A Culture of Safety in the COVID-19 Pandemic

Letter from the Chairman, April 2020

Dear Readers,

Currently, all healthcare workers are focused on the COVID-19 pandemic.  Both they and their patients are at risk. That’s because the virus is so infectious that any mistake by a health provider — for example, a failure to wear adequate personal protective equipment, or an oversight in basic hand washing — may result in transmission to another patient or to themselves.

Now is a time when a culture of safety must be paramount.  The smallest error could result in loss of life of either patients, caregivers, or both.  In a recent article in The New Yorker, Atul Gawande observed that both Hong Kong and Singapore, both very similarly small and very crowded countries, put the brakes on the spread of the COVID-19 virus.  

How did they do it?  By not only putting in place the social distancing measures that many countries have instituted but also enforcing measures on healthcare workers.  For example, when seeing patients, healthcare providers practiced thorough hand hygiene and wore disposable surgical masks and gloves, which were discarded after the visit. Surrounding surfaces were thoroughly wiped clean.

Not only did these measures flatten the COVID-19 curve in both countries, but they did so with zero health care worker infections and zero deaths.  

We must learn from the experiences of others in the fight against COVID-19.  Unpublished clinical data from Wuhan, China reveals that the simple measure of continuous non-invasive wireless monitoring positively impacted survival.  Patients sent home with mild COVID-19 were monitored, and when their fever reached 37.3 C and oxygen saturation fell below 93%, the patient needed to come back quickly into the hospital, as these are signs of a potentially life-threatening condition.  Continuous non-invasive monitoring is already widely used for heart monitoring, fever measurement, and in fitness devices. Applying this type of monitoring in a more widespread manner could prevent failure to rescue events, and allow early intervention so that no patient is found dead in bed from a preventable cause.

With all that is happening, hospitals have become very different places.  Elective procedures have been postponed, and patient and personal protection and cleanliness have remained of utmost priority.  Hopefully, we will learn much from this incident, so that next time, we will be well-prepared.

As we work through this episode, we at PSMF are in the initial stages of planning a March for Patient Safety on September 17th in Washington DC. We would love to get a million people to join us and bring safety in our hospitals to the attention of the politicians and the rest of the world. More importantly, we would like our survivors from this pandemic — patients,  doctors, nurses, and all health care workers and first responders — to march together and show the patient safety team that this has generated.

May your God bless you and keep you safe.  We will win the battle against COVID-19 if we take the appropriate precautions — and we will emerge more resilient, having learned many lessons in patient and healthcare worker safety.


Mike Ramsay, M.D.
Chairman, Patient Safety Movement Foundation
President, Baylor Scott & White Research Institute, Dallas, TX