Despite the fact that medical harm is prevalent nationwide, experts and advocates struggle to talk about patient safety in a way that leads to widespread support for effective solutions.
Two new reports using innovative research methods suggest that one reason may lie in conflicting beliefs about the role that humans and systems play in the complexity of modern medicine.
Health care professionals and the public understand that people are crucial to health care delivery, but also see humans as inevitably prone to error. And though patient safety experts know that systems-based improvements make care safer, broader support and demand for these approaches are stymied by an implicit assumption that safety is in the hands of an individual doctor, nurse or other practitioner when treating a patient.
The reports -- from the Betsy Lehman Center and FrameWorks Institute, a D.C.-based nonprofit that uses research to shape public discourse on social and scientific issues -- explore the understandings and implicit assumptions that clinicians and the public have about patient safety. The research also reveals how the media covers and portrays medical error and how its approach influences public perception, behavior and dialogue.
Non-experts see safety differently
In the first report, “Safety Is More than Caring,” researchers distill expert views that reflect the field’s understanding of what patient safety is, what causes patients to be harmed, who is responsible for safety and what needs to happen to improve the safety of care.
Those views, the research suggests, are challenging to convey more broadly because:
- Patients and providers rely on pre-existing assumptions and understandings – or “cultural models” – about health care delivery, which clash with patient safety expertise. For example, patients may believe that choosing a “caring doctor” will keep them safe, while doctors may think that patients stay safe by adhering to doctors’ orders. Neither model leaves room for conversations about system-based solutions.
- Patient safety is not widely understood as a vital component of health care quality.
- Expert emphasis on creating a “culture of safety” in health care organizations is not top of mind for front line health care providers or patients.
Media influences perceptions
The second report, “Telling a Story of Safety,” analyzes the way materials published by the mainstream media and patient safety advocates talk about the topic. Key findings include:
Media stories about patient safety topics focus on reacting to adverse events, rather than preventing them from happening.
- Expert emphasis on creating a “culture of safety” in health care organizations does not strike a chord with front line health care providers or patients.
- The term “patient safety” is not well understood by health care professionals or the public, and it is used inconsistently by the media and advocacy organizations
Over the next 12 months, the research described in the two reports will be used to drive the development of new “frames,” or ways of talking about patient safety, to influence the way both patients and frontline providers approach this important aspect of health care quality.
“We look forward to continuing our work with FrameWorks and other patient safety leaders and to sharing these new framing strategies more widely,” says Barbara Fain, Executive Director of the Betsy Lehman Center. “This research is a valuable first step.”
READ these in-depth reports.