Every year, on 17th September, World Patient Safety Day is celebrated to bring together patients, policymakers, healthcare workers, and families, to show their commitment to patient safety.
This year, we've put together a special series of interviews in honour of Patient Safety Month, where we gather insights from leading experts in the field of patient safety and quality management. These interviews are a unique opportunity to delve into the challenges and innovations shaping healthcare today. We hope these insights help healthcare staff improve patient outcomes, elevate care quality, and prioritise safety at all levels.
This piece is an interview with Abdel Latif M. Marini, the Director of Quality at UM Upper Chesapeake Health, part of the well-renowned University of Maryland Medical System in the US. Abdel Latif started his career as a nurse in ICU Critical Care at the American University of Beirut - Medical Centre and soon thereafter transitioned to the role of a Quality Review Analyst. Today, almost two decades later, he is an innovative and accomplished healthcare leader with progressive experience in healthcare quality, and patient safety. He is currently pursuing a doctorate degree in Public Health at the Johns Hopkins University - School of Public Health.
Here are some interesting insights from our conversation.
What key performance indicators (KPIs) or metrics do you consider important for assessing the quality of care in today's healthcare setting?
When speaking of key performance indicators (KPIs), we have our traditional metrics that have stood the test of time, as well as some emerging ones that organisations are beginning to explore.
One of the most frequently used KPIs is the patient satisfaction survey, which is essentially a feedback form or survey that patients fill-in or submit online. A higher score typically reflects a higher level of care quality. We also commonly use KPIs that measure clinical outcomes, complications, and infection rates. KPIs like falls, medical errors, and evaluations of environmental conditions are also valuable factors for assessing patient safety. For example, suppose there is a higher rate of patient readmissions. In that case, we investigate probable causes, such as inadequacies in the discharge or follow-up process, to prevent recurring issues. Having a mix of leading and lagging indicators is crucial to see the big picture.
An emerging KPI that's interesting is healthcare disparities.
Another increasingly popular metric is patient-reported outcomes, where patients assess the impact of the healthcare they receive on their well-being. This can offer valuable insights into the effectiveness of treatments and interventions in enhancing their quality of life. For example, if a patient undergoes hip or knee replacement surgery, they can rate the improvement in their overall well-being, mobility, and functionality.
What do you think are some of the key challenges in ensuring patient safety, and how can healthcare providers address them?
While I hate to blame workforce issues or shortages, it is the current reality in many nations. There are notable nursing and provider shortages, and sometimes operational roles like environmental services, housekeeping and kitchen staff are also affected. Our complex healthcare system relies on a network of individuals, not just those in patient care roles.
The ongoing workforce shortage contributes to burnout and fatigue among healthcare workers. When individuals take on additional shifts and struggle with insufficient sleep, it does impact patient safety.
During the Covid pandemic, organisations like the Joint Commission conducted research, revealing a surge in safety incidents linked to healthcare worker burnout. This trend was evident nationwide in the United States, with issues such as patient falls becoming more prevalent.
Another challenge, in my opinion, is that the new, younger generation of healthcare professionals may have missed out on extensive hands-on training during the pandemic compared to their predecessors. Typically, traditional online training methods seem inadequate for onboarding new personnel. That being said, there is an opportunity here for the adoption of virtual training and augmented reality (AR) training — something that has not yet gained substantial traction in the healthcare sector.
As a Quality Director, how do you engage frontline staff in the quality improvement process?
As leaders, we play a crucial role in setting the tone for quality improvement. Visibility and communication are very important — frontline staff need to hear from us that quality and safety are at the core of everything that we do. How we emphasise this message and, even more importantly, how our actions align with it can make a big difference.
I also always like to recognise and reward the front line for their contribution. Often, even the seemingly small actions within an improvement project can have a significant impact. Celebrating these minor victories need not be reserved for year-end occasions; Recognising and celebrating successes along the way can work wonders for boosting their motivation.
How do you encourage healthcare staff to report near-misses and adverse events without fear of reprisal?
Encouraging staff to report adverse events or near misses is very important because those are learning opportunities. Building a sense of psychological safety is essential in achieving this. As a leader, we need to demonstrate a commitment to establishing a safety culture within our organisation by actively participating in the reporting process and supporting those who come forward with incidents.
We must understand that no one intentionally causes harm; often, it occurs due to systemic or other factors at play. Without awareness of these issues, we cannot rectify them. For example, when you share the lessons learned from reported incidents in a public forum, and detail the actions taken for improvement, this signals to others that reporting is valued and acted upon. In our journey to zero harm, we even disclose this information to patients and their families. Reporting alone isn't enough; a feedback mechanism is essential to this process.
What trends or emerging tech innovations do you foresee impacting quality management and patient safety in healthcare?
We can also explore advanced technologies for patient identification. While barcode scanning is currently in use, newer facial recognition technology offers more reliability, as wristbands can sometimes be obscured. However, it's essential to balance the adoption of these technologies with patient safety considerations and cost.
AI and advanced analytics are causing a transformative shift in healthcare — it is already being used in applications like interpreting radiology reports. Major players like Google, Amazon, and Microsoft are heavily investing in AI. In the coming years, machine learning algorithms will play a large role in predicting patient risks and optimising personalised treatment plans.
The rise of Internet of Things (IoT) devices and wearable technology is another up-and-coming trend in healthcare. These tools provide real-time data for monitoring patient health and enabling early intervention to prevent adverse events — something that will support healthcare organisations in improving patient safety. Genomic medicine, or precision medicine, is also another exciting field that is gaining traction where you can tailor treatment plans based on an individual's genetic makeup.
What advice would you give other healthcare organisations striving to enhance their quality management and patient safety efforts?
Safety and quality are everyone's responsibility and it applies to all areas, not just the Quality and Safety Department. The way I think about this is that there is a mini quality department embedded in each functional area in IT, Lab, Pharmacy, Kitchen, etc. Think of it like a fractal model that keeps repeating itself.
Encouraging open communication, transparency, and a blame-free culture where incidents and near misses can be reported is more important than ever. Building capacity in quality improvement across different domains such as performance improvement, data analytics, change management to equip the teams with the right tools and support is key.
The theme for Patient Safety Day this year is ‘Engaging Patients for Patient Safety’. How can healthcare organisations and staff support patient empowerment?
Imagine this: we're all part of a never-ending circle, where each of us can find ourselves at any point as a patient. Just as we passionately advocate for top-notch care, let's remember that we'd all love to receive that same excellent care when it's our turn in the spotlight. Let us engage with our patients by first knowing them, what matters for them, go beyond their “room number” and the diagnosis.
I believe patient engagement starts even before the patient is hospitalised or seen in the clinic. If the first time your practice or facility thinks about a patient is when they first check-in, you are already behind schedule with patient engagement. We need to be cognizant of the Social Determinants of Health (SDoH) factors that can play a role in patient outcomes such as language barriers, access to care, and consider beliefs and values etc. These go a long way in building trust and support.
As a healthcare professional, I find it difficult to navigate health care services sometimes but there are huge opportunities to make things easier, transparent, and more accessible. When patients connect with their doctors, they are more likely to follow prescribed treatment plans, be prompt with their medication schedules, and modify their long-term behaviours. Together, we can create a healthcare world where patients are not just recipients of care but active partners in their own well-being.