A Broader View of Patient Safety

Patient safety

By James N. Phillips Jr., DBA, PMP, CFCM, NCMA Fellow

Elevators are arguably the most dangerous pieces of equipment in a hospital

In August, a patient in Spain died – not because of an error in medication or one of the “never events,” but from an elevator mishap. Would this be seen as a patient safety or healthcare contracting concern?

Accidents related to elevators in hospitals are high-risk and low-occurrence. For example, it is not uncommon to find an elevator that is not level with the floor. At minimum, this represents a potential trip hazard and an impediment to a patient in a wheelchair or on a gurney. Some might see this as inconsequential, yet for many, this is an unnecessary risk and a patient safety matter.

Elevators are arguably the most dangerous pieces of equipment in a hospital. They are used constantly, and by everyone. Elevator maintenance is highly regulated, and the people who work on the elevator are trained members of IUEC, the International Union of Elevator Constructors. Training to become a journeyman takes four to six years.

Supply chain executives don’t get to pick and choose the events that dictate our success. Often we must respond according to something bad that has occurred. Ideally, we learn from each other and create a comprehensive risk registry to help our mitigation efforts. Bricks and mortar concerns are left unattended to.

The elevator tragedy in Spain is a patient safety and healthcare contracting matter as much as a medication error or wrong-site surgery. In each case, harm has been done to a patient. So what can be done?

• First, we need to broaden the definition of patient safety and healthcare contracting, so it includes all potential risks – not just the obvious ones.

• Second, conduct a comprehensive Healthcare Failure Mode and Effect Analysis (HFMEA) to address physical plant concerns. Consider this question also in light of the recent disasters of Hurricanes Harvey, Irma and Maria.

• Third, and more germane, ensure that elevators are properly maintained following the manufacturers’ specifications by experienced and qualified professionals from a reputable elevator company.

• Finally, ensure that there is oversight of their work and that the facilities management office receives a legible and signed copy of the work performed and checks completed.

As healthcare contracting executives, we must look at all areas of risk and actively address them with key hospital leadership. We can do no less.

Dr. James N. Phillips, Jr., PMP, CFCM, NCMA Fellow, has 25 years of experience as a contracting professional, 15 of them in healthcare. Prior to that, he was an X-ray technician for 12 years. He serves as volunteer mentor for the National Contract Management Association (NCMA) Contract Management Leadership Development Program. He may be reached at jnortonphillips@gmail.com