By Megan M. Krischke, contributor
April 29, 2012 - Patient safety is at the forefront of health care industry concerns, and because of the role of nurses in direct patient care they have ideal experiences for leading the industry in addressing these concerns. Nurses can work in a myriad of patient safety positions, ranging from informatics to risk mitigation to quality improvement.
“The message is consistent: we need to have nurses taking a leadership role in redesigning clinical processes and health care delivery in order to contribute to improvements in patient safety,” asserted Mary Beth Edmond, RN, MBA, senior nurse executive and executive vice president for Juran Health Care, a consulting firm that assists health care providers with improving quality of care while reducing costs. “Because they are working day to day at the bedside, nurses need to be trained as leaders in how to improve processes that result in better patient outcomes.”
In the realm of patient safety, Edmond notes that the typical career opportunities exist in most health care settings: risk management, infection control, patient safety and compliance officers.
“Where I see advances is in nursing informatics,” she said. “Nurses have opportunities to be involved in the design and implementation of technologies and the redesign of nursing processes in order to improve safety and clinical outcomes.”
“There are really a ton of opportunities in this field,” stated Paul Craig, RN, JD, chief human resources and risk officer at University of California San Diego (UCSD) Health System. “Probably 90 percent of the positions are hospital-based, but there are certainly patient safety officers in the ambulatory arena, as well as those who work in either benefit or liability insurance.”
“Ten years ago, nearly all hospital-based risk managers were nurses who had worked their way up the ranks,” he continued. “Mostly they didn’t have advanced degrees, but grew into the position. Today, people are being more purposeful about going into patient safety as a specialty. An advanced degree isn’t necessarily required, but it is recommended.
Edmond agreed. “One of the changes I’ve seen in the area of patient safety is the hiring and training of specialists. More patient safety officers (PSOs) are being trained in how to lead robust quality improvement changes that will improve customer safety and satisfaction. There is a major opportunity for nurses who want to combine safety and clinical outcomes with process improvements.”
Even so, being a PSO is rarely a nurse’s sole role. Quite often an organization’s chief nursing officer (CNO) or chief medical officer (CMO) also functions as their PSO. Craig doesn’t fault this approach because the PSO must have the ability to influence an organization’s leadership; if the PSO is not a member of the executive suite, then the officer must have the ear of the executives. Edmond hopes that as the importance of the PSO is increasingly acknowledged that it will more often be a position in and of itself.
For nurses interested in pursing a career in patient safety, Edmond recommends that the first thing to do is to become a certified professional in health care quality. Next is to become certified as a PSO.
“There are a number of organizations offering this certification,” she explained. “At Juran we have a five-day training program that covers topics such as how to do a cultural assessment on patient safety, system wide data management, analyzing the reporting of safety measures and root cause and special cause analysis. We require that participants also complete two case studies and they have to evaluate a safety event that happened within their facility. Most important, they have to become teachers. Being a PSO is really about mentoring, teaching and changing behavior.”
“The PSOs who are really doing well are pursuing more robust training in Lean and Six Sigma,” she added. “These improvement methodologies are designed to improve process failures that could lead to a safety event.”
Craig points out that a variety of graduate degrees can benefit a patient safety officer, including a law degree, a master’s in public health, a master’s of health administration or a master’s in health law.
“For people who aren’t in a position to pursue an advanced degree, there are probably about half a dozen nationally recognized certificates, largely self-study with some course work,” he mentioned.
“Ultimately, my goal is to make patient safety ‘invisible,” Craig concluded. “We are always striving to make it easier to do the right thing and harder to do the wrong thing. When we have the right system in place, it will be easy to keep patients safe.”
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