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Massachusetts health care — wonky, with a healthy dose of reality

Patient Safety Awareness Week Guest Blog #1: PROMISES Project

Patient Safety Awareness Week Guest Blog #1: PROMISES Project

March 5, 2014

(To mark Patient Safety Awareness Week, we will be presenting a number of guest blogs. Here's the first:)

During the second season of “I Love Lucy”, the infamous duo of Ethel and Lucy find themselves working in a chocolate factory wrapping sweets from a conveyor belt. In a classic television moment, the two women fear they may be fired if they cannot perfectly wrap every chocolate while the unseen conveyor belt operator rapidly increases the speed (see the video above).

This is the story of primary care in the United States. Well-intentioned and skilled providers are faced with increasing demands without support or meaningful orientation. And the demands are increasing. Just as Lucy and Ethel fear losing their jobs, primary care providers worry about endangering their patients. And with every harmed patient, the provider’s malpractice risk increases.

A group of Massachusetts primary care offices signed up to make care safer for patients. Over 15 months, a network of 16 small-medium primary care teams worked to remedy selected operational failures that harm patients.

For example, one practice improved their referral system to ensure that every patient was booked with a specialist and followed up. This meant that at-risk patients were provided clear communication and that all providers were working together. After strengthening the processes, the Practice Manager exclaimed, “I don’t know how we weren’t doing this before!”

This same practice had a scare only 18 months before. After receiving a call about a referred patient who never visited a specialist to have a crucial test, the primary care practice vowed to provide more reliable care to keep patients safe.

Other teams improved medication management, lab test results follow-up and communicating effectively with patients. Together, the group of 16 practices found ways to ensure that no patient was missed and that all patients received safer care.

Like Lucy and Ethel, primary care teams face seemingly insurmountable challenges. However, we found that with coaching to see problems, analyze them, and test solutions to find what works,  patients received the care they needed.

In the end, that victory is far sweeter.

(Nicholas Leydon is the Director and Improvement Advisor for the PROMISES Project. To learn more about PROMISIES visit, www.brighamandwomens.org/PBRN/promises