For all of the discussions about cost, access and bureaucracy, it's becoming increasingly clear that one of the biggest problems we face in healthcare is inertia.
Ironically, in a field that is constantly evolving with new research and scientific knowledge, healthcare providers have a natural instinct to do things the same way they learned years ago and have always done them—and patients are paying the price.
A study by researchers at Johns Hopkins University, released in May, found that medical errors in hospitals and other healthcare facilities account for more than 250,000 deaths each year, a significant increase since an Institute of Medicine 1999 study, To Err Is Human, offered solutions for the healthcare system to achieve a better safety record. Suggestions included developing safety oversight programs, raising performance standards and instituting mandatory reporting for adverse medical events. Years later, though, it's clear that people are still dying more from their care than they are from diseases such as Alzheimer's or stroke.
This is unacceptable by any measure. But let's not jump to the conclusion that these dangerous errors are the result of carelessness or disregard for the patient's well-being. I can attest from years of teaching and working with nurses and other healthcare professionals that clinicians working in hospitals, clinics and primary-care offices are as dedicated as I have ever seen. The problem is that many have yet to develop the knowledge and skills to consistently deliver the best evidence-based care.
A follow-up IOM study in 2001, “Crossing the Quality Chasm,” offered six aims to improve the quality of care—among them, that effective care means “providing services based in scientific knowledge.” However, that gap in care between the growth of evidence-based practices and what is actually happening at the point of care still exists today. Evidence-based practice is an approach to healthcare that melds clinical expertise and patient preferences with data emanating from relevant, high-quality research. When we are able to support that a particular practice generates better health outcomes than traditional practice, clinicians should adapt and make that change. It's about prioritizing problem-solving and implementing best evidence over doing what's become comfortable.
I would guess that most patients already enter a hospital or healthcare system thinking they are going to be receiving evidence-based care. However, studies have shown that is not the standard of care in many facilities.
The implementation of best standards of patient care won't happen without a concerted, systemwide effort. We're trying to accelerate this movement by launching, in the fall of 2017, a national institute for evidence-based practice in nursing and healthcare that will be headquartered at Ohio State University. Our goal is to revolutionize the future of patient care by replacing practices that are steeped in tradition with the best evidence-based care. We're also going to be ramping up our advocacy for the kind of sensible steps that will integrate evidence-based practice into all care settings.
This begins with strengthening nursing curriculums at schools nationwide and educating nursing and other health sciences students on how to implement the steps of “EBP” and access the premier standards of care, so that they can implement them in their clinical practices. We need to create online hubs for healthcare providers to review best practices and have access to reliable resources. And, in the interest of dynamic learning, there must be a constant stream of webinars, conferences and summits to disseminate newly emerging research, evidence and knowledge.
The Johns Hopkins study only confirmed what we've known for years. Patients, regardless of where they are receiving care, deserve the benefits of breakthrough research and best practices. It may take many years to develop cures for cancer, heart disease and other life-threatening illnesses, but the quarter-million lives lost annually to medical errors is a problem we can begin fixing now.