American College of Physician Executives

Related Articles

 

Doctors Say Many Obstacles Block Paths to Patient Safety
By Bill Steiger

Challenges in Patient Safety and Quality: Replacing Discouragement with Hope
By Diane W. Shannon, MD, MPH

The Reality of the Hospital:
Physician Leaders in Harm’s Way
By Donald Mellman, MD, MPH, MBA, FACHE

 

Quality Models: Selecting the Best Model to Deliver Results
By William F. Martin MPH, PsyD

Improving Patient Flow
By David C. Pate, MD, JD and Michael Puffe


 

 

 

Survey Results
1. Below is a list of some of the most common obstacles to providing high-quality health care and patient safety initiatives. Please rate each one as it relates to your health care organization.
Not an obstacleSometimes an obstacleA major obstacleResponse Average
Lack of resources/money
10% (116)55% (626)35% (403)2.25
Federal government policies
20% (234)62% (703)18% (205)1.97
Insurance companies’ practices
20% (229)50% (568)30% (345)2.10
Patient compliance and awareness of healthy habits
7% (75)59% (678)34% (391)2.28
Physician resistance to use evidence-based care
12% (137)61% (690)27% (313)2.15
Administrative culture that doesn't support quality/safety initiatives
41% (473)41% (469)17% (199)1.76
Clinician communication and culture (interaction of physicians, nurses, and paraprofessionals)
11% (123)56% (638)33% (383)2.23
Fear of reporting quality and safety problems
22% (253)49% (565)28% (326)2.06
A desire to maintain the status quo
12% (141)52% (601)35% (403)2.23
Total Respondents  1147
(skipped this question)  8
2. Have you ever struggled with finding an appropriate balance between what you believe is best for the patient(s) and what's best for your health care organization when it comes to implementing quality/safety initiatives?
 Response PercentResponse Total
  Yes
59.1%676
  No
37.7%431
  Not applicable
3.1%36
Total Respondents  1143
(skipped this question)  12
3. How frequently are decisions about quality/safety initiatives made at your health care organization that favor the organization rather than what you believe is best for the patient(s)?
 Response PercentResponse Total
  Always
1.8%12
  Frequently
19.7%132
  Sometimes
33.7%226
  Seldom, but it happens
37.1%249
  Never
7.7%52
Total Respondents  671
(skipped this question)  484
4. Please share an example of a decision that was made to aid the organization rather than the patient(s).
 Total Respondents  
372
(skipped this question)  783
View All Responses for Question 4
5. In your health care organization, are there situations where low or poor quality is tolerated for physicians or departments that generate high amounts of revenue?
 Response PercentResponse Total
  Yes
39%436
  No
61%682
Total Respondents  1118
(skipped this question)  37
6. Please provide an example of a situation where low or poor quality is tolerated for physicians or departments that generate high amounts of revenue.
 Total Respondents  
303
(skipped this question)  852
View All Responses for Question 6
7. Do you have a strong whistleblower policy at your organization that is enforced and protects those who report a medical error or patient safety hazard?
 Response PercentResponse Total
  Yes
60.9%666
  No
39.1%428
Total Respondents  1094
(skipped this question)  61
8. Do you believe employees in your organization fear reporting errors or safety hazards because they may suffer repercussions or lose their jobs? (i.e. A punitive workplace environment.)
 Response PercentResponse Total
  Yes
54.7%245
  No
45.3%203
Total Respondents  448
(skipped this question)  707
9. Generally speaking, how supportive are the physicians in your organization of quality and patient safety improvement projects?
 Response PercentResponse Total
  Very supportive
34.1%379
  Somewhat supportive
51.9%576
  Slightly supportive
12.6%140
  Not supportive
1.4%15
Total Respondents  1110
(skipped this question)  45
10. Does your organization have physician financial incentives (pay for performance or other bonuses) that are aligned with improving the quality of care?
 Response PercentResponse Total
  Yes
23.9%264
  No
76.1%841
Total Respondents  1105
(skipped this question)  50
11. Below is a short list of problems that can contribute to waste and inefficiency in a health care organization and impact the ability to deliver safe, high-quality care. Please rate the inefficiencies as they relate to the quality of care at your organization.
Not a problemSometimes a problemA major problemResponse Average
Medical errors, including nursing and pharmacy
11% (121)76% (831)13% (140)2.02
Overuse or underuse of care
9% (103)58% (637)32% (349)2.23
Complications from procedures (such as infections)
25% (269)68% (741)7% (77)1.82
Unexplained variance in care
11% (123)61% (664)28% (301)2.16
Patient flow problems
8% (89)49% (537)42% (460)2.34
Total Respondents  1093
(skipped this question)  62
12. Is your organization doing anything to correct the major problems you listed above?
 Response PercentResponse Total
  Yes
76.7%826
  No
11.5%124
  Didn't list any major problems
11.8%127
Total Respondents  1077
(skipped this question)  78
13. Please share an example of how one of the inefficiencies listed above affects your organization. Be sure to include how you're fixing it, or why it is not being corrected.
 Total Respondents  
615
(skipped this question)  540
View All Responses for Question 13
14. Generally speaking, how are resource allocation decisions that affect health care quality and safety made in your organization?
 Response PercentResponse Total
  With patient safety as the primary focus
42.9%461
  With clinician efficiency as the primary focus
14.2%153
  With cost as the primary focus
32.7%352
  Other (please specify)
 View responses 10.1%109
Total Respondents  1075
(skipped this question)  80
15. There are several well-known quality programs being promoted nationally. Which of the programs listed below is your organization primarily using to improve quality?
 Response PercentResponse Total
  Six Sigma (DMAIC)
18.5%192
  Lean processes
13.3%138
  Proprietary products provided by vendors
12.2%126
  None
29.2%303
  Other, including homegrown measures (please specify)
 View responses 26.7%277
Total Respondents  1036
(skipped this question)  119
16. Why did you choose that program and why do you think that program is most effective?
 Total Respondents  
413
(skipped this question)  742
View All Responses for Question 16
17. Do physicians sit on the Board of Directors of your health care organization?
 Response PercentResponse Total
  Yes
84.7%894
  No
15.3%162
Total Respondents  1056
(skipped this question)  99
18. In many organizations, the Board of Directors is ultimately accountable for quality and patient safety. However, the actual work of carrying out and monitoring quality and patient safety efforts often lies elsewhere. In your organization, who is primarily responsible for carrying out quality and safety initiatives?
 Response PercentResponse Total
  CEO
10.1%107
  CMO
33.5%355
  Medical staff
18.8%199
  Nursing staff
11.1%118
  Board of directors
5.3%56
  Other (please specify)
 View responses 21.2%225
Total Respondents  1060
(skipped this question)  95
19. In which sector of health care are you currently employed?
 Response PercentResponse Total
  Hospital
43.5%458
  Group practice
26.1%275
  Insurance/managed care
7.4%78
  Government
5.8%61
  Industry
1.5%16
  Academia
7.5%79
  Other (please specify)
 View responses 8.1%85
Total Respondents  1052
(skipped this question)  102
20. Please choose the category below that best describes your title or position.
 Response PercentResponse Total
  CEO, Administrator, President, COO, Commander, Dean or similar
8.7%92
  VPMA, CMO, CIO, CQO, Chief of Staff, Vice Commander, Assoc Dean, or similar
30.9%326
  Medical Director of a Hospital or Group Practice
17.1%180
  Clinical Department Chair, Chief of Service, Medical Director of Clinical Department, Residency Director, Professor of Medicine or similar
25.2%266
  All Other Positions including Practicing Physician, Consultant and Resident/Fellow
18%190
Total Respondents  1054
(skipped this question)  101
21. Please share any comments you have about obstacles to achieving safety and quality in health care.
 Total Respondents  
290
(skipped this question)  865
View All Responses for Question 21