Recently, HealthStream interviewed two leaders in patient safety to learn more about what top-performing organizations are doing to improve patient safety. Joan Wynn, PhD, RN is the Chief Quality Officer and President of Vidant Home Health and Hospice. Brenda Kuhn, RN, Ph.D, FACHE, CPHQ is the Network Chief Quality Officer at Kettering Health Network. Both shared their strategies as well as the challenges faced by senior healthcare leaders trying to address patient safety and quality issues.
Engaging Staff in Safety Initiatives
We asked both leaders about how they engaged staff in patient safety initiatives and they both agreed that employee engagement with these initiatives was a key to success. “You can have the best plans, but the real work happens at the bedside. Clinicians need to understand the ‘whys’. Engaged clinicians will own exceptional care. It is critical to have them involved in developing and monitoring processes that lead to the consistent delivery of quality care,” said Dr. Kuhn. Staff understand the workflow and can identify barriers to success that most likely are not obvious to leaders. Walk in my shoes initiatives are meaningful for leaders to gain a better understanding of the realities faced by clinicians as they balance multiple priorities in the care of patients.
Ideas from the Front Lines of Care
Dr. Wynn agreed, saying that “the front line really does have all of the ideas. Direct caregivers really have the best ideas about how to improve care and really understand where the gaps are. Recently we were working on a blood clot prevention program. We decided to use an e-Survey tool to quickly get a better understanding of nursing perceptions and practices regarding anticoagulant medications, particularly when a patient refuses that medication. We got much more feedback than we would have been able to get from other means and we got it much more quickly. Moreover, what we learned really helped to point us in the right direction moving forward with our blood clot prevention work, using data that we otherwise might not have gotten.
Reporting Progress Is Vital for Maintaining Staff Commitment
"In addition, Vidant uses an organization-wide format for reporting quality scores. The report is used from the boardroom to the bedside. This weekly and monthly focus on the areas for both celebration and improvement is a crucial way in which Vidant engages employees in key initiatives. This thorough and transparent reporting is shared widely and builds the will to improve.”
Daily Safety Huddles
Dr. Wynn also shared that every entity within Vidant participates in a daily safety huddle. The president of each entity runs the huddle which includes all disciplines and department managers. The stand-up meeting lasts approximately 30-minutes, and agenda items might include: anything that has happened within the last 24 hours, what is going on today, the numbers for admissions, discharges and transitions, anything unusual that may be happening and each department has a report from which they share that helps keep managers aware of key issues with staffing, equipment and any other safety or risk concerns. While these meetings happen primarily at their hospital entities, they are also being rolled out in ambulatory settings as well where Dr. Wynn believes that they are equally important.
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