was driven by clinicians with intrinsic motivation and it was guided by a valid measurement system.”

Russell Johnston, AIG casualty product line executive, agrees, since he sees most of the impact happening at the nurse level. “I think what was telling is that although safety a priority for all of the constituents involved, where it ends up actually manifesting itself is at the nurse level. So, I think the real question that the study prompts is do hospitals actually operate in a way that actually supports what everyone agrees is an important initiative,” said Johnston.

While nearly all respondents (96 percent of C-suite and risk managers) say their hospital has a "culture of patient safety," one-third (33 percent of C-suite and 37 percent of risk managers) acknowledge that their hospital needs to undergo major changes to maintain that culture in the future.

Photo used with permission from