The Risks to Patient Safety From Health System Expansions.

TLDR: Analysis of patient safety risks for Harvard-affiliated institutions by interviewing clinicians and convening system leaders both locally and nationally found 3 types of significant safety risks that are related to changes inpatient populations, infrastructure, or clinician practice settings.

Abstract: The health care system in the United States is undergoing substantial consolidation through mechanisms ranging from mergers and acquisitions to institutional affiliations tosingleserviceagreements,oftenwithexpectationsofimproving the safety and quality of care. However, there has beenlittleevaluationoftherisksthatsystemexpansionhas on patients.1,2 In a partnership between a medical liability insurer(CRICO/RiskManagementFoundation)andahealth systems research center (Ariadne Labs), we analyzed the patient safety risks for Harvard-affiliated institutions by interviewing clinicians and convening system leaders both locally and nationally. System expansions create 3 types of significant safety risks, often unrecognized and unaddressed,thatarerelatedtochangesinpatientpopulations, infrastructure, or clinician practice settings (Table).