CASH Initiative Builds the Business Case for Patient Safety Investments

The Coalition for Advancing Safer Healthcare (CASH) is underway to create a practical business case for investing in patient safety solutions, an approach organizers say is urgently needed to help health systems prioritize safety improvements alongside other competing investments.

During its January meeting, Michael McShea, MBA, MS, Group Chief Scientist of Health and Human Machine-Systems at Johns Hopkins University Applied Physics Laboratory, presented an update on an enterprise-focused working group designed to support a forthcoming CASH report.

Although the high costs of patient harm are widely recognized, health systems often lack robust financial models that show the financial return on investing in patient safety. To make the business case and develop financial ROI models, the working group is assembling patient safety experts, hospital administrators, policy and payment experts, payer and malpractice insurance advisors, and health system C-suite advisors early this year. The project’s central aim is to create an “enterprise-centric” framework that captures patient safety return on investment from multiple perspectives, including those of health system leadership, payers, and malpractice insurers.

McShea cited challenges in current research, including inconsistent scope, varying cost metrics, and limited integration of payment models. While some efforts, such as hospital safety grading systems and domain-specific work on hospital-acquired infections, have helped move the field forward, McShea said a comprehensive “total cost of harm” approach remains missing.

The team is putting together practical resources that health system leaders can use right away, including a peer-reviewed scoping review manuscript, real-world examples showing how the ROI model applies to recommended safety initiatives, and board-ready slide decks to support executive and board discussions.