Patient Safety Bottoms Out in the Pandemic: Does this Convince a Nation that the U.S. is Unprepared to Protect the Safety of its Population?

Some participants of the virtual West Coast SWERVE meeting on April 2.

As the U.S. views the grim details of a healthcare system unprepared for the overwhelming threat of the COVID-19 pandemic, we must also face a reality that we have, for too long, neglected to protect our patients. Alarmed by the horrifying estimates that 100-200,000 people may die of this novel virus, the public cannot ignore that more than this number of our citizens die each year from preventable medical errors.

It is possible that solutions to our current unpreparedness may also have a long-term effect on guaranteeing patient safety.

Against this backdrop, the third SWERVE meeting took place on April 2, 2020. SWERVE is the Pittsburgh Regional Health Initiative's (PRHI) latest effort to improve patient safety that began well before COVID-19 was in our dictionaries. However, in light of the many gaps that have been exposed in our healthcare system, the SWERVE initiative takes on a new dimension. More than ever bold solutions for healthcare safety are needed to ensure never again.

One solution to the pandemic's chaos and to the dispersed responsibility for patient safety in America is the establishment of a National Patient Safety Authority—one central body responsible for regulating safety education and preparedness; coordinating research, communications, and measurement; and holding all the appropriate players accountable.

This was the proposition that the Pittsburgh Regional Health Initiative and its partner, the Network for Excellence in Health Innovation (NEHI), put before 75 of our nation's foremost thought leaders in health during three separate conversations. We called the initiative "SWERVE" because we're suggesting that it's time for a major change in direction—time to challenge the assumption that what we have in place is acceptable.

Unable to meet face to face, the participants took a break from their harried lives to convene virtually—from Kaiser Permanente, Kaiser Family Foundation, the Pacific Business Group on Health, RAND, Blue Shield of California Foundation, Gordon and Betty Moore Foundation, Michael E. DaBakey VA Medical Center, SCAN Foundation, California Healthcare Foundation, UC Berkeley School of Public Health, Columbia University Mailman School of Public Health, University of Utah health system, Stanford Medical School, the Hospital Quality Institute, Estes Park Institute, Comagine Health, and Washington Health Alliance. The objective was to construct a bipartisan recommendation for Presidential candidates in the upcoming election to add patient safety to their platforms. SWERVE conversations started in Boston and DC, and employed an intense, rapid-fire format that revealed many substantive suggestions.

The West Coast conversation was facilitated by Ken Segel, managing director of Value Capture, who led the two previous sessions. The group wrestled primarily with the question, Should a National Patient Safety Authority (NPSA) be designed and with what functions to achieve a rapid and profound reduction in patient harm, and to guarantee future preparedness for catastrophic events?

There was consensus that the U.S. does not have a central authority capable of addressing this current crisis, let alone patient safety more broadly. Gaining public trust and compliance in an atmosphere of conflicting and constantly changing information and guidelines from scientific experts, government leadership, and our federal agencies adds another challenge.

The group, led by Tricia Neuman, Executive Director of the Kaiser Family Foundation's Medicare Policy Program, also discussed how a Public Option might be constructed to guarantee excellence in patient safety and protection.

These insights will guide phase two of the SWERVE initiative. On March 30, JHF announced a $150,000 grant to take the next steps. NEHI and PRHI will form two task forces to make strategic recommendations for building a wider coalition of consumer and purchaser organizations, shaping a strong argument with guidance from government relations experts, and delivering a coherent proposal to the Presidential candidates. 

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