Increasing Awareness and Changing Attitudes Towards Patient Safety: Evaluation of an Employer Initiative

Presenter: Jon Christianson, University of Minnesota

Abstract

Rationale: Through the Leapfrog Group, large employers have pursued a multi-faceted agenda pertaining to patient safety and medical errors. Part of the agenda has included efforts on the part of some employers to educate employees about patient safety and variation across hospitals in medical errors. The hope is that these efforts will make employees better informed consumers in their selection of hospitals. The success of these efforts is unknown.

Objectives: The objective of the paper is to examine the impact of a comprehensive initiative undertaken by a single large employer that combined education on patient safety and medical errors with financial incentives in a benefit program redesign.

Methodology: The analysis utilizes survey data collected from a sample of the employer's workforce before and after the initiative was implemented. A portion of the workforce was exposed to the initiative, while a portion was not, permitting the use of a quasi-experimental design and a difference in difference methodology. The dependent variables in the analysis included the likelihood that employees sought out information on health benefits and quality of care; acknowledged variation in hospitals with respect to medical errors; expressed willingness to go to a different hospital with a better safety record; and chnaged the value placed on traditional sources of information about hospitals. Employee characteristics were controlled in the analysis, and various statistical techniques were employed as appropriate for each dependent variable.

Results: The were no significant impacts of the initative on any of the dependent variables employed in the analysis.

Conclusions: The initiative's lack of impact could be the result of a variety of factors including: uncertainty about the financial incentive in the initiative; inadequate communication of information about patient safety; employee delegation of decisionmaking regarding choice of hospitals to physicians; the rarity of serious adverse events leading employees to perceive little value in searching for information; and employee uncertainty regarding the likelihood of hospitalization. The initiative's lack of impact underscores the difficulty that employers face in educating employees about patient safety and its potential importance as a hospital attribute using traditional communications channels.

Authors: Dennis Scanlon, Jon Christianson

Session: Hospital Productivity 2
Time: Mon 5:45 p.m.-6:45 p.m.
Room: 311A