5 minute read
CULTURE OF SAFETY
The Culture of Safety
By Denny Angelle
One morning this past April, the world came knocking at The Methodist Hospital’s front door for a bit of cultural exchange.
As the symposium opened early that morning, representatives from more than 100 hospitals and health care institutions from around the globe sipped coffee and hoped to get a taste of Methodist’s famed culture of quality patient care and safety.
Why Methodist? Perhaps because The Methodist Hospital received top rankings last year for quality and accountability from the University Health System Consortium, an organization of U.S. academic medical centers and hospitals. Methodist ranked No. 2 in patient satisfaction and No. 5 in mortality rates. And perhaps because Methodist has a reputation for not settling for even those kinds of numbers — the bar can always be raised a bit higher.
Mary Daffi n, a member of the board of directors and chair of the board’s Quality Committee, gave some insight on the reason for Methodist’s success on the quality front.
“Leadership at the highest level of this organization is committed to creating a culture of safety here at Methodist,” Daffi n told attendees. And she quoted board chairman, Judge Ewing Werlein Jr., who directed, “Make Methodist the safest hospital in the world.”
Quality is the most important word in hospital care today. It means keeping patients safe while they are in the hospital. It means living up to the most basic concept of medical care: First do no harm.
This is a 180-degree turn from the state of hospital safety from only 10 years ago. In 1999, an Institute of Medicine safety report assessed the quality of care hospital patients received around the country, and what they found wasn’t good.
Their research showed that as many as 100,000 deaths occurred annually due to medical errors. The report also uncovered 1.5 million people who were injured by medication errors. These shocking statistics served to erode the public trust, to be sure, but hospitals recommitted to make quality and safety an integral part of the their mission.
“Everyone working at a hosp and think about quality eve
The Methodist Hospital System, for its part, recruited Dr. Thomas Knight to be its chief quality offi cer. “You can’t manage quality and safety,” he says, “it must be inspired.”
The key, Knight says, is to make the quest for safe patient care a goal shared by everyone in the organization, from top to bottom. “It should be an emotional investment backed up by action and commitment,” he explains. “Everyone working at a hospital should live, breathe and think about quality every moment.”
Methodist has groups representing all phases of medical care — physicians and nurses with other disciplines including food service and patient transporters — examining all aspects of quality and safety at its hospitals. Groups examine statistics representing core measures like mortality, stroke and infection. Others focus on particular patient issues like pressure ulcers and falls.
Each group reports to administrators and offers suggestions for improvement initiatives. And it makes an impact — take, for example, simple hand hygiene among hospital staff. More than 2 million patients a year get hospital-based infections, and the Centers for Disease Control and Prevention lists these infections as the 10th leading cause of death in America. Hand hygiene among hospital workers is a proven way to prevent the spread of infection, so in 2005 Methodist launched a far-reaching program to promote hand hygiene.
The importance of hand hygiene was emphasized by everyone from the chief hospital administrator on down. A set of hand-washing “rules” was established, outlining all instances when staff should sanitize their hands.
More than 4,000 dispensers for alcohol-based hand sanitizer were installed, virtually in every nook and cranny of the hospital and even in offi ce buildings where behind-thescenes employees do not usually come in contact with patients. The hospital designated “secret observers” to watch and quantify handwashing activities among staff and physicians. And Methodist drove home the message that it was time to change its culture to make simple hand hygiene a priority.
As these efforts began to take seed, they were shown to make a big difference. Where the average for hand hygiene compliance is about 50 percent in the nation’s hospitals, Methodist’s compliance rates reached as high as 97 percent in 2006. Currently the compliance rates fl utter around the 90 percent mark at all of Methodist’s hospitals.
It took hours of conversation, education, training and reminding — and a bonus for all hospital employees when hand hygiene goals were reached — but hand hygiene is now an integral part of the culture.
Another group focused on preventing patient falls. They held monthly meetings with staff on units that most needed improvement, sharing best practices and sifting through different tools and strategies to help prevent patient falls. The group even helped to devise a way to identify patients who may be at high risk for falls.
pital should live, breathe ery moment.”
This effort led to a dramatic reduction in patient falls. And yet, good is not good enough: Each week, caregivers on a different unit are recognized, and their fall prevention tips and techniques are shared across the hospital.
No one believes in this effort more than Werlein, who was once chair of the Quality Committee. He can fl uently discuss quality measures with physicians or analyze the work fl ow in an operating room.
“There is a lot riding on our ability to improve the health of our patients, the health of our communities and the very nature of our health care system,” Daffi n says. “Every person, from the chairman of our board to the people who transport patients around the hospital, is integral to improving quality and safety.” !
You can take a detailed look at quality and safety efforts at all four of Methodist’s hospitals. Go to www.methodisthealth.com and enter “quality and safety” in the search box.
Dr. Thomas Knight
