Zero harm in healthcare with doctor and patient.

Zero Harm in Healthcare: 4 Lingering Obstacles

Zero harm in healthcare is attainable with cooperation in our industry. Here are four of the obstacles we face as we try to achieve this critical goal.

Almost 23 years ago, the monumental report, “To Err Is Human: Building a Safer Health System” was published. This report outlined the alarming statistic that as many as 98,000 Americans were dying annually due to medical errors. Yet despite new initiatives, such as “Chasing Zero,” researchers now estimate that medical errors cause 251,454 deaths per year. There are a number of obstacles that still are in the way of improving patient safety, such as a lack of interoperability, culture, and training, as well as burdens on the physician and nurse that get in the way of quality clinical care. 


4 Obstacles to Zero Harm in Healthcare

  1. Lacking Interoperability: Interoperability in healthcare refers to the ability of different computerized systems, such as electronic health records (EHRs) to readily connect and exchange information with one another so providers can have access to all data for a patient that is being treated.  Interoperability in healthcare is designed to boost efficiency and productivity, improve care, coordination, and patient experiences, improve patient safety, and help lower costs. It is estimated that if we had system-wide interoperability, it could save the United States healthcare system more than $30 billion a year. So, if this is the case, then why is interoperability so difficult to achieve? EHRs are currently controlled only by a handful of companies, which results in a fragmented system. Each EHR’s design is different. Currently, there is nothing to “bridge” them together, and the willingness of the EHR companies to make the bridge happen has been lacking for some time. Furthermore, ensuring privacy and security for system-wide interoperability has many challenges. 
  2. Lacking Culture: Having an organizational leader’s investment to zero harm in healthcare systems is the first step in leading the way to an improved patient safety culture. Utilizing tools and proven strategies consistently from the top down will help to form a more united and highly reliable hospital system.
  3. Lacking Adequate Training: When healthcare leaders give the opportunity for more people to be continuously trained on the different strategies for improving patient safety, it allows those individuals to stay more focused and consistent in giving excellent patient care and become coaches to the other team members. It is also vital for coaches and team members to prepare through simulation, deliberate practice, and training to maintain excellent performance against committing patient harm
  4. Physician and Nurse added burdens: The increasing number of administrative burdens placed on physicians and nurses has and will continue to have adverse effects on the patients, the healthcare system as a whole, and the clinicians themselves. The administrative burden diverts time and focus from the clinical activities, such as providing quality care to patients. These burdens may prevent patients from receiving timely and appropriate care when they do get it, which can lead to unnecessary costs. It can be a challenge to have the most appropriate means to address the burden, but if the approach is looked at analytically, it can help to define the solution that should be taken. EHRs capture data of the people that use it, breaking down the usage to specific areas of a chart, such as a chart review, ordering, medications, after-hour documentation, etc. If a healthcare leader takes the time to analyze the physicians and/or nurses of a particular department to compare and contrast the time spent on what areas of the EHR, it will help to decide the solution for the problem. For example, medical scribes can help reduce or eliminate after-hours charting, as well as time spent in a large number of areas within the EHR, which in turn reduces burnout.  Likewise, utilizing bedside terminals and central station desktops, for example, can help save nurses 24.5% and 23.5% of their overall time spent documenting during a shift, respectively. Hospitals have been seeing physician and nurse shortages, but since the COVID pandemic, that has significantly increased. Alleviating the admin burden, which in turn reduces burnout, can have a positive result in retention and getting the support the healthcare team members need to do their jobs efficiently.  


Leveraging these possible tools and focusing on removing these obstacles can help physicians and nurses to focus more on the patients and reach “zero harm” patient care. Every person deserves reliable, consistent, safe healthcare. Zero harm in healthcare is attainable if we all work together, look and find ways to fix the obstacles, and stay focused on building a better tomorrow.