Cleveland Clinic has embraced a high-reliability concept called “deference to expertise.” “We recognize caregivers and patients are the experts here,” says Anthony Warmuth, FACHE, executive director for clinical transformation.
The health system uses a variety of approaches to get input from patients and front-line staff, including pulse surveys and leadership rounding. The organization also has a tiered huddle process. Care teams meet every day to discuss what happened during the previous 24 hours, including any safety challenges. Key takeaways are then communicated up the chain of command, which proves helpful in identifying where to focus care redesign efforts.
Cleveland Clinic also has patient-family councils called Healthcare Partners. “We talk to them about what we could do better to meet patients’ needs and where our provision of care is working well and where it’s breaking down,” Warmuth says.
He points to three ways to ensure success when soliciting patient and staff feedback.
- Do something with the feedback. “You’ve got to be able to demonstrate that you’re actually doing something with the feedback, which may include proactively involving patients or staff in a care redesign effort,” Warmuth says.
- Seek patient or staff input prior to completing a care redesign plan. “You have to involve patients and caregivers early and often,” Warmuth says.
- Seek input from a diverse group of patients or staff members. In addition to considering race/ethnicity, gender, age and occupation, Cleveland Clinic includes people with various backgrounds and perspectives on patient-family councils, ranging from working mothers and shift workers to older adults. “You have to make it easy for people with diverse viewpoints to participate,” Warmuth says. “A lot of hospitals pull groups together, and then the only patients who have the time to participate are retired people.”
Maggie Van Dyke is a freelance writer and editor based in the Chicago area.
Necessary Change
Redesigning Care to Achieve Patient Safety
Care redesign efforts that are underway or being planned to improve patient safety and quality should continue, despite epidemic levels of staff burnout and turnover. These efforts may even help resolve persistent staffing challenges.