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The zero harm journey in 2023: What’s new, what’s next?

Inequities contribute to many harms experienced by patients and employees across the healthcare continuum. And in order to achieve our goal of zero harm, inequities must be addressed in every aspect of the work we do. 

Various healthcare organizations are making progress to advance equity by putting forth new standards and frameworks. For example, healthcare regulators, including The Joint Commission, have put into place new standards that prioritize reducing healthcare disparities among patients, and the Centers for Medicaid and Medicare has also developed a framework for addressing inequities and will finalize requirements in early 2023. 

Equity and safety are inextricably linked. At Press Ganey, we take a broad, multidimensional approach to understanding harm in order to assess safety within health systems. We gather insights on the physical and emotional harm experienced by both patients and the workforce across the continuum. To understand what a healthcare partner needs to reduce harm, it’s imperative that we understand that inequities are one of the contributors. Many inequities exist in healthcare, based on factors like gender, race, ethnicity, socioeconomic status, sexual orientation, gender identity, language, and weight. Clinical conditions, such as behavioral health or addiction, can also be drivers. It’s essential that we segment data by these characteristics to identify disparities.  

This holds true for all Human Experience metrics—like quality, safety, workforce engagement, and patient experience—that healthcare organizations measure and analyze regularly. Efforts to advance safety; engagement; and diversity, equity, and inclusion (DEI) are all too often siloed. We need to recognize their interconnectedness and identify strategies to seek organization-wide improvement. 

Utilizing high reliability principles, Press Ganey takes a value-aligned approach to improving equity and safety issues within a healthcare organization:  

1. Consulting: A Press Ganey expert-led, data-driven assessment of patient and workforce safety utilizing DEI drivers allows healthcare organizations to learn the current state of workforce engagement and perceptions of safety for various demographic groups. Segmenting workforce and patient harm data by age, race, sexual orientation, gender identity, and social risk factors helps organizations strengthen their learning systems by identifying multiple causes of harm, like bias and failures driven by system gaps.  

2. The Press Ganey High Reliability Platform empowers healthcare organizations to develop road maps driven by their current equity and safety data. The platform: 

  • Encourages submission of race, ethnicity, and other demographic data to allow segmentation of events. In addition, Press Ganey’s DEI standard methodology allows real-time classification and identification of equity factors in safety. 
  • Utilizes leading DEI methodology embedded within the learning system, enabling real-time linkage between safety and equity. 
  • Employs effective cause analysis programming with an intentional DEI component to support healthcare organizations in identifying their own high-risk populations and causes of harm. 
  • Leverages high reliability leadership skills to ensure the practice of DEI principles, enabling organizations to recognize system failures and implement effective improvements for harm based on specific population demographics, and empower executive leaders to effectively communicate the importance of safety and DEI for all, among numerous other capabilities. 

3. Safety culture measurement: Safety culture is closely correlated with employee perceptions of organizational diversity and equity, and Press Ganey has the largest national database of safety culture data. We help organizations segment safety culture data by demographic characteristics to help them develop the most impactful interventions to improve their safety culture. 

4. Industry-wide sharing and learning: Press Ganey Patient Safety Organization (PSO) members are encouraged to view safety events through a DEI lens. PSO members are asked to include DEI fields in safety event data submitted to the PSO, as well as to analyze segmented safety event data to identify gaps in care for specific patient populations. PSO learning forums highlight strategies for building diversity, equity, and inclusion into safety improvement programs.  

The Press Ganey Equity Partnership supports organizations as they build equity in healthcare, by providing feedback on the quality of race and ethnicity data, helping organizations segment their data, and through sharing of best practices through learning forums.  

There is no such thing as high-quality, safe care that is inequitable. To ultimately achieve zero harm, healthcare leaders need to focus on embedding equity into all aspects of their improvement efforts.   

Learn more about how your organization can apply high reliability organizing principles to improve equity. Or reach out to a member of our team directly to talk next steps.

About the author

As Chief Safety and Transformation Officer, Dr. Gandhi, MPH, CPPS is responsible for improving patient and workforce safety, and developing innovative healthcare transformation strategies. She leads the Zero Harm movement and helps healthcare organizations recognize inequity as a type of harm for both patients and the workforce. Dr. Gandhi also leads the Press Ganey Equity Partnership, a collaborative initiative dedicated to addressing healthcare disparities and the impact of racial inequities on patients and caregivers. Before joining Press Ganey, Dr. Gandhi served as Chief Clinical and Safety Officer at the Institute for Healthcare Improvement (IHI), where she led IHI programs focused on improving patient and workforce safety.

Profile Photo of Dr. Tejal Gandhi, MPH, CPPS