Are You Doing Enough to Promote Patient Safety?

Does your staff feel safe to report medical errors without fear of punishment? When you speak with senior leaders about patient safety, are they responding constructively or defensively? Do your frontline leaders feel that when they report a patient safety concern, their concerns are going to lead to action? Do care teams collaborate on patient safety, or are they working in siloes?

It is crucial for CMOs and other senior leaders to establish psychological safety as part of their workplace culture to boost reporting of patient safety concerns, which, according to Scharf, begins with the behavior of senior leadership.

“At AdventHealth, those behaviors include humility, curiosity, and a commitment to action,” Scharf says. “The actions senior leaders are engaged in include leadership rounding. We require our senior leaders to round on the frontlines, so they can understand patient safety concerns.”

When adverse events occur, the health system generally focuses on the role of systems or processes in the events rather than blaming individuals, Scharf explains.

“When a patient safety event occurs, we want to determine whether it was a system problem, an individual staff member problem, or something in between,” Scharf says. “In most cases, there are systemic causes of patient safety events, where systems or processes set up team members for failure.”

Promoting patient safety in the hospital setting

AdventHealth has several measures in place to boost patient safety in the hospital setting, according to Scharf. These measures include daily huddles that develop a sense of community among staff members and address the top safety issues facing hospital units.

Additionally, multidisciplinary rounding helps operationalize patient safety at the bedside. The health system requires doctors and nurses to round on patients together.

AdventHealth has invested heavily in technology to boost patient safety at the bedside, including tools in the electronic health record and barcode scanning for medications. The health system has set a target for 98% of medication barcodes to be scanned at the bedside, which is higher than national benchmarks.

“The Leapfrog Group has set a medication barcode scanning target of 95%,” Scharf says. “At AdventHealth, we believe we can do better than that target. At about a third of our hospitals, the medication barcode scanning rate is 99% and above.”

The health system has aggressive practices in place to promote infection prevention, including hand hygiene measures, reducing the unnecessary use of central lines and catheters, and care bundles for the use of catheters.

AdventHealth has several measures for preventing falls in the hospital setting.

“We have hourly rounding on our hospitalized patients,” Scharf says. “We help patients get to the bathroom—we don’t want unstable patients getting up by themselves. For patients who are at high risk of a fall, we have sitters who monitor them. At some of our hospitals, we have electronic monitoring to avoid falls.”

Patient safety training for leaders

AdventHealth’s Patient Safety Academy trains CMOs, CNOs, chief operating officers, human resources leaders, risk managers, quality leaders, and other leaders about patient safety science. The academy features an intensive three-day session held at the corporate campus’ Leadership Institute.

The curriculum of the Patient Safety Academy focuses on four areas: culture, knowledge, learning, and leadership. In each of those areas, there are sub-topics.

The culture curriculum includes promoting a healthy work environment and making sure there is alignment around safety culture at the health system’s more than 50 hospitals. The knowledge curriculum includes having discussions about data and transparency. The learning curriculum includes strategies for decreasing the time from when a patient safety development is first reported in the literature to when it is utilized at the bedside. The leadership curriculum includes discussing the behaviors, activities, and skills that leaders can use to promote patient safety.