Hospitals are bustling places where lives begin, end, and are saved. It takes many people in many dynamic roles to deliver care at the highest level. Care delivery is not without its risks but there are ways in which that risk can be mitigated, creating a safer environment for everybody. In a 2018 pilot study led by Inspirien, three hospitals embraced a “rethinking risk” mindset and the results were dramatic. Across differences in size, specialty, team dynamics, and appetite for risk, each hospital took to six key areas of impact in unique ways. The primary purpose of the pilot study was to evaluate the organizational competency and risk readiness of each hospital and to do so through interventions that are easy to influence, yet low cost. Here we explore six key areas that move the needle towards exemplary patient care and safety.

Arguably the most essential tenet of rethinking risk is the nature of a hospital’s (1) Culture and Communication. This cannot be an afterthought, but rather revered as the foundation, or the DNA, for which all “rethinking risk” efforts are built upon. It is to be woven across departments and up and down verticals and to include multiple opportunities to get it right. The most successful hospitals already have an internal culture of accountability baked in, but it can also be developed, especially when the highest levels of leadership are engaged.

One of the greatest byproducts of a strong culture is good (2) Documentation. Over time, the day to day task of data input can become tedious. Mistakes, vagueness, or irregularities can plague a patient record for a lifetime unless a hospital can shift the narrative. The key to overcoming form-fatigue is a show, not tell method of demonstrating impact and explaining why it matters. “People innately want to do the right thing,” says Debbie Franklin, a Risk Management Consultant. “Empower them. Help them do that.”

(3) Medication Safety is a high-risk sector of data input, and monotony in this area can truly be a matter of life or death. The considerations for a single prescription are numerous: safe administration, appropriate dosage, checked for potential adverse interactions, and so on. While technology can assist in this endeavor, Debbie emphasizes the importance of human intelligence to ensure the order is sound.

In a world driven by technology-enabled everything, there is one area in which analog is still considered essential: (4) Patient Handoff. With growing rates of Americans suffering from multiple chronic conditions simultaneously, the care coordination challenge is huge. Something as simple as knowing how to write an “old-fashioned nurses note” can go a long way in bridging technological gaps in the event of a system shortage to keep patients safe and hospital operations running smoothly.

It’s important to remember that, just like readmissions, (5) Infections acquired in the hospital are not reimbursable. This makes them vulnerable in terms of both patient safety and hospital bottom lines, while also serving as an opportunity to make a big difference quickly. Infections are largely preventable, especially when detailed processes exist and all the dots are connected faithfully; handwashing being the chief example.

(6) Slips and Falls can happen to anyone: visitors, patients, or staff. And when they happen on hospital property, the financial costs associated with tending to the incident falls solely on the shoulders of the hospital. One mitigating strategy is to implement a “Post-Fall Huddle.” This is an opportunity for the team to identify the root cause of the incident, what led up to it, and ultimately integrate these learnings into future hospital work processes.

Behavior change at the individual level alone can be a challenge, but when changing the dynamics of a group, there is actually strength in numbers. These six impact areas are simple, but they are not easy. To achieve success, it is critical that everyone involved, from the janitor to the CEO and everyone in between, feel like they have skin in the game because they do. Accountability is three-dimensional and it also expands on itself exponentially when the internal Culture and Communication is strong. Ultimately, these low cost, high reward areas for impact, reduce medical malpractice claims for a win-win model of patient safety.

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