Hospital Quality Improvement (HQI): Empowering Our Culture of Safety

Loma Linda University Health has been given the opportunity to participate in a collaborative focused on our Culture of Safety. Beginning in 2022, we joined forces with other hospitals across the country, and are participating in the Hospital Quality Improvement (HQI) Cares collaborative, which is a program that supports our efforts in our culture of safety journey. Loma Linda University Health has a long history of engaging in activities to advance our culture of safety, and this is another opportunity to implement specific, evidence-based activities to continue to advance the safety of our organization and support our teams in providing care. Our engagement with HQI Cares will be ongoing over the next five years.

The collaborative focuses on five domains, including Culture Measurement and Just Culture implementation, Rapid Event Response processes, Transparency in Communication, Care for the Caregiver, and Early Resolution for patients and families after harm events. We began our activities in early 2022 with an assessment and gap analysis conducted by HQI of our site-specific organizational strengths and opportunities in the five domains. The HQI team evaluated established processes, available data surrounding our safety culture, and conducted in person focus groups. The gap analysis provided us with insight into our areas of opportunity to guide our prioritization of our efforts. Our initial domain focuses are Culture Measurement and Just Culture implementation, as well as Care for the Caregiver. We completed our Culture of Safety survey in March 2022, inviting our patient facing team members to provide feedback related to perceptions of safety in several domains. We will be engaging with our teams whose feedback represented greatest opportunity for improvement, and we will conduct briefings surrounding the feedback and leadership/team coaching for advancing Just Culture.

We additionally have begun work in the Care for the Caregiver domain. The Service Best Practice meeting focus for July 2022 was on the Care for the Caregiver domain and establishing mechanisms for peer support. Healthcare is a challenging field to work in and the past two-and-a-half years have added significant and different stressors, leading to burnout and turnover in healthcare teams across the country, including our Loma Linda University Health teams. We also know from the literature that significant harm events have a tremendous impact on our team members, leaving affected individuals feeling frustrated, embarrassed, isolated, incompetent, stressed, guilty, and more. One of our first commitments in the Care for the Caregiver domain is to establish a formalized peer support process to help support our team members during times of stress and after significant events. In 2022, we will be piloting the peer support process in three departments at LLU Medical Center, three departments at LLU Children’s Hospital, one department at LLU Medical Center – Murrieta, and one department at the Behavioral Medicine Center. In 2023 and beyond, we will continue the rollout of the peer support process throughout all departments. Efforts surrounding our culture of safety and support of our teams are critical to continuing to set Loma Linda University Health apart as an exceptional workplace and will result in continued advancement of excellence in patient outcomes.