That could mean providing care to the patient in the home, for example getting the patient a new chair that reduces risk of injury, rather than treating the consequences of injury.
"We need to flip from focusing on the medical condition to focusing on the patient," Bisognano says.
4. Financial Harm
Patient harm is usually considered a medical intervention that hurts the patient, such as administering a contraindicated medicine. But with medical debt now the biggest reason for bankruptcies, some doctors admonish their colleagues to look out for healthcare that may cause "financial harm" and stress to the patient.
Providers should appreciate financial harm as a real quality and safety issue, and screen for this with the same fervor with which they try to prevent central line infections, these physicians argue.
Writing in JAMA, hospitalists Christopher Moriates and Vineet Arora, and OB/GYN Neel Shah all involved with the Costs of Care project to reduce unnecessary healthcare spending, also say providers should take responsibility for knowing how much certain services actually cost.
"In my view, financial harm is a real form of harm," Shah says.