Jointly sponsored by TDI. By invitation only. Title of presentation: Why is improving quality and safety in healthcare so hard?

Abstract

Progress in improving the safety and quality of patient care has remained disappointingly patchy and slow. This talk seeks to explain why. It shows that our underlying models of safety have remained under-developed and poorly conceptualized, often misappropriating ideas from other industries. The result is incoherence of goals and approaches. Important targets for improvement – such as systems defects – are rarely resolved at industry level, and methods for quality improvement applied locally may have the ironic effect of decreasing safety by eroding standardization. Important challenges remain in generating and acting on intelligence about patient safety; we are measuring both too much and too little, and failing to recognize and account for the effects of measurement that go beyond measuring. Debates about the role of cultural and behavioral issues in contributing to safety have suffered from polarized and often simplistic renderings of the role of personal responsibility. The talk concludes by identifying what needs to happen next.

Biography

Mary Dixon-Woods is Professor of Medical Sociology and director of the SAPPHIRE group, Department of Health Sciences, University of Leicester, UK, and Deputy Editor-in-Chief of BMJ Quality and Safety.  She leads a programme of research focused on patient safety and healthcare improvement, healthcare ethics, and methodological innovation in studying healthcare. She is an Adjunct Professor in the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins University, a visiting professor at Imperial College’s Centre for Infection Prevention and Management, and a visiting associate professor at Dartmouth College. She was, in 2012, one of the first recipients of a Welcome Trust Senior Investigator Award, given “world-class scholars asking the most important questions at the interface of science, medicine and the humanities”. She is a fellow of the Academy of Social Science.