Winning the battle to improve patient safety and health care quality, while always tough, may be getting harder instead of easier.

In talking to patient safety experts at the National Patient Safety Foundation's 15th Annual Patient Safety Congress, it came out that there are real concerns that the cost-saving pressure brought on by health care reform is diverting attention away from patient safety.

That's a somewhat distressing development to specialists in patient safety, including the newly named president of the NPSF, Tejal Gandhi, M.D.

Health care reform "clearly forced a lot of systems to focus on cost. Cost and efficiency," says Gandhi, who currently is chief quality and patient safety officer for Partners HealthCare in Boston. "And I don't necessarily think that needs to be at odds with patient safety," she says. "If you have fewer complication, fewer errors that actually helps reduce cost, but making that case is challenging."

Gandhi, who takes over as head of the NPSF July 1, talks some more about health care reform in the video below.

She sounded ready to take on a role as one of the country's leaders of the patient safety effort, and says she decided to seek out the position of president of the NPSF to build on her experience as a patient safety officer and researcher. As a clinician, she has worked in patient safety at multiple levels, in an outpatient setting, at a hospital and at a health system.

"Each part of my career … has been great, but I was certainly looking for the next level of influence that I could have, so having an opportunity to try to drive patient safety on a national level is really exciting," she says.

Gandhi says that health care has advanced far in some ways regarding patient safety. "I think there's been great strides in that 10-12 years ago (many) hospitals didn't even have patient safety programs. Now it would be shocking to hear that (a hospital) didn't have one."

Nevertheless, there are a number of issues that will keep her busy at the NPSF, in addition to the struggle of emphasizing patient safety amid the pressures of implementing health care reform

She couldn't pinpoint the exact action items that she will emphasize at the NPSF, saying that a strategic review at the foundation will take place in coming weeks that will provide more direction, but among the matters that might command some attention are the growing roles of ambulatory care and health information technology, as well as a need to continue to educate providers. Ambulatory care "is really important as more and more care is provided in that setting," she says. Health IT, in which she includes the use of medical devices, has great potential to help and to do harm from a patient safety perspective. She discusses these issues in more detail in the video as well.

More can also be done to adequately train providers, especially physicians on patient safety. "I don't think it's really a core competency yet in how we train physicians," Gandhi says.

"There's progress happening, but a lot more needs to be done there," she says.