What Are the Main Patient Safety Risks Related to Health System Expansion?

April 11, 2018 | Strategic Insights for Health System


Health system expansion can have substantial effects on both clinical care and patient safety, according to an April 6, 2018, viewpoint in JAMA. These risks particularly occur when clinicians encounter changes in practice setting, patient population, and infrastruct­­­ure. According to the article, 87% of physicians must travel to new practice sites after expansion of their networks. This creates risk because these clinicians often receive little orientation at their new settings. This could lead to doctors adapting to their new situation through trial and error, which creates a particular risk during emergency situations when, as the authors say, "clinicians can ill-afford to spend time trying to understand and manage the idiosyncrasies of an unfamiliar facility's crash cart, electronic health record, or phone-number list." After a health system expansion, physicians may also face significant changes in patient population, including increases in case volume and the need to treat patients who have demographic characteristics or medical conditions that they had not faced before.

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