Issue link: https://beckershealthcare.uberflip.com/i/1543613
7 PATIENT SAFETY & OUTCOMES 'Average' ED performance linked to low care quality: Report By Paige Twenter M any U.S. emergency departments operate "good enough," and this level of performance is harming patients, margins and morale, according to a Jan. 29 report from Kaufman Hall. "Average ED performance is not neutral. It is a decision to tolerate risk, leakage, patient dissatisfaction and variable quality of care," the report said. "It exposes patients to avoidable harm, quietly erodes margin and accelerates workforce fatigue, while signaling to patients that mediocrity is an acceptable standard." The typical ED has a median door-to-provider time between 25 and 45 minutes, as well as a left-without- being-seen rate of 3% to 5%. These EDs usually operate with reactive staffing models, thus creating predictable bottlenecks in patient flow, according to the report. "Many EDs staff to historical averages in daily volume, arrival patterns and acuity," the report said. "But emergency care is defined by variability. Arrival patterns change by hour, day and season. Fluctuations can quickly overwhelm resources." Additionally, "staffing to averages guarantees average outcomes" while fueling burnout for an already strained workforce, the report said. Kaufman Hall recommends EDs staff to demand not based on historical averages but on patient arrival data and predictable surges. The report also underlines the importance of ensuring physicians, nurses and support staff operate in tiers that are flexible to demand shifts. n — a finding with growing relevance as climate change drives more frequent and intense fire seasons. Dr. Spoon describes these efforts as "just the tip of the iceberg." He sees Resolve's structure as exactly what is needed to accelerate innovative, locally driven solutions to persistent challenges in rural healthcare. A long-term goal of the collaborative is workforce development and retention. Dr. Spoon hopes Resolve will inspire future nurses, techs and advanced practice providers to not only train in rural areas but also stay, by embedding them in the development and implementation of solutions that directly affect their communities. "ere's a lot of brain drain from rural America, and so when you build something like Resolve, we've got the ability to incorporate that in educational programs … and hopefully inspire the next generation of people to build a skill set and then be very passionate about continuing to practice in rural America," he said. Looking ahead, Dr. Spoon envisions Resolve evolving into a shared, statewide and potentially national platform open to all hospitals, universities and organizations committed to improving rural healthcare delivery. "I don't feel rural America benefits from silos and strong, ruthless competition in healthcare because there isn't enough that we can duplicate service lines in these large areas, so that's been a foundational ethos of our program," he said. "We want anyone who wants to be a part of this to be involved." n The case for embedding emotional safety into patient safety work By Mackenzie Bean E motional safety should be assessed as a core component of patient safety, researchers at New York City-based NYU Rory Meyers College of Nursing wrote in a Dec. 29 article published in Advances in Nursing Science. While current literature explores emotional harm in healthcare, the industry has lacked a clear definition of emotional safety. "Despite the need to incorporate patients' emotional safety into care delivery to reduce emotional harm, the literature is limited regarding the definition and dimensions of the concept of 'emotional safety' or how patient safety includes patients' perceptions and feelings of safety during their healthcare experiences," the researchers wrote. ey analyzed 56 U.S. studies addressing emotional safety and harm and proposed a preliminary framework defining patient emotional safety across four core dimensions: • Autonomy — Giving patients a voice and control over their own health decisions through respect, informed consent and transparent communication. • Human connectedness — Using person-first language, taking a holistic view of patients lives, leaving adequate time for communication and taking accountability aer harm. • Practice of structural humility — Addressing cultural humility, affirming patients' lived experiences, demonstrating equitable power-sharing and dismantling discriminatory systems. • Secure environment — Ensuring patients feel safe and secure within the healthcare setting by maintaining privacy, minimizing emotional and physical stressors and fostering a culture of respect and coordinated care. e researchers noted that emotional harm can occur even in the absence of physical harm and can erode trust, delay care-seeking and worsen outcomes. ey conclude that health systems must embed emotional safety into patient safety work and organizational accountability to meaningfully improve care and equity. n