“Never events” has been part of the patient safety lexicon since 2001. A malpractice insurer suggested in 2009 that there also should be “always events.”
Now, patient safety advocates affiliated with the Boston-based National Patient Safety Foundation have proposed instituting a set of “must-do” practices for all healthcare organizations.
Writing on the Health Affairs blog on Thursday, well-known patient safety evangelist Dr. Robert Wachter, chief hospitalist and chief of the medical service at UCSF Medical Center, called for the first two of these practices to focus on infection prevention: hand washing and flu shots for healthcare workers.
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“Both practices address significant safety problems. Substantial literature has demonstrated that widespread adherence with hand hygiene and influenza vaccination is associated with major reductions in harm,” Wachter wrote on behalf of fellow board members of the NPSF’s Lucian Leape Institute.
“We should expect 100 percent adherence to ‘must-do’ practices,” Wachter continued. “Of course, there will be exceptions, such as emergency procedures in which there isn’t time for hand hygiene, or legitimate medical reasons to forego [sic] influenza vaccination, but such circumstances are rare and should not weaken the general expectation for compliance.”
Wachter suggested there will be other “must-do” practices in the future by laying out five criteria for inclusion on such a list:
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Wachter also said that the prevailing “no-blame” approach to reporting safety breaches is flawed. He wrote that this strategy is ineffective whenever “clinicians are disruptive, incompetent or willfully choose to ignore evidence-based safety rules.”
Images: Flickr user tv’s Spatch, Health Affairs
