“Safer care saves money” Grattan Institute report focuses in on patient safety to reduce public expenditure
Yesterday saw the release of the Grattan Institute report “Safer care saves money: How to improve patient safety and save public money at the same time” which follows on from a 2018 report that revealed one in nine patients who go into hospital in Australia suffers a complication. This latest report detailed the financial cost attributed to those complications which the Grattan Institute estimates to be more than $4 billion per year for public and $1 billion for private. The numbers are mind boggling.
Currently hospitals are reimbursed for patients who acquire further complications during their stay. The Activity Based Funding (ABF) system increases the reimbursement for a hospital proportionally to the number of conditions a patient has, including complications they get while in hospital. But a very significant finding of the Grattan Institute analysis on Australia’s 20 biggest public hospitals showed that the cost of treating complications was on average three times larger than the additional revenue the hospital received.
Lack of patient safety is bad for everyone concerned.
The devil is in the data
The Grattan Institute makes seven recommendations from its report, the main focus of which is on transparency of patient safety information, accreditation and a shift in focus away from compliance so that hospitals are more focussed on outcomes and improvement. Their reasoning behind this is that the current “one size fits all” accreditation system has failed in its bid to improve patient outcomes pointing out that “practically every significant safety failure in Australian hospitals in recent decades happened in a hospital that had passed accreditation with flying colours”.
The idea of making patients safety information transparent is important, but the report doesn’t directly address the question of why patient safety problems remain an intractable problem in healthcare, and what can be done to improve patient safety on the ground by clinicians?
It’s important to realise that clinicians working in hospitals do their best to provide safe care to their patients, but they don’t get much support. Healthcare is not safe by default and trying to improve patient safety requires personal heroics from doctors and nurses every day.
In recent years there has been huge investment in Australia, the US (US$40 billion) and the UK in replacing paper records with electronic medical records, but these systems do not provide enough support for improving patient safety as evidenced by the Grattan Institute report, and similar reports globally.
Despite having huge amounts of electronic patient data existing IT systems don’t do enough for patient safety which puts doctors and nurses under immense strain. Systems today require clinicians to manually search for information. These systems deluge clinicians with masses of data that they must manually inspect making it hard to identify the critical information to which they should pay most attention.
As more patient data becomes digital there is a growing need to invest in IT systems that can generate meaningful intelligence from data to assist clinical decision making. We should expect IT systems to play an active role in assisting clinical staff with patient safety, instead of simply being electronic filing cabinets.
Patient safety is a design problem
It’s time to acknowledge that we can’t solve patient safety simply by getting clinical staff to work harder. We now have the data required to improve patient safety, but systems must be designed to support clinicians to deliver safe care.
At Alcidion, we are doing this right now with our Miya Precision platform. We believe that smart IT systems should be monitoring data 24×7 in real-time and intelligently escalating issues that may result in avoidable patient harm.
The Grattan Institute report provides a basis for hospitals to create a business case for improving patient safety and we commend that but what hospitals need are the tools to help them achieve this in a manner that supports the clinicians charged with providing care. While it’s important to improve the transparency of hospital patient safety data as the Grattan Institute recommends, it’s even more important to provide clinicians with smart tools, such as Miya Precision, that make it possible to improve patient outcomes rather than putting clinicians under even more pressure.
All the pieces are in place to finally make an improvement to patient safety.
Professor Malcolm Pradhan, Chief Medical Officer, Alcidion