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The PA Role in Patient Safety



The PA Role in Patient Safety

In any healthcare setting, there is always an emphasis on patient safety. But if I am being honest, it took me a while to really understand the meaning behind it.  We are all taught as physician assistants, doctors and nurses the Hippocratic Oath: First Do No Harm, and we do the best we can to adhere to it. But at times, even the best intentions cannot prevent this from happening.

The World Health Organization (WHO) defines patient safety as the prevention of errors and adverse effects to patients associated with health care, but unwanted and unexpected events can happen anywhere along the continuum of care. The increased pressure on providers and healthcare systems to generate revenue leads to patient overload, burnout, and medical errors.  We are treating older patients with multiple comorbidities that require complex decision making and coordination of care. Patient safety is truly centered around avoiding preventable adverse events that negatively impact patients, families, providers and the economic health of the system as a whole.

PAs have long been praised as providing access to healthcare, but have also been shown to improve transition of care as well as patient safety.  In a study of the utilization of PAs and NPs in academic medical centers, 77% said secondary reasons for employing PAs/NPs was to improve patient safety and quality.(2)  Other secondary reasons included increasing patient throughput (88%), reducing length of stay (73%), and improving continuity of care (73%). (2)

In the primary care setting, access to safe and effective medical care is enhanced when PAs are part of the primary care provider team, and some patients may preferentially select them.(1)

As a practicing PA there are certain areas in which I feel I contribute to patient safety more than others.  Medicine reconciliation, healthcare literacy and transition of care are areas in which I see the most preventable errors in practice, that that I focus to improve.  Something as simple as reviewing which medications a patient is taking and why they are taking them, can avoid costly errors. Evaluating a patient’s level of understanding of their health, using vocabulary they can understand and using a teach-back method (have them repeat the plan to you) to ensure understanding can be an effective way to educate patients as well as reduce complications. Lastly, communication amongst various teams when moving a patient between specialties or care centers can be challenging. Developing a standardized way in which we communicate throughout the transition and empowering patients/families to assist in this process could minimize those who may fall through the cracks.

The Center for Patient Safety’s (CPS) #Healthcareforward campaign focuses on reducing preventable harm by raising awareness about the connection between patient and provider safety and quality care. PAs can help minimize complications by providing comprehensive, patient centered care.

So lets all #healthcareforward this week for #patientsafetyawarenessweek (and every day) to be our best for our patients!

Hooker RS, Everett CM. The contributions of physician assistants in primary care systems. Health Soc Care Community. 2011;20(1):20-31.

Marc Moote, MS, PA-C, Cathleen Krsek, RN, MSN, MBA, Ruth Kleinpell, PhD, RN, FAAN, FCCM, Barbara Todd, DNP, CRNP, FAANP. Physician Assistant and Nurse Practitioner Utilization in Academic Medical Centers. American Journal of Medical Quality. 2011; Volume: 26 issue: 6, page(s): 452-460.

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