Patient safety has increasingly become a matter of interest to health care organizations and accrediting organizations. Patient safety, as defined by the World Health Organization, is the prevention of errors and adverse effects to patients that are associated with health care. To manage patient safety risks within the environment of care, health care facilities must effectively plan and execute effective programs related to safety, security, hazardous materials and waste, fire safety, medical equipment, and facility/utility management.
ISSUE - Terms and Concepts
- Occupational Safety and Health Administration (OSHA) Hospital Worker Safety (PDF) (Posted Dec. 1, 2015)
- Best practices: Design Guide for the Built Environment of Behavioral Health Facilities (Facility Guidelines Institute) (Posted Dec. 1, 2015)
- Joint Commission Safety Findings for EC.02.06.01 EP 1 (Posted Dec. 1, 2015)
RISK – Defining Failure Modes
Patient Safety: Facility related issues can adversely affect patient safety. Properly managing the environment of care—the space, the equipment, and the people—mitigates risks and reduces the potential impact of these risks to patients, staff, and visitors.
Worker Safety: Hospitals have many unique hazards that can potentially affect the health of employees. These hazards include biological and chemical hazards, ergonomic hazards, hazardous drugs, ionizing and non-ionizing radiation, shift work, stress, and violence. They can be eliminated or reduced by a variety of exposure control methods, including design elimination, substitution, engineering controls, administrative controls, and personal protective equipment.
IMPACT – Identifying Patient Outcomes
One of the earliest proponents of the importance of the physical environment was Florence Nightingale. Her efforts on behalf of the British soldiers during the Crimean War focused on design engineering to improve lighting (especially with sunlight), ventilation, heating and cooling, and clean water. The safety aspects of clean air and water were not inconsequential. The effects of her improvements on patient outcomes were reflected in the mortality figures for 1855, which fell from 42.7 deaths per 1,000 to 2 per 1,000 within 3 months of Nightingale's changes. (Dossey BM. Florence Nightingale: Mystic, Visionary, Healer. Springhouse, Pa: Springhouse Corp; 2000.) Although risks are inherent within the environment of care, properly managing these risks saves patient lives and reduces stress for health care workers.
MITIGATION – Assessment Tools and Resources
- Agency for Healthcare Research and Quality Detection of Patient Safety Hazards (AHRQ)
- Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (AHRQ)
- Occupational Safety & Health Administration Hospital eTool (OSHA)
- Centers for Disease Control and Prevention Workplace Safety & Health Topics for Healthcare Workers (CDC)