The Joint Commission focuses on the ‘Quadruple Aim’ during Patient Safety Awareness Week

March 14, 2022

As reported in a Joint Commission news release, over the past 20 years, The Joint Commission has embraced Patient Safety Awareness Week as a period of inspiration for those committed to the mission of the safest and most reliable care. This year, however, they also are turning the lens from care to the caregivers at the very front lines.

The events of the past two years have brought sharp focus to the need to advance from the “Triple Aim” of healthcare (health, care, and cost) to the “Quadruple Aim,” which adds improving the “health and well-being of care providers.” 

The logic for caregiver well-being as critical to patient safety is incontrovertible: without our own health, we cannot bring the necessary focus to supporting the health of others. Some truths do not require a randomized, controlled trial. We need only ask ourselves, are our best decisions made under duress? Are we most compassionate when we are exhausted?

The Joint Commission wholly embraces well-being as a safety concept, but also as a component of a healthy work environment. We are not alone in that mindset. The National Academy of Medicine is leading an Action Collaborative on Clinician Well-Being and Resilience, and its work, convening the most renowned experts, has produced a compendium of resources that will inform our efforts over the next year. 

The Joint Commission (TJC) is planning some new resources for Patient Safety Awareness Week, that provide insights to some of the major challenges caregivers face, either personally or in the context of their daily work. So, here’s the agenda for the week:

  • Monday, March 14- The importance of the workforce’s well-being, specifically among nurses with a reprise of the Quick Safety bulletin on “Developing Resilience to Combat Nurse Burnout.”

COVID-19 exacted a toll on the healthcare workforce, and perhaps no members were more directly affected in the hospital setting than nurses and respiratory therapists. TJC estimates are that they witnessed mortality rates approximately six times higher than ever before in their career. And they experienced this in settings that were often over capacity and under-resourced, leading to burnout, workforce attrition, and even greater hardship. Two things need to occur to break this cycle: build greater reliability in our healthcare settings and greater resilience among our colleagues. 

  • Tuesday, March 15 - Healthcare equity. More than five decades ago, Dr. Martin Luther King, Jr. said, “Of all the forms of inequality, injustice in healthcare is the most shocking and the most inhuman.” Scholars have written that he said “inhuman” not “inhumane,” as this injustice was not just cruel, but beneath human dignity. Disparities exist in the communities we serve and, we must acknowledge, in our institutions. Tuesday’s resources will address initiatives to close gaps, promote inclusion, and build equity. Making a difference, especially for those facing disproportionate challenges, is one of the best ways to find greater joy and meaning in our work.
  • Wednesday, March 16 - Workplace violence awareness. Personal safety is important in any role or job, but it is even more important in healthcare settings, because if healthcare staff do not feel safe, they cannot appropriately care for patients. The Joint Commission has made workplace violence prevention a cornerstone of its quality and safety efforts, creating an online repository of information, strategies, and resources.
  • Thursday, March 17 - Maternal health. Out of every 100,000 pregnancies, nearly 18 women die each year in the U.S., and poor maternal and infant outcomes, including death, are far higher for people of color. In 2021, women constituted about 88% of the nursing workforce, so this issue is not just a societal issue, but one that hits close to home for our colleagues.

The Joint Commission has developed hospital standards to improve the quality and safety of care provided to women during pregnancy, at delivery, and in the postpartum period. We’ll be sharing our maternal safety requirements and our patient-focused “Speak Up” campaign materials for new or expecting parents that provides information on how to spot signs of preeclampsia (a toxic form of pregnancy-related hypertension), infection, and hemorrhage.  

Friday, March 18 - Relationship between mental health and quality healthcare. Too often, when we think of mental health, we only consider the patient. Healthcare workers have been tasked with unimaginable hardships during the COVID-19 pandemic. Beyond managing their own personal and family challenges and meeting the clinical needs of their patients, they’ve also been proxies for those patients’ families, and often, theirs has been the last hands held by a dying patient. 

Caregivers are not immune to the stresses, physical exhaustion, and moral injury that have been amplified in the cruel wake of COVID. We know that without a mentally healthy workforce, we cannot have safe care.

To address this, The Joint Commission has put together several resources — such as the statement commending Congress for passing the Dr. Lorna Breen Healthcare Provider Protection Act and newsletters providing insights for supporting the psychosocial well-being of healthcare staff.

Joint Commission release