Advancing Safe and Equitable Healthcare: The New Patient Safety Structural Measure by CMS
On July 31, 2024, the Centers for Medicare & Medicaid Services (CMS) announced a significant update to the hospital quality reporting program with the finalization of the Patient Safety Structural Measure. The new measure is a robust initiative intended to elevate patient safety standards across hospitals. This move has been widely supported by ECRI—a globally recognized nonprofit organization dedicated to improving patient safety and healthcare quality. ECRI regards this measure as a crucial step forward for healthcare institutions who want to adopt a total systems safety approach for their workforce.
Understanding Total Systems Safety
Total Systems Safety is a comprehensive methodology aimed at enhancing the efficiency and resilience of safety operations within healthcare settings. This proactive systems approach is anchored in clinically-informed human factors, systems design engineering, health equity, and advanced safety science. By redesigning elements of the safety system, Total Systems Safety helps healthcare providers deliver care in a highly reliable and resilient way. The ultimate goal is to enable healthcare teams to deliver safer and more effective care.
ECRI has extensive expertise in both the design and implementation of many safety management processes encompassed within the new Measure. These processes include advancing health equity, just culture, tiered safety huddles, root cause analysis, and communication and resolution programs, among others. ECRI is committed to supporting health systems as they strive to eliminate preventable harm through the implementation of the practices outlined in the Measure.
How ECRI Supports the Patient Safety Structural Measure
ECRI provides a range of resources and tools to help healthcare providers meet the requirements of the Patient Safety Structural Measure. Here are a few ways that ECRI assists hospitals across the five key domains outlined by CMS:
- Domain 1: Leadership Commitment to Eliminating Preventable Harm
Leadership commitment is pivotal to advancing patient safety. ECRI supports this by conducting system-wide assessments on safety and executing patient safety initiatives. As part of its offerings, ECRI provides health systems with the Total Systems Safety Organizational Self-Assessment. This tool, derived from the National Action Plan to Advance Patient Safety, helps leaders measure, plan, and act upon opportunities for improvement related to their safety management programs.
- Domain 2: Strategic Planning & Organizational Policy
Strategic planning and the development of organizational policies are critical for embedding patient safety into the healthcare culture. ECRI—in collaboration with its affiliate—the Institute for Safe Medication Practices (ISMP), offers a comprehensive curriculum of training and professional development opportunities. These opportunities include competency-based training in areas such as medication safety, root cause analysis, clinically informed human factors and safety systems design, and psychological first aid training. This curriculum ensures that all hospital staff, from clinical personnel to C-suite executives and governing board members, are equipped with the necessary skills and knowledge to prioritize patient safety.
- Domain 3: Culture of Safety & Learning Health Systems
A culture of safety is fundamental to a learning health system. ECRI employs clinically informed human factors engineering principles in the selection and design of devices, equipment, and processes. ECRI's team of human factors engineers collaborates with healthcare professionals to take a blended approach that considers the clinical environment and safety infrastructure. This human-centered, total systems approach aims to transform patient safety while accounting for the realities faced by clinicians.
- Domain 4: Accountability & Transparency
Accountability and transparency are vital for continuous improvement in patient safety. ECRI—through the ECRI and the ISMP Patient Safety Organization (PSO)—supports hospitals in reporting serious safety events, near misses, and precursor events. ECRI and the ISMP PSO is the largest of its kind in the United States, with a database of over 7 million patient safety events and more than 5,000 root cause analyses. This extensive repository allows ECRI to act as a national learning system for safety with the mission of advancing evidence-based healthcare globally, ensuring that high-quality healthcare is accessible to all.
- Domain 5: Patient & Family Engagement
Incorporating patient and family input is essential for identifying and addressing patient safety events. ECRI's Total Systems Safety program assists healthcare providers in designing processes that enable safety teams to collect and analyze patient- and caregiver-reported safety concerns. This patient-reported safety-outcomes process allows safety teams to measure and act on issues as they occur and are identified by patients and families, thereby enhancing the overall quality of care.
The Road Ahead
The finalization of the Patient Safety Structural Measure marks a significant milestone in the journey toward zero preventable harm in healthcare. By adopting a total systems safety approach, hospitals can create safe, equitable, and effective clinical environments. ECRI's comprehensive support across the five domains outlined by CMS provides healthcare systems with the necessary tools and expertise to meet these ambitious safety goals.
Investing in patient safety is not just a regulatory requirement; it is a moral imperative. By focusing on , leadership commitment, strategic planning, culture of safety, accountability, and transparency, healthcare providers can make substantial strides toward eliminating preventable harm.
ECRI stands ready to support healthcare systems in this critical endeavor, offering a wealth of resources and a commitment to advancing patient safety on a global scale. As healthcare continues to evolve, the principles of total systems safety will undoubtedly play a pivotal role in shaping the future of patient care.
Learn more about how healthcare providers can work with ECRI to use our transformative methodology to examine all elements of the system to understand where vulnerabilities exist—and most importantly—put people at the center of everything you do.