Ambulatory Patient Safety Hinges on Addressing Clinician Stress

By | November 13, 2017

More needs to be done to improve outpatient safety, ACP says
by Debra Shute,, HealthLeaders Media November 12, 2017

The American College of Physicians (ACP) has called for healthcare organizations and other stakeholders to address physician burnout and stress, among other measures, as a means to improve patient safety in ambulatory settings.
“Burnout and stress may affect patient safety in various ways,” wrote the authors of the ACP’s new policy paper, Patient Safety in the Office-Based Practice Setting.
“Emotional exhaustion, which is linked to standardized mortality ratios among intensive care units, may affect cognitive and physical ability to perform tasks and diminish memory and attention, lessening ability to attend to details and process highly technical information; mental detachment and deficiencies in personal accomplishment may cause individuals to neglect duties or complete seemingly minor but crucial patient safety activities,” the authors continued.
The paper went on to support the National Patient Safety Foundation’s recommendations that organizations should strive to improve working conditions and staff resiliency, and that programs should include fatigue management systems, and communication, apology, and resolution skills.
Other safety principles outlined by the paper include the following:
• Physicians and healthcare organizations have a responsibility to promote a culture of patient safety within their practices and among colleagues with whom they collaborate
• Patient and family education, engagement, and health literacy efforts are needed to educate the public about asking the right questions and providing the necessary information to their physician or other healthcare professional
• ACP supports the continued research into and development of a comprehensive collection of standardized patient safety metrics and strategies, with particular attention to primary care and other ambulatory settings
• Team-based care models, such as the patient-centered medical home, should be encouraged and optimized to improve patient safety and facilitate communication, cooperation, and information sharing among team members
• Health information technology systems should be tailored to emphasize patient safety improvement
• ACP supports the establishment of a national effort to prevent patient harm across the healthcare sector
“In recent years, much attention has been focused on improving patient safety in hospitals,” said Jack Ende, MD, MACP, ACP president. “We now must extend that focus to include the ambulatory setting. Medical errors that happen outside of the hospital are just as important to prevent.”

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