Patient safety does not trump cost

Summary

Here is a real example from the US of why embedding patient safety can be so difficult.

Content

We assume that patient safety is something everyone cares about. But what happens when it goes up against cost imperatives?

Patient safety is easiest to move forward, particularly with the Centers for Medicare & Medicaid Services (CMS) Transforming Episode Accountability Model (TEAM) initiative, when improved outcomes and safety equal cost reductions. However, even this is not a guarantee.

For example: in one provider, a trial on an AI analytics package was done on a hospital and results showed, according to their own cost estimates (not the vendor's), a potential 10-20 million US dollars savings that would recur if they remained 'under control'. A 'no brainer' right?

Clinicians liked it. A patient safety genius there (I'm labelling his abilities correctly) loved it. So why didn't it happen?

There is no line item in the accounts for cost reduction. The finance team refused to believe it. They were under huge pressure and did not want to put their heads above the parapet so an accounting quirk led to no savings. This was potentially hundreds of millions of dollars of saving, demonstrable improvements in outcomes and protection against outside scrutiny and criticism... It still didn't happen.

I'd like to say there is a happy ending. There isn't. There is a lesson. Engage all stakeholders in discussions and then, perhaps, you might make a bit more progress. However, institutional issues are going to continue to create havoc until outcomes are aligned. If revenue versus cost is the main metric (and it is in some provider systems), you'll continue to get strange decisions driven by potentially perverse incentives.

About the Author

Richard Jones is the hub AI topic lead and committed to building new organisations that change healthcare globally.