Sharon Gilliam, MSN, RN, is the Director of Patient Safety & Quality at Williamson Medical Center with over four years in her current role. She holds a Master of Science in Nursing Administration and has extensive experience managing accreditation, patient safety, and clinical quality in healthcare settings.
In an exclusive interview with Medical Care Review, Gilliam spoke about the nuances of patient safety, emphasizing the importance of human-centered care, effective communication, and the integration of technology to protect patients at every stage of treatment.
Shaping Accreditation through a Human-Centered Lens
When I think about the key moments that shaped my career in patient safety and accreditation, they all originated from my experience in patient care as a bedside nurse. Providing patient care to patients established the human component as it pertains to patient safety and accreditation. There are real people behind what we do to advance patient safety and meet accreditation standards. Also, when we are trying to make improvements related to patient safety, I think back to my experience in patient care to remember that not all patients are the same, and we have to be mindful of that when we’re developing our processes and workflows. This also helps impact the patient experience and their openness with clinical staff, which also goes hand in hand with patient safety.
It is important to reshape accreditation standards and requirements from being viewed as things we must do simply because a regulatory or accrediting body requires it, to seeing them as practices we do because they are the right thing for the patient. For example, the National Patient Safety Goals from the Joint Commission are accreditation requirements, but they are also essential to patient safety. Identifying patients correctly is critical to ensuring that the right care is delivered to the right patient at the right time. If this is not done well, significant harm can occur.
Involving the patient in these conversations helps them understand why these practices are important and encourages them to partner with us to stay safe. Patients sometimes assume we know who they are because they wear an armband or because they are already in the hospital. However, they may not realize that there are many patients being treated by the same team, and some may even have similar names that could cause confusion. Explaining to patients that staff will consistently ask them to state their name and date of birth (or another identifier) sets the expectation and helps them comply.
Just as we encourage patients to speak up if a caregiver does not wash their hands, patients can also prompt staff to verify their identity. Similarly, fall risk agreements help patients understand why they may be labeled at risk and encourage collaboration. Engaging patients in these formalized conversations makes them feel empowered, valued, and safe.
Balancing Safety, Access, and Resources
Our current healthcare environment is quite complex, and unfortunately, this can result in the patient getting lost in the mix. Clear and concise communication with the patient, in a way they best understand, is crucial. One of the best solutions I have seen is the implementation of nurse navigators or care coordinators. Some insurance companies have introduced these programs to improve care coordination on the payor side. However, there is also a strong opportunity to expand these roles on the healthcare delivery side.
A patient may be admitted to a hospital, treated by the hospital team, and then referred to specialists or physicians after discharge. These specialists may or may not be part of the same hospital system. When they are not, it often means different electronic medical records, incomplete transfer of information, or other issues that leave the patient caught in the middle. At the same time, the primary care provider, who is supposed to be the point person for overall care, may not even be aware of the hospitalization or the treatment plan from other providers.
This puts an extra burden on patients, who must request records and make phone calls to manage care. For many, this is overwhelming. A dedicated coordinator can ease this burden, improve safety, reduce readmissions, and help patients stay compliant with their treatment plans.
It can be challenging when it comes to balancing safety, access and resources. Ensuring patient safety is not free, and implementing processes to enhance patient safety can cause unintended consequences that must be considered as well. As an industry, I think it is important to always keep patient safety at the forefront when making decisions. In a patient safety role, I think it is important to be able to communicate to the senior leadership team or Governing Board why investments in patient safety activities and resources are necessary. This can be challenging for others to grasp because there often isn’t a clear return on investment when talking about resources needed for patient safety activities.
However, not designating time or resources to patient safety often leads to financial implications down the road that may include potential litigation related to patient safety incidents, financial penalties under CMS Pay for Performance Programs or hospital-acquired conditions (such as infections, returns to surgery, etc). This does not include the potential loss of future revenue from bad publicity and loss of market share. Therefore, the patient safety leader should keep an open line of communication with their senior leadership team to ensure that patient safety is a consistent topic of discussion and part of the strategic planning process.
Remembering the Human behind the Data
I think the biggest opportunity coming with patient safety that will be impactful to patients is AI and technology. We’ve seen some of this with some hospital-at-home programs as well as medical devices that have been approved for in-home and consumer use. However, AI is still relatively new in healthcare, so I think a lot of organizations are still trying to understand potential use and safety considerations. However, as AI is integrated into other areas of patients’ lives, I think it will become more of a factor and possibly be desirable for those who are seeing AI use in other areas of their day-to-day experiences.
A perspective that was instilled in me by another patient safety and quality leader when I transitioned from bedside nursing to patient safety and quality was to always remember there is a patient at the heart of all we do. When we are reviewing data, those are not just numbers but patients. That number is someone’s husband, daughter or mother. Everything we do (or choose not to do) in patient safety and quality could have an impact on those patients.
