We are encouraging organizations to break down the silos between the finance function and the quality and safety function, says Tejal Gandhi of the Institute for Healthcare Improvement.
“CFOs are a critical piece of the leadership team that impacts patient safety,” says Tejal Gandhi, chief clinical and safety officer of the Institute for Healthcare Improvement (IHI). Gandhi is co-chair of the new National Steering Committee for Patient Safety, which was launched in May. In this interview, she explains that patient safety is not just a clinical issue, but one that all hospital leaders should address.
Why was the National Steering Committee for Patient Safety formed?
We’ve been trying to accelerate our progress in patient safety, and one of the ways that we have been doing that is to talk about patient safety as a public health issue. In 2017, the National Patient Safety Foundation (NPSF), which merged with IHI that same year, released a call to action stating that patient safety is a public health issue and it needs a public health response, including working on patient safety with a framework similar to what’s been used in other public health issues. Part of that framework is a national coordinating function—which is the National Steering Committee—that will set national goals around patient safety and establish some measures about how we would track our progress on those goals. The committee will help us work synergistically together and in a coordinated way.
Aren’t there already a lot of groups working on patient safety issues?
Yes, there are many organizations working on safety, each with their own set of priorities. It’s a very diverse group which is why sometimes, there have been silos. To bring everybody together to say, “What are our top couple of priorities that we can all collectively work on?” is really important. There have been successful national collaboratives before, but they have focused on specific issues, such as readmissions or infections. We think this group needs to focus on foundational issues that cut across various interests and can help the performance on any of those specific issues.
What are these foundational issues?
These are issues such as culture and leadership, patient engagement, and the safety and support of the workforce. No matter what specific issue you’re working on, whether it’s infections or medication errors or falls, you need some of these foundational elements in place to achieve our goals.
Why should hospital CFOs be interested in this committee?
Patient safety is critical in every healthcare organization. It has significant financial repercussions. As the trend in payment models continues to shift to quality as opposed to volume, these kinds of patient safety issues are going to become more and more tied to payment, which they already are to an extent. I think that sometimes the return on investment for, say, work on leadership and culture or training and education is not obvious. What’s going to be important to the CFO audience is to understand that these foundational things are actually important if you want to achieve a reduction in readmissions or other financial goals. These are not just “kind of nice” add-ons, but these are foundational and fundamental to achieving goals on other measures that may be more directly tied to finance and payment.
What role do CFOs play in a patient safety culture?
The CFO needs to be part of creating that culture of safety and understanding the basics of safety because requests are going to be coming to the CFO to fund safety initiatives. One of the things that we’ve encouraged organizations to do is to break down the silos between the finance function and the quality and safety function. For example, there may be a need to develop a business case for some safety investment. To work as a team with finance as opposed to in silos is more likely to lead to success. It’s important that CFOs can champion patient safety and not only look to the clinical folks to play that role.
Ed Avis is a freelance writer and editor and a regular contributor to HFMA publications.
Tejal Gandhi, MD, MPH, CPPS, is chief clinical and safety officer for the Institute for Healthcare Improvement.