Getting to zero – can we end preventable deaths in hospitals?

Getting to zero – can we end preventable deaths in hospitals?
Joe Kiani (Right) with President Bill Clinton at the summit © Patient Safety Movement Foundation

Speaking to Health Europa, Joe Kiani reflects on the Patient Safety Movement Foundation’s progress towards eliminating preventable deaths in hospitals.

More than three million people die every year due to medical errors that could have been avoided. In high-income countries, one in ten patients is harmed while receiving hospital care. In the UK, medical errors kill 1,000 NHS patients every month. In the USA, preventable deaths in hospitals now number upwards of 200,000.

That’s why, in 2012, the Masimo Foundation for Ethics, Innovation, and Competition in Healthcare launched the Patient Safety Movement Foundation – a dedicated effort to reduce the number of preventable deaths in hospitals to zero by 2020 (0X2020).

It is getting there in two main ways:

  1. By encouraging hospitals and healthcare facilities to implement evidence-based actionable patient safety solutions; and
  2. By asking healthcare technology companies to sign the Open Data Pledge, a public commitment to make patient data from their devices and systems available without charge or interference.

To date, 83 firms have taken the pledge, including giants like Medtronic, IBM Watson Health and Philips Healthcare, and more than 4,000 hospitals in 44 countries have committed to the 0X2020 goal, which has also won support from global health authorities such as Dr Tedros Adhanom Ghebreyesus and world leaders like President Bill Clinton (above left).

Thanks to this work, in 2014, the foundation reported 83 lives saved; in 2018, it reported more than 81,000.

Health Europa sat down with the foundation’s founder, Masimo CEO Joe Kiani (above right), at the 6th Annual World Patient Safety, Science & Technology Summit to find out more.

Have you been pleased with the number of commitments and progress made since the launch of the Patient Safety Pledge and Summit in 2013?

I’m blown away and humbled by the number of hospitals, medtech companies, elected officials, and patient advocates that have come together on this mission. When you look at the results that we have – 4,598 hospitals that have committed to zero by 2020, 81,533 lives saved every year by those hospitals – that’s incredible.

At the same time, I feel like we’re still so far away from zero, and we only have two years left. I hope that now is the time when anyone who’s watching us out there realises that if they don’t join us we’re going to fail. We’re not going to get to zero by ourselves. We need help.

You’ve said that you’ve never considered moving the goalpost, but are you at all doubtful that you’ll get there?

From the day we set the goal I doubted it, but at the same time I wish I could have said zero by next year. I think it’s a crime to want zero by 2020. We have to get there. What people need to realise is that we could be there this year if everyone just agreed to make sure their department is planning for zero. If the departments get to zero, the hospital gets to zero. If every hospital gets to zero, we’ll be at zero. I’ve seen this work over and over again in many wonderful hospitals; it can be done.

Have you been surprised by the number of companies that have signed the Open Data Pledge?

Think about it – Medtronic and Massimo are fierce competitors, yet here we are co-operating with one another on patient safety and pledging to share our data. But we are still missing some important companies. None of the infusion companies have made the pledge, and we need them to. Except for one company, none of the EMR (electronic medical record) companies have made the pledge, and we need them to. I hope that if they’re watching the conference they realise they need to make the pledge, because while they’re the CEOs of their companies they can improve things so that one day when they’re not the CEOs of their companies anymore and they rely on our healthcare system, it’ll be a safer, better healthcare system.

With more and more healthcare technology companies coming onboard with the idea of interoperability, what do you feel are the main barriers to achieving a true ‘patient data super highway’?

I’m really happy that to say that I think we might be at the critical mass. Today, we’re seeing many companies develop these decision-support algorithms, whereas, just several years ago, no-one in their right mind would have even begun that work because they would have had no idea how to connect with the machines in the hospital and they wouldn’t have been given permission by the companies to do so. So, I think we’re getting there.

We all hope to have a Six Sigma clinician when we’re in hospital, but, frankly, by definition, we won’t – most of us will have a ‘one sigma’ clinician. But with the decision support that is only possible from us all sharing our data, you can turn a one sigma clinician into a Six Sigma clinician and maybe then not have those errors of omission.

How is the Patient Safety Movement holding companies and organisations to account for their pledges?

We assume – hopefully not wrongly – that if any of the companies who have made the pledge are not honouring that commitment, then someone would contact us and tell us. Knock on wood, we haven’t had that message. It looks like the pledge is working, and the people who have promised to share their data are sharing their data.

Can we get to zero without greater government intervention?

I’ve often thought that government could play a role that would not be destructive or feared by those who are frightened of new legislation. There are two things they could do that would hopefully be harmless to any organisation but also very good for patient safety.

The first is to do as Jeremy Hunt has done and improve transparency: have every hospital report every quarter on a similar dashboard what number of avoidable harms they’ve had.
The second is to come up with an incentive for hospital executives to empower their nurses and doctors to implement the known processes that would save lives. It’s very simple: if a hospital has implemented the processes and someone is harmed due to a medical error, the hospital should still be paid for that patient’s care, from beginning to end. But, if the hospital doesn’t have the processes in place and someone gets hurt, that hospital wouldn’t get paid at all, not even for the initial care. That would be huge.

Those are the two things we hope governments across the world will do to help us actually get to zero by 2020, instead of just hoping for it.

Joe Kiani
Patient Safety Movement Foundation

This article will appear in issue 5 of Health Europa Quarterly, which will be published in May.

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