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Hospitals feel weight of poor economy


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Facilities find cost-effective ways to continue training

Many hospitals are beginning to see the effects of the recession as leaders cut budgets, postponing expansions and renovations, and philanthropists decrease their annual giving.

The American Hospital Association (AHA) conducted a survey in November 2008 titled The Capital Crisis: Survey of Impact on Hospitals, which queried nonfederal hospital CEOs about the state of the industry. The report found that 38% of hospitals have seen a decrease in philanthropic giving since November 2008. Also, more than 50% of hospitals have postponed or considered postponing expansion or renovation projects.

More alarming statistics to come out of the AHA survey show that half of hospitals have put capital projects on hold or stopped projects already in process. Of these hospitals, 82% have put facilities projects on hold, 65% have put clinical technology projects on hold, and 62% have put information technology projects on hold.

Of the hospitals that stated they would have to delay facilities projects, 63% said that they had anticipated an improvement to quality/patient safety with these projects.

Diane Pinakiewicz, MBA, president of the Na-tional Patient Safety Foundation (NPSF), says although many healthcare providers are not hearing good news about their budgets, it is still too early in the year for many facilities to have experienced the full force of what is to come.

This year’s theme for the 2009 NPSF Patient Safety Congress, which will be held May 20–22 at the Gaylord National Resort & Convention Center outside of Washington, DC, will focus on patient safety programs in these challenging economic times.

“The whole reason the theme is what it is is because we are being responsive to the economic crisis,” says Pinakiewicz. “We have concern that the work everyone has been doing in patient safety is at stake. We don’t want it to suffer or stop.”

Although many facilities have cut budgets and are freezing travel expenses, Pinakiewicz says that the expected attendance for the Congress is right on target with last year’s numbers.

Central Vermont Medical Center (CVMC) in Barre has not been directly affected by the poor economy, says Barbara Sharp, RN, MS, CPHQ, CPHRM, director of quality management. However, due to a couple of bad financial years, CVMC had to cut some expenses in 2008.

“In today’s economy, we are seeing more uninsured patients, and you can’t let your guard down on your patients,” says Sharp. “Patient safety errors lead to legal suits, and in the long run, it is not feasible for the hospital in the kind of atmosphere we are in now.”

With the cut in spending at CVMC, Sharp had to come up with creative ways to get her message across while also finding a way to utilize the resources the facility already had available.

“At the end of last year we had to think, ‘How can we cut our expenses so we can recoup?’ ” says Sharp. “We were constantly looking at our materials, and looking at equipment that met the needs of everyone.”

CVMC targeted the purchasing of educational resources, such as the Speak Up campaign run by The Joint Commission (formerly JCAHO). Before the budget cuts, Sharp used to order the handouts and have them delivered to the facility. Now, the facility develops its own patient safety posters to educate patients and staff members about the importance of asking questions, giving background information, and ensuring that there is a level of understanding between all parties involved.

CVMC also made an effort to order the most cost-effective equipment. “We wanted to make sure that we were not ordering something just because a staff member wanted it without justification,” says Sharp.

The AHA survey also found that 68% of hospitals have put a hold on improving their quality and patient safety programs and projects.

However, although many hospitals’ overall budgets have been cut, patient safety programs have remained intact for the most part.

Cynthia Barnard, MBA, MSJS, CPHQ, director of quality strategies at Northwestern Memorial Hospital (NMH) in Chicago, says her facility has not felt as much of a strain from the economy.

NMH has seen some budget cuts, but the hospital’s patient safety programs have not been affected by them, says Barnard.

“There is no inkling that we will suffer [cuts to the programs] in the future,” says Barnard. “Aside from instilling a normal discipline of where we put our resources, we will do everything we can to avoid cutbacks in the programs.”

To offer more guidance for patient safety programs in this economic crisis, the NPSF released a Universal Patient Compact during National Patient Safety Awareness Week (March 8–14), a resource to better involve patients in their care by incorporating them into the safety team.

“The Universal Patient Compact is an evolution of the concept of the Patients’ Bill of Rights. It will focus on the patient and provider working together as a team,” says Pinakiewicz. “We want to get the patient’s voice inside the provider team and build a partnering between the parties.”

Sharp, Pinakiewicz, and Barnard agree that despite the current state of the economy, patient safety must remain a priority.

“You can’t afford to walk away from this work,” says Pinakiewicz. “This is a challenging time, and the last thing that should be happening are people putting patient safety work aside, saying they don’t have the time or resources for it.”

“It doesn’t make a difference on what the economic situation is; we always have to practice patient safety no matter where we are financially,” says Sharp.