Effectively managing a healthcare entity's financial and quality outcomes is beneficial for the sustainability of the organization. Evidence supports the concept that fiscally well-managed healthcare organizations deliver better healthcare to patients then organizations that do not (Dong, G.N., 2015). Conversely, others suggest improved patient safety performance is associated with improved financial performance at the hospital level (Beauvais, Richter, & Kim, 2019). Can both be true? In a few paragraphs, discuss whether financial management or quality management is the primary driver of long-term economic development and growth.

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2 January-March 2019 Doing well by doing good: Evaluating the influence of patient safety performance on hospital financial outcomes Brad Beauvais Jason P. Richter Forest S. Kim Background: As financial pressures on hospitals increase because of changing reimbursement structures and heightened focus on quality and value, the association between patient safety performance and financial outcomes remains unclear. Purpose: The purpose of this study is to investigate if hospitals with higher patient safety performance are associated with higher levels of profitability than those with lower safety performance. Methodology/Approach: Using multinomial logistic regression, we analyzed data from the spring 2014 Leapfrog Hospital Safety Score and the 2014 American Hospital Association to determine the association between Leapfrog Hospital Safety Score performance and three dimensions of organizational profitability: operating margin, net patient revenue, and operating income. Results: Our findings suggest that improved hospital safety scores are associated with a relative risk of being in the top versus bottom quartile of financial performance: 5.41 times greater (p < .001) for operating margin, 10.98 times greater (p < .001) for net patient revenue, and 4.03 times greater (p < .001) for operating income. Practice Implications: Our findings suggest that improved patient safety performance, as evaluated within the Leapfrog Hospital Safety Score, is associated with improved financial performance at the hospital level. Targeted focus on patient safety may allow hospitals to improve financial performance, maximize scarce resources, and generate additional capital to continue to positively evolve care. In early 2016, researchers at Johns Hopkins identified lapses in patient safety as the third leading cause of death in the United States, indicating that over 250,000 deaths a year could be attributed to medical errors among admitted hospital patients (Makary & Key words: financial performance, hospitals, patient safety Daniel, 2016). Berwick and Hackbarth (2012) indicate that patient safety failures within the U.S. health care system cost the nation up to $154 billion annually. Beyond the obvious impact on human life, what is less clear is the extent to which patient safety performance impacts Brad Beauvais, PhD, MBA, FACHE, is Assistant Professor, Department of Health Care Administration, Trinity University, San Antonio, Texas. E-mail: bbeauvai@trinity.edu. Jason P. Richter, PhD, MBA, MHA, FACHE, is 4th Medical Support Squadron Commander, Seymour Johnson Air Force Base, Goldsboro, North Carolina. Forest S. Kim, PhD, MHA, MBA, FACHE, is Program Director and Assistant Professor, Army Baylor Program in Health and Business Administration, Fort Sam Houston, Texas. The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article. DOI: 10.1097/HMR.0000000000000163 Health Care Manage Rev, 2019, 44(1), 29 Copyright 2019 Wolters Kluwer Health, Inc. All rights reserved. 2 January-March 2019 Doing well by doing good: Evaluating the influence of patient safety performance on hospital financial outcomes Brad Beauvais Jason P. Richter Forest S. Kim Background: As financial pressures on hospitals increase because of changing reimbursement structures and heightened focus on quality and value, the association between patient safety performance and financial outcomes remains unclear. Purpose: The purpose of this study is to investigate if hospitals with higher patient safety performance are associated with higher levels of profitability than those with lower safety performance. Methodology/Approach: Using multinomial logistic regression, we analyzed data from the spring 2014 Leapfrog Hospital Safety Score and the 2014 American Hospital Association to determine the association between Leapfrog Hospital Safety Score performance and three dimensions of organizational profitability: operating margin, net patient revenue, and operating income. Results: Our findings suggest that improved hospital safety scores are associated with a relative risk of being in the top versus bottom quartile of financial performance: 5.41 times greater (p < .001) for operating margin, 10.98 times greater (p < .001) for net patient revenue, and 4.03 times greater (p < .001) for operating income. Practice Implications: Our findings suggest that improved patient safety performance, as evaluated within the Leapfrog Hospital Safety Score, is associated with improved financial performance at the hospital level. Targeted focus on patient safety may allow hospitals to improve financial performance, maximize scarce resources, and generate additional capital to continue to positively evolve care. In early 2016, researchers at Johns Hopkins identified lapses in patient safety as the third leading cause of death in the United States, indicating that over 250,000 deaths a year could be attributed to medical errors among admitted hospital patients (Makary & Key words: financial performance, hospitals, patient safety Daniel, 2016). Berwick and Hackbarth (2012) indicate that patient safety failures within the U.S. health care system cost the nation up to $154 billion annually. Beyond the obvious impact on human life, what is less clear is the extent to which patient safety performance impacts Brad Beauvais, PhD, MBA, FACHE, is Assistant Professor, Department of Health Care Administration, Trinity University, San Antonio, Texas. E-mail: bbeauvai@trinity.edu. Jason P. Richter, PhD, MBA, MHA, FACHE, is 4th Medical Support Squadron Commander, Seymour Johnson Air Force Base, Goldsboro, North Carolina. Forest S. Kim, PhD, MHA, MBA, FACHE, is Program Director and Assistant Professor, Army Baylor Program in Health and Business Administration, Fort Sam Houston, Texas. The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article. DOI: 10.1097/HMR.0000000000000163 Health Care Manage Rev, 2019, 44(1), 29 Copyright 2019 Wolters Kluwer Health, Inc. All rights reserved.