Overview

As we shared last month, the management of clinical risk is undergoing a tectonic shift. For an introduction to the topic, please see last month’s blog here.

This is part of a three-blog series covering the following:

  1. Mindset Shift (January’s blog) – changing how we think about patient safety and risk management
  2. Model Comparison (this blog) – understanding the differences between the traditional model and the next-generation risk model
  3. Mathematic Value (upcoming March blog) – calculating the value created in three major ways.

This month we are digging deeper into the differences between the legacy model and the next-generation model, which is fueled by AE Outcomes – the data which in this domain are optimal, if not essential, for training machine learning, AI, and other advanced analytic models.

A Tale of Two Hospitals

Comparing and contrasting the approach of a traditional hospital implementing broadly what is considered risk management with what next-generation hospitals are already doing with highly positive results is instructive.

This table summarizes the key differences between traditional risk management and risk management driven by clinically validated adverse event outcomes based on real-time EHR data (AE Outcomes), as well as the latter’s benefits:

DimensionTraditionalNext GenerationBenefit
Data Source, PrimaryEvent reportingElectronic health record and health ITMore accurate, timely, and actionable
MeasurementNoYesScientifically valid and clinically credible versus narrow serendipitous observations
Identification %Approximately 5%, but can be as high as 12%Approximately at least 78% and increasingIdentify 10x the level of serious harm
% Probability that a patient will be analyzed for harmVery low100%Increase safety for the vast majority of patients
SeverityGenerally disproportionate value in identifying near misses (NCC MERP A-D)Generally disproportionate value in identifying higher severity harm (NCC MERP E-I)Disproportionately target scarce resources on higher human suffering and financially costly harm
InterventionVery little opportunity with 90-95% of reported events not constituting harm reaching the patientOpportunity provided to interveneCreates a business model for patient and risk given actionability while patient receiving care
ImprovementCycles measured in weeks, months, and yearsCycles measured in minutes, hours, and daysReduces time to value, boosts clinical team morale, and gets more done with less
EquityRacial and social biases validated to exist in reported dataEliminates bias in identification step – all patients surveilledPath to eliminating all bias requires eliminating identification bias first
Outcomes DataNoYesMeasure to enable management and advanced analytics
ML-AI Training DataNoYesAE Outcomes are optimal if not essential for training data
Business CaseMinimal – largely done to comply and viewed as a cost centerYes – 3x to 5x annual ROI for patient safety alone when considering only XLOSAdds CFO-grade business case which is critical for meaningful investment in safety and more ROI in risk

A Question from Patients

After reviewing the comparison, why would any hospital or delivery care leader opt to remain in the traditional model?

More importantly, why would any patient or their family prefer the traditional model?

Does this next-generation approach promise to deliver a superior patient experience, as measured by better clinical outcomes and more financial sustainability? The answer to this question is, “Yes.”

A Question from Health Systems

How does a hospital implementing traditional risk management move to a next-generation approach and realize these benefits?

The answer is to implement a Virtual Patient Safety (VPS) solution that has operationalized the peer-reviewed, published, and real-world evidence showing how EHR data elements – or “triggers” – and advanced analytics can be used to measure using AE Outcomes.

Pascal’s VPS solution does just that, and much more.

How do these benefits translate into clinical and financial value? This will be the subject of next month’s blog.

Conclusion

For too long, change in patient safety and risk management has been excruciatingly incremental.

Innovations have been focused on annual initiatives instead of sustainable strategies; driven disproportionately by external calls for action instead of internal real-world evidence; and implementing “tools” instead of platforms.

Indeed, what is required is a wholesale change in executing how patient safety and risk management are done going forward.