The president of the Colorado Patient Safety Coalition said that in addition to playing a direct role in patient safety, nurses are very influential in creating the safety culture at their facilities.
"Nurses are on the front lines of patient safety," said David West, PhD. "They are the ones who are providing care to patients. They are the ones who are looking at systems of care. They are the ones who care and feed. So they’re in a very unique position in patient safety both to observe problems and to affect change."
"Some of the things, too, that we see in working with different professionals is that nurses are sometimes the ones who are most sensitive to issues of culture within any kind of a setting. When you take a look at fostering a culture of patient safety, it’s very often that a nurse can play a leadership role in that – either through a leadership role formally within an organization as a quality improvement coordinator or a patient safety director, or something like that. Also, [a nurse can be] a convener either formally or informally within a number of different settings," West said.
"Nurses are very important to making the changes that we need to make to make sure people are sensitive to the issue of patient safety, that we are creating blame-free environments, so they can tell us when they do make a mistake, and synthesizing the data so we know how to make these environments safer based on the problems that we see," he said.
West, a researcher in the University of Colorado Health Sciences Center Department of Family Medicine, has observed health care from many different perspectives. A member of the Colorado Patient Safety Coalition’s original board of directors, he became the organization’s president last year.
"I spent a lot of my career as Colorado state Medicaid director, and under governors Lamm and Romer ran the Medicaid program. From there I left and started Colorado’s largest Medicaid health maintenance organization, called Colorado Access, and ran that for a number of years. Then, three years ago, I began my research career and began working here in the Department of Family Medicine as the director of our office of program evaluation and research. I head up a number of different types of research," he said.
His time is divided among a number of significant patient safety projects.
"Number one on my list is that we are a recipient from the Agency for Healthcare Review and Quality of about a $3 million patient safety grant," he said. "We are developing and have developed patient reporting systems where physicians in our network – and office staff, nurses, secretaries, pharmacists in our network – if they see an error, they’re encouraged to report it to us, whether or not somebody is harmed. So it’s a voluntary reporting system – no one forces them to do it. You can report confidentially, you can report anonymously.
"We analyze those data. We’ve taken the data gathered over the last two-and-a-half years and are developing experimental interventions within practices to reduce the errors that we’re seeing. It’s very, very interesting work," West said.
"I have another grant from the federal government where we’re looking at how to improve the nursing home enforcement system nationwide to improve quality of care and outcomes in nursing homes," he said, adding that his office also holds contracts with several different states in order to evaluate tobacco-control programs’ effectiveness.
Though West isn’t actively recruiting for participants in any of his studies, he hopes anyone interested in his work will contact him and the Colorado Patient Safety Coalition to find out more.
"Nurses are hugely important to the patient safety movement. One of the reasons I say that is when you take a look at who attends our patient safety conference. Over half of our attendees are nurses," he said, referring to the coalition’s "Do No Harm" safety conferences. The next conference is being planned for November.
West said membership in the patient safety coalition is free, and the organization’s e-mail listserv – found at www.coloradopatientsafety.org - is a terrific resource.
"The listserv will do a number of things – one is we see interesting articles, interesting issues that we think would be helpful to members of the coalition and the community. We get those out on the listserv so they can use them either personally or at work. When we have our monthly meetings, we always publish what the meetings are going to be about. If someone has a specific interest, they can come.
"For example, at our February and March meetings we’re holding a seminar, limited to 25 participants at each meeting, on how you communicate unintended health outcomes to patients. It will be facilitated by a physician who has a great deal of expertise in this area," West said.
The listserv helps spread information – a main objective for the coalition, West said. "Our mission is to foster a culture of patient safety here in the state."