Patient Safety: A Q&A with New Patient Safety Officer Mitesh Rao, MD

How did you come to specialize in patient safety?

I originally became interested in patient safety during my residency. Events I witnessed during my training drove me to delve further into the science of patient safety. When I realized that my residency would not be able to equip me with the skills to tackle the problems that health systems face, I applied to the Robert Wood Johnson Clinical Scholars Program. I completed a two-year fellowship at Yale, where I focused on quality, safety, innovation and provider engagement. Since then, I have been actively engaged in driving not only system-level change but policy on the national level.

Most recently, I served as Director of the Patient Safety Education Program at Northwestern, where I focused on improving safety and quality in health systems both domestically and internationally. In this role, I also led the teams serving both the overall Centers for Medicare & Medicaid Services (CMS) Partnership for Patients campaign leadership and the Hospital Engagement Network for the Joint Commission Resources. Also as Head of Research and Integration for the Innovation Program at Northwestern, I helped leverage human factors, design methodology and innovation thinking to advance patient care and incorporate promising mHealth technologies.

What prompted you to come to Stanford Health Care?

Making the transition to this new role at Stanford comes from my appreciation of the incredible talent and resources that the health system has dedicated to improving safety and quality. From my first visit to SHC, I have been continually impressed at the dedication of every individual I've had the pleasure of meeting with, and I quickly realized that this organization is poised to achieve incredible gains in improving the way academic medical centers deliver health care. To be a part of that is an opportunity I couldn't pass up.

Please describe your vision in further developing the Patient Safety Program at SHC.

Patient safety as a science has a core knowledge base and methodology that has been well adapted to numerous aspects of health care. However, in order to move beyond average, I believe that health systems need to leverage innovative approaches to address care provision. Patient safety and quality remain two sides of the same coin, and working together to leverage resources across the numerous parts of SHC will allow us to achieve greater gains as a whole. Expanding our engagement in the sciences of human factors, design thinking and innovation sciences will further allow SHC to be a leader in the field, and help ensure our continuing relevance in an ever-changing field.

Patient Safety is working to develop a proactive "culture of safety" at Stanford. Please describe what that means.

Historically, health systems have leveraged patient safety teams as reactive elements; after an event, they analyze and effect change. However, this dated style of engagement results in a system that is more focused on putting out proverbial "fires" rather than preventing them from occurring in the first place. Therein lies the true value that a robust Patient Safety Department can bring—creating a culture of safety that helps adverse prevent events from occurring in the first place. In an ideal world, systems would achieve zero harm rates and my colleagues and I would be unnecessary. We are one of the few areas of health care whose goal is to make itself obsolete.

What do you see as the strengths of Stanford's current patient safety efforts?

The infrastructure and organization that is being developed within the Department of Quality, Patient Safety and Effectiveness is visionary. True change in patient safety is reliant on evolving the culture of an organization, and the team that has been brought together at SHC has not only the skills but the resources to effect culture change on multiple levels.

That being said, no change is truly sustainable without the buy-in of the people at the front line. In the short time I have been here, I have been continually impressed by dedication of the physicians, nurses and staff at SHC. Everyone I meet wants our system to continue to be better for the right reason, our patients.

Where is there room for improvement?

As we increase our engagement in patient safety, there is an incredible opportunity to advance research and scholarship. Publishing our accomplishments will further the science, and allow us to disseminate the advancements we achieve. Incorporating new and innovative directions in how we ensure the safety of our patients will afford SHC the ability to not only take a leadership position in the field, but serve as a role model for other health systems.

What are the most important things physicians can do to promote a culture of patient safety? 

Be an active participant in improving safety culture, and engage with your colleagues and patients. Physicians have the ability to dramatically shape the culture of any organization they are a part of; they're natural leaders in many aspects of clinical care. When physicians choose to engage in improving patient care, the changes can be not only incredibly effective but lasting as well. Further, when physicians actively partner with nurses and patients on joint efforts to improve quality and safety, the potential for truly transformative change is limitless. I look forward to working with representatives from all parts of our organization to help advance SHC into the future.