Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Place emotional harms on par with physical ones

Diane W. Shannon, MD, MPH
Physician
February 20, 2017
Share
Tweet
Share

Why would a well-respected, venerable health care organization adopt a soft and squishy approach — tracking disrespect and other forms of emotional harm — to monitor its performance?

In 2007, Beth Israel Deaconess Medical Center (BIDMC), a 672-bed health system affiliated with Harvard Medical School, adopted the audacious aim of eliminating all preventable harm by January 1, 2012. According to Kenneth Sands, MD, chief quality officer of BIDMC, the organization has not yet achieved perfection in this area, but the bold goal has catalyzed substantial advancement in patient safety at the organization.

Sands and colleagues described this courageous approach and their patient safety efforts at a presentation at the Institute for Healthcare Improvement Annual Forum in December. BIDMC patient safety experts have developed a process by which serious events, such as medical errors, are sifted from the “noise” of the thousands of reports received each year, such as “near miss” events. High-level statistics regarding these events are included on the organization’s performance dashboard, portions of which are shared publicly. Since launching the initiative, BIDMC has seen a 70 percent drop in serious harm events, despite improved reporting mechanisms that likely increased the number of harms reported.

According to Sands, the bulk of the improvement was due to several initiatives to decrease specific harms (for example, decreasing cardiac arrest in med/surg units). Quality and safety leaders realized that the harms that remained would require a broader approach.

At the same time, the organization had a parallel focus on improving the patient experience of care. Leaders recognized that patient safety and the patient experience were intricately linked (for example, disrespect often signaled a situation ripe for physical harm) and shifted their strategy regarding harm prevention.

“We merged the patient experience and the quality and safety committees. We now have a single group that reviews reports of possible harm — physical or emotional,” Sands explained. In addition, the organization created a dashboard for emotional harm similar to that for physical harm events and developed a process for identifying serious events.

According to Patricia Folcarelli, RN, PhD, senior director of patient safety at the medical center, a Respect Working Group reviews all complaints related to disrespect or incivility and uses a scoring methodology to rate severity and categorize events by type of harm. As with episodes of physical harm, the group conducts root cause analyses to better understand the upstream factors that created the situation in which the emotional harm occurred. According to Folcarelli, the group has found that the process “brings rigor” to the study of emotional harm, uncovers systems issues, and exposes “blind spots” that can then be addressed.

During my residency training in the early 90’s, I constantly worried about medical errors — due to a fault of mine or to a broken process that would expose patients to potential harm. I was grateful to see patient safety taken more seriously, after the release in 1999 of the seminal Institute of Medicine report, To Err Is Human.

I’m even more encouraged now to see that non-physical harms are being given their due “respect.” Among my friends and family members, the longest lasting harms I’ve observed have been the emotional ones. As a dear friend told me with still vehement anger almost two decades after such an event, “I felt like a case. Like I was wrong to be sad. He ignored my feelings and humanness.”

Virtually every one of us is a patient at some point in our lives. Why wait until then to fully appreciate the importance of respect to the patient experience, to patient safety, and to health outcomes? Placing emotional harms on a par with physical ones, and rigorously tracking both, is the step toward fixing the upstream events that put patients at risk.

Diane W. Shannon is an internal medicine physician who blogs at Shannon Healthcare Communications.

Image credit: Shutterstock.com

Prev

A positive visit with a patient with chronic pain

February 20, 2017 Kevin 2
…
Next

Overdiagnosis harms kids. Here's how to avoid it.

February 21, 2017 Kevin 3
…

ADVERTISEMENT

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
A positive visit with a patient with chronic pain
Next Post >
Overdiagnosis harms kids. Here's how to avoid it.

ADVERTISEMENT

More by Diane W. Shannon, MD, MPH

  • Why this doctor hid her story for a decade

    Diane W. Shannon, MD, MPH
  • Why women doctors spend more time on EHRs and what it means for patient care

    Diane W. Shannon, MD, MPH
  • Unexpected lessons in self-care from my backyard garden

    Diane W. Shannon, MD, MPH

Related Posts

  • Why social media may be causing real emotional harm

    Edwin Leap, MD
  • The tension between intense commitment and physical, emotional, and interpersonal well-being

    Timothy Keyes
  • Emotional support animals for health care providers

    Brittany Ladson
  • The emotional side of genetic testing

    Erin Paterson
  • How physical should medical training be?

    Orly Farber
  • A physician’s addiction to social media

    Amanda Xi, MD

More in Physician

  • Why more doctors are choosing direct care over traditional health care

    Grace Torres-Hodges, DPM, MBA
  • How to handle chronically late patients in your medical practice

    Neil Baum, MD
  • How early meetings and after-hours events penalize physician-mothers

    Samira Jeimy, MD, PhD and Menaka Pai, MD
  • Why medicine must evolve to support modern physicians

    Ryan Nadelson, MD
  • Why listening to parents’ intuition can save lives in pediatric care

    Tokunbo Akande, MD, MPH
  • Finding balance and meaning in medical practice: a holistic approach to professional fulfillment

    Dr. Saad S. Alshohaib
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 8 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Place emotional harms on par with physical ones
8 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...