Quality Leaders Forum: New Ways to Think About "Safety" in Health Care

The impact of the COVID-19 pandemic on patients and those who care for them has revived the need to prioritize health care safety. The message at UHF’s recent Quality Leaders Forum (QLF) was that harm reduction must go beyond physical safety. 

“We need to broaden the definition of harm to include emotional, sociological, and financial harm,” Tejal Gandhi, MD, MPH, CPPS, the chief safety and transformation officer at Press Ganey, told attendees at this year’s second QLF meeting, held virtually on June 28th. 

The invited speakers, Dr. Gandhi and Peter Silver, MD, senior vice president, chief quality officer, and associate chief medical officer at Northwell Health, discussed new data about patients and health care staff experiences regarding psychological safety and explained how safety priorities are evolving as a result of the pandemic. 

Dr. Gandhi’s presentation, Emerging from COVID: Re-Energizing our Approaches to Achieving Zero Harm, focused on new and inclusive ways of thinking about safety.

She cited a 2017 survey that found that “disrespect” was the fourth most frequent patient-perceived medical error. Power imbalances and implicit biases also plague the health care workforce. Recent surveys conducted by Press Ganey reveal that staff engagement declined for virtually every type of health care worker during the pandemic, from physicians and nurses to clerical workers. 

Caregivers must be factored into harm reduction as well, Dr. Gandhi said. Stress, burnout, fears for self and family, and moral distress all increased for caregivers during the pandemic. And inequitable care can cause harm to both patients and their caregivers. 

“We need to transform our organizations with an integrated approach to quality, safety, and patient centeredness,” she said and called on health care leaders to pursue organizational resilience. “In safety, much has improved, but we have a long way to go,” she concluded. 

Dr. Silver underscored that optimal care must include deliberate attention to the health of the community being served.

QLF is a group of emerging and established quality leaders committed to improving the delivery of high-quality care in the greater New York area. Members are invited to four meetings that UHF hosts each year to network and discuss current issues in health care quality with nationally recognized quality leaders, and to share best practices.

There are about 70 members in this year’s Quality Leaders Forum, including graduates of the UHF/GNYHA Clinical Quality Fellowship Program and honorees from the UHF Tribute to Excellence in Health Care. The next meeting, to be held mid-October (exact date TBD), will address the topic of the quality of virtual medicine. Past Forum summaries can be found here

UHF is grateful to Elaine and David Gould, whose generosity supports the Quality Leaders Forum. 

July 14, 2022