Looking at the past, present and future of patient safety in healthcare leadership, the 19th annual National Patient Safety Foundation’s Patient Safety Congress, held recently in Orlando, Fla., highlighted both the remarkable achievements of the past two decades and the work that must continue.
Keynote speaker Donald M. Berwick, MD, former administrator of the Centers for Medicare and Medicaid Services and president emeritus and senior fellow of the Institute for Healthcare Improvement, warned about getting too complacent given the change that can be celebrated. As reported in the Hospitals & Health Networks publication of the American Hospital Association, Berwick said, “The concept of safety as a box-checking enterprise, where we start and finish, is lethal to patients of the future.”
Although “we’ve made progress” improving patient safety; it doesn’t end here, Berwick adds, “In the next 20 years, I don’t think we should be able to say we’ve learned what we need to know – I think we need to say, ‘Now what do we do?’”
Safety, Berwick noted, is an important piece of the bigger pie: quality. “Quality improvement is the big tent,” he said. “It’s the enterprise of constant improvement to everything we care about.”
In a shared session also held at the Patient Safety Congress, Executive VP and COO Charles Stokes of Houston’s Memorial Hermann Health System and Gary Kaplan, MD, chief executive of Virginia Mason Health System in Seattle, discussed how leaders at their respective systems are working to achieve higher quality and improved safety.
According to an HHN magazine report, Stokes said, progress is reflected in multiple areas:
Quality and safety have become part of the organization’s core values
Kaplan talked of how Virginia Mason executives toured a Toyota manufacturing plant in Japan in their search for an effective management model worth aspiring to, according to the HHN report. Observations there inspired implementation of safety measures into their own culture.
Once rushed through in favor of other topics, quality and safety can now be the focus for half of the length of a board meeting
At every board meeting now, Kaplan said, a patient’s story kicks off the agenda – with the patient in attendance. Moreover, half of the stories are negative, emphasizing the need to continue improving the quality of care. “It’s helped to evolve and change our culture,” Kaplan is quoted as saying. “It’s not about figuring things out, it’s about creating an environment and culture that will allow us to continue to survive into the future.”
Furthermore, a physician council meets quarterly with one of the physicians on the Memorial Hermann board to review safety concerns and then report back to the full board
About 4,000 physicians and 27,000 employees among their 17-hospital system have engaged in quality and safety training as part of a Breakthroughs in Patient Safety initiative
Memorial Hermann has created an awards program to recognize facilities in their system that go a year or more with exemplary performance in various federally defined areas.
Nursing executives and educators AnnMarie Papa and Victoria Rich, in a 2013 article for the Patient Safety & Quality Healthcare website, noted that nurse leaders of the future will need “clinical acumen and organizational awareness” to succeed in promoting quality and patient safety, and that it can’t just come from the top. “It is an overarching culture that needs to be cultivated and nurtured,” they wrote. While not specifically mentioning emotional intelligence, Papa and Rich stressed that three C’s— communication, collaboration and courage — are needed to realize the best patient outcomes and success for an organization (Focusing on patient outcomes rather than procedures is a key component of the evolving value-based healthcare model.).
3 Techniques for Improving Patient Outcomes
A report from that same year in the American Nurses Association Online Journal of Issues in Nursing pointed to more specific, concrete techniques being employed to improve patient outcomes within three of the largest healthcare systems in the nation: the Department of Veterans Affairs, Kaiser Permanente and Ascension Health:
- The Veterans Affairs system’s use of bar code medication administration, integrated with electronic health records technology, saw medication error rates fall by as much as 93 percent
- Kaiser credited nurses’ access to clinical decision support tools, real-time dashboards across multiple levels of care and administration, and data mining technology to analyze nursing effectiveness for their ability to achieve dramatic improvements in problem areas such as patient pressure ulcers, falls and other hospital-acquired conditions
- Ascension Health utilized smartphones and mobile workstations to enable not only swifter, more efficient care from their nurses but also to analyze information and report back to them on the effectiveness of their care.
Leadership skills to help working professionals in their quest to develop themselves for the future are available through the wide-ranging curriculum of the Executive Master of Health Administration program at USC’s Sol Price School of Public Policy.