The number of topics to cover when on-boarding new employees can be dizzying, but a changing healthcare environment makes it increasingly important to make sure that patient safety and quality expectations remain an important part of the on-boarding process.
HealthStream spoke with Joan Wynn, Ph.D. RN the Chief Quality Officer and President of Vidant Home Health and Hospice. Dr. Wynn is the Chief Quality Officer and President of Vidant Home Health and Hospice. She was recently named one of the top 50 experts in the country in the field of patient safety. Vidant has successfully implemented many strategies that address patient safety and quality.
Vidant is a large organization. Their flagship medical center in Greenville, North Carolina has just under 1,000 beds and the system includes 8 hospitals, 90 physician office practices, home health and hospice services and a wellness center. Vidant serv es 1.4 million people in 20 different counties in Eastern North Carolina. With nearly 12,000 employees, the challenges of creating a culture of transparency and accountability are significant, but Vidant recognizes the importance of starting at the beginning.
So…, with hospitals ranging in size from just 6 beds to just under 1,000, how do you create a consistent culture of patient safety, quality and accountability? Dr. Wynn agrees that there are challenges at both end of the spectrum. In the smaller hospitals, the resources are more finite; leaders frequently wear more than one hat and may be stretched a bit thinner than their colleagues in larger facilities. Conversely, in larger facilities, more people, processes and systems make management more complex. However, from the very beginning, Vidant senior leaders made it clear that there was no option for simply opting out of their emerging systems to improve patient safety and quality.
On-Boarding For Organization, Employees and Patient and Family Advisors
Of course, employees go through an ongoing process, but what happens when a system is growing largely through acquisition? How do you on-board an entire organization so that they too have the organizational will to make safety and quality as much of a priority as their new parent system?
When Vidant is on-boarding a new hospital, one of the very first orders of business is a patient safety assessment and training which includes regular and ongoing follow ups. When developing their culture of safety, transparency and accountability, Vidant developed an implementation timeline that included training and teach-back.
“We said from the beginning that this was going to be the way that we as a system approached safety and quality. It was going to be in lock-step and we were going to have a system-wide approach. I think that if leaders simply say that this is not something that is happening within a single department or facility, but we are going to have a system-wide approach and we are going to implement to a standard and we are going to consistently follow up on that standard, they can get further in this journey.”
And After On-Boarding Comes…
Project fatigue can often accompany even the best strategies and tactics, so how does Vidant maintain its’ focus across the entire system? At Vidant, the senior-most leaders in the organization participate in a monthly patient safety meeting. A video conferencing system allows for every entity, president, nurse executive, quality director and chief of staff to participate in a meeting that also includes the system CEO and CMO. “Leaders from across the breadth of the system are in the room continuing to learn and drive to the improvements that we want in safety and quality.”
Dr. Wynn shared that “Having our CEO visible in the room engaged in discussing events and preventative actions really demonstrates to the whole organization the importance of the work, and again when you talk about leadership it really is about what leaders put their time into and for our CEO to put his time into this monthly meeting really shows that it is important to him, and I think we all know the saying 'What's important to my boss is important to me.'”
The Proof Is In The Outcomes
Ultimately, the evidence will tell an organization whether or not they have successfully implemented the right strategies and tactics to make their organizations safer for patients. Vidant has achieved a 60% reduction in hospital acquired infections. Moreover, because patient stories are incorporated into virtually every meeting at Vidant, Dr. Wynn and her team regularly hear about safety catches and they passed their most recent Joint Commission survey with the lowest number of findings in the organization’s history.
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