A Conversation with Pam A. Thompson
By Pat Muccigrosso, contributor
March 18, 2010 - Patient safety is not a new topic. It has been making headlines and driving practice reviews and changes for nurses for years. It has also been the object of intense research and study by organizations like the Agency for Healthcare Research and Quality (AHRQ).
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Pam A. Thompson, MS, RN CENL, FAAN, chief executive officer of AONE, believes patient safety starts with nurses.
Every year since 2003, AHRQ has released a report on health care quality which tracks several measures, including patient safety. Although progress has been made overall, findings released in their most recent report revealed that, “...reporting of hospital quality is leading improvement but patient safety is lagging.”
Other organizations like the National Patient Safety Foundation (NPSF) have mounted a concerted effort to raise awareness of safety initiatives and provide resources for hospitals and health care providers to use, such as Patient Safety Awareness Week, March 7-13, 2010. But for Pam A. Thompson, the focus of a lot of these efforts is on nurses -- the women and men doing battle on the front lines at hospitals across the country.
Thompson, MS, RN CENL, FAAN, is chief executive officer of the American Organization of Nurse Executives (AONE), a national professional organization which has been providing leadership, advocacy and research to advance nursing practice and patient care since 1967. She believes patient safety starts with nurses.
Q: There are a lot of health care workers involved in caring for a patient. Why are nurses considered so pivotal to improving patient safety?
A: Nurses are at the intersection of where all the work takes place and managing that intersection is the key role that nurses do in their practice. When you sit at the intersection, as nurses do, then it is incumbent upon you to be able to manage all those people coming and going at the patient’s bedside.
Other roles come and touch the patient, move the patient, interact with the patient, but there is really no role in the hospital that is with the patient as the nurse is. They manage that environment in which the patient is living while they are in the hospital. They are the one professional there 24 and 7. It is their responsibility for being the advocate for the patient around patient safety.
Q: What is the nurse’s primary role relative to patient safety?
A: The nurse is the one that provides that direct care. They are direct participants in the delivery of therapeutic care to patients so they are the users of the systems that we design. They provide the medications. They do many of the treatments that are provided. They support nutrition. So, the provision of the therapy that the patient is in there to receive or the care of the patient after surgery or major therapeutic intervention. They are at the place where they can influence the ability to assure that what reaches the patient is safe.
Q: Why is patient safety so important that organizations like NPSF and AONE are involved?
A: The ability to provide safe care in these complex environments has become a challenge. As the environment has become more complex and the diseases that people are presenting with have become more complex, the importance of safety as a part of the culture has become more necessary and that’s why you are seeing a significant amount of focus on it.
I think it has finally become more of a combined responsibility with attention to the importance of it in multiple areas across health care. That’s why you are seeing so many different focuses on patient safety in a multitude of arenas.
Q: The theme for this year’s National Patient Safety Awareness week is “Let’s Talk!” – why “Let’s Talk?”
A: Good communication is one of the key foundations for any patient safety discussion. Research has told us that is an area where sometimes we have problems with patients’ safety – not being clear in our communications, making sure that what we are communicating is understood and the multiple levels of communication that happen. And there has to be really good, clear communication between them [the levels] -- physician to physician, physician to nurse, nurse to nurse – all of the people that are involved in the care of the patient.
Q: These are economically tough times for health care. How can hospitals reduce costs and still improve patient safety?
A: Costing less doesn’t mean there is a direct correlation to the quality of the care. One of the key ways we can lower costs and improve quality at the same time is to take waste out of the system. Providing the right care at the right time to the right patient and in the right manner is really where you can control costs and make sure that all your costs are going to the provision of safe care.
I think that one of the key ways we can do that is really looking at the processes of care and the way in which we deliver the care—the flow of the care and making sure that is as efficient as possible. Make sure that every effort put forward is at the essential place it needs to be and we don’t have a lot of unnecessary work taking place or complicated processes.
Q: If nurses are looking at the process for efficiency, are they looking at the process for its effectiveness as well? Can that reveal some issues that could affect patient safety?
A: That kind of vigilance is used at every place in the system. One of the key criteria is asking: Is the care safe if we use this process or can we improve the safety if we change the process? Safety becomes the guiding principle in the work that we do in designing our systems, modifying them and continuing to work on them.
About the author:
Pat Muccigrosso is a former journalist with both a marketing and public relations background. She’s written articles for Advance Magazine for Nurses, Delaware Hospice and The Equine Journal and helped to start MD News Magazine in Philadelphia, acting as its first editor.
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