12 Questions to Determine if Patient Safety is a Strategic Priority

By Raj Shah

The COVID-19 pandemic’s devastating impact on patients and employees at nursing homes and senior care facilities exposed longtime safety issues. While safety (e.g., infection control,  resident/patient injury, medication administration) has always been important, for many it may not have been at the same strategic priority level as business performance or operational efficiency. 

As a result, trust in long-term care safety practices among seniors is now at an all-time low. A Qualtrics survey finds that nearly half of America’s seniors do not trust long-term care safety. 

Low confidence in patient safety practices has already impacted the census and occupancy rates for many, if not most, senior care organizations. If safety trust is not rebuilt, business performance and staff morale will continue to decline. 

Analyzing other industries that have overcome their own safety challenges can provide insights into how healthcare organizations can also make safety a strategic priority. The following 12 questions are adopted from best practices in safety-first industries.  

1. Does the organization have a comprehensive safety strategy and plan that includes all safety aspects and types (e.g., infection safety, care delivery safety, ,facility safety)?
2. Are safety KPIs and metrics on par with financial, census, and client satisfaction metrics?
3. Are safety matters discussed at weekly leadership, management, and/or executive meetings?
4. How many safety risks are actively being managed?
5. How often is the organization’s safety posture discussed in board/trustee/owner meetings?
6. Is there a single executive with oversight of ALL safety initiatives across all functions? Does that executive report to the CEO?
7. Does the organization have a real-time dashboard of all safety risks and action plans?
8. Is there a process in place to identify and remediate high-risk employees, functions, and facilities before an incident happens?
9. How often does the executive leadership personally communicate (outside of email/newsletter) with frontline caregivers on safety matters?
10. Are safety risk assessments up to date? How often are they updated?
11. During the annual strategic planning session, how much time is spent on safety and risk?
12. What are the hard economic costs of safety incidents (e.g., census impact, worker’s comp, lost time, lawsuits, insurance premiums, staff turnover)?

Affirmatively answering all 12 of these questions—without hesitation—is a good indication that safety is a strategic priority in an organization. Otherwise, additional work may be needed by the leadership team to create a safety-first organization and culture.  

Lessons learned from other safety-first industries 

Studying other industries that have weathered devastating safety challenges can be instructive in building a path to a safety-first organization. An analysis of construction, food, and manufacturing sectors shows that prioritizing safety can benefit customers, employees, business performance, and the entire industry’s health. 

For example, construction and mining sectors adopted a safety-first approach decades ago. Since then, injury rates have fallen dramatically. Today, the injury rate for construction workers (3.0 per 100 full-time workers) is 50 percent lower than for senior care workers (6.1 per 100 full-time workers). Think about that a moment. A worker is half as likely to get injured working on a construction site than taking care of a patient in a long-term care facility¹. 

Another successful safety-first transition occurred in the food processing industry over the last decade. Driven by consumer pressure from repeated food recalls and illnesses, Congress passed the Food Safety Modernization Act (FSMA). FSMA put real teeth in FDA and USDA enforcement and audits. It required food companies to make safety a strategic priority—or be shut down by regulators. Food is now safer than ever for consumers. 

Make safety a strategic priority and a competitive advantage

Organizations that embrace safety as a strategic priority can also make it a competitive differentiator. Think Volvo, Honda and Subaru for car safety. Forward-thinking senior care organizations that make safety a strategic part of their value proposition, and effectively communicate it in the marketplace, have a unique opportunity to stand apart from competitors.

Organizations that fail to prioritize safety will continue to face regulatory scrutiny, lawsuits and consumer dissatisfaction. Rather than a “wait and see” approach, take a page from other safety-first industry successes, and make safety a priority. 

While long-term care organizations are still responding to COVID-19, it does not preclude the possibility of the “next one” that could come without warning. Safety programs need to be strategic, agile, and proactive. It’s not just about fighting the last battle but preparing for the next one. To make safety a competitive advantage, organizations need to:

• Make safety a top strategic priority
• Take a systems-based approach to safety
• Assess risks more comprehensively
• Improve onboarding training and ongoing coaching
• Digitize safety program management and be proactive

Other safety-first industries have learned and adopted best practices from their own industries and other sectors. Now is the time for the healthcare community to do the same.  

1. Bureau of Labor Statistics, 2018 

About the author

Raj Shah is the founder of CareSafely, a software platform for senior care safety, compliance, and quality management. He is passionate about applying innovative technology to make a meaningful impact in people’s lives. Prior to CareSafely, Raj was the president of Alchemy Systems which engages nearly two million frontline employees on safety, compliance, and quality assurance.