Patient Safety & Quality: "Wellness is Not Enough!"

February 1, 2013

Just fresh from attending and speaking at the Hospital Association of Southern California’s Patient Safety Colloquium in Garden Grove, CA, I continue to hear the words of keynote speaker, Charles Denham, M.D., Founder and Chairman Texas Medical Institute of Technology (TMIT) in my head.

Dr. Denham said several times that “wellness is not enough…not it!” At least, not enough when it comes to reducing costs, improving care, and securing a safe healthcare system. His presentation went over and over the statistics related to deaths that are and have been shown to be preventable…and then provided evidence that hospitals are not only “chasing zero,” but are achieving it.

I remember the Institute for Healthcare Improvement’s “100,000 Lives Campaign” that stirred the pot of accountability to its core by itemizing six simple steps that would literally save 100,000 lives. So many more are saved each year.

Being at a conference like this brings home the point that hospitalization is, itself, a risk. That being sick carries a high risk of getting sicker. And, that those who care for the ill are, themselves, at risk.

I am trying to be intolerant of human error while, at the same time, I cannot find it rational or reasonable to expect the impossible. I wonder how we can expect a physician or nurse on 12+ hour shifts to be as sharp and discerning, as focused and directed at the end of these many hours as at the beginning. I also question whether the cutting of costs in staffing is wise, efficient, or, in the end, effective.

The theme of the conference was, “Practicing What We Preach.” I so appreciate the determination to keep patients safe, and, I also remain concerned that patient safety is not merely a “to do or not to do” list. It is accountability and a promise that is ever in competition with other priorities, namely cost.

While the discussions are somewhat fragmented, let’s say that “safety” now includes all risks, including risks related to the dreaded readmission of a patient following discharge. The Robert Wood Johnson Foundation funded a study that looked at specific readmit conditions as they related to nursing staff levels.

And, all the studies, all the experience, and all the human costs have not put together the promise of healthcare with the practice.  If anything, the economic pressure has become a barrier to reducing costs related to compromised patient safety.

Nope. Wellness is not enough. And, patient safety must be the “it,” not merely a priority.