For healthcare leaders, ensuring the safety of the patients who place trust in their providers is the highest priority. Cultivating a culture of safety—one that is also backed by technology, connected data and shared resources—is critical. Following is a look at how Children’s Hospital of Orange County, Orange, Calif., and Nemours Children’s Health are building safety cultures and using tools and solutions that are scalable to hospitals of all types.
Point the Finger at Problems, Not People
Learning from mistakes and focusing on what the organization is doing well builds the trust, communication and transparency that are key to a robust safety culture.
“The atmosphere should be one of pointing fingers at problems, not people,” says Jared Capouya, MD, chief quality and patient safety officer, Nemours Children’s Health. To help create that kind of environment, the health system is implementing a just culture model, which emphasizes trust, accountability, transparency, and a belief that safety errors and incidents are learning opportunities.
“This will further our ability to foster an atmosphere where we’re really addressing the underlying systems and processes that lead to harm,” Capouya says.
CHOC is cultivating a just culture that strikes a balanced approach in which staff are made to feel comfortable about reporting errors, speaking up about safety concerns and celebrating the good work being done to keep patients safe.
“We want to focus on learning from our mistakes but also learning from what goes well, because 99.9% of the time things go really well,” says Sandip Godambe, MD, CMO.
Hosting town hall-style meetings for staff to talk openly about safety and share ideas is one way leaders can encourage transparency and communication, as well as break down geographic and metaphorical siloes. CHOC leadership encourages sharing positive stories at frequent enterprisewide meetings across the health system, which includes two hospitals and multiple primary care practices.
Embrace Connected—and Connecting—Technologies
Safety cultures today are about being proactive. Nemours Children’s Health and CHOC are embracing technological tools and solutions that help staff anticipate and prevent harm.
“Children’s Hospital of Orange County partners with RLDatix on our safety reporting, such as incident reports, which give us visibility across the enterprise, not only in the inpatient realm but in the ambulatory setting as well,” Godambe says. Sharing data about patient safety issues or incidents across the organization helps staff identify potential risk factors and reinforces the idea that safety is everyone’s responsibility.
As a geographically broad, multistate health system, with hospitals in Delaware and Florida, Nemours Children’s Health relies on a centralized logistics center that allows staff to monitor patients’ vital signs from anywhere in its system.
“We’ve already seen a great impact from an increase in reporting,” Capouya says.
Predictive tools that can be embedded in or layered on to the EHR also play an important role in safety efforts. CHOC’s staff use such tools for early event recognition to diagnose sepsis and assist with predicting which children have a high likelihood of being readmitted.
“When we can predict that, we can focus on making sure that before the patient is discharged, they have the right access to care and supplies where they live,” Godambe says.
Both health systems see technology’s role growing as their safety journeys evolve. The potential for artificial intelligence to bolster safety efforts is of particular interest. Capouya envisions AI pulling together data from disparate sources—faster—to help proactively identify and communicate risks.
“Our teams process an amazing amount of information daily,” he says. “They manage event reporting, safety indicators, surveillance data and triggers. If we could pull all those inputs together, synthesize and learn from it faster, that would be an awesome benefit.”
CHOC is working on better understanding how AI tools that track care movements, such as the processes involved with inserting central lines, could prompt clinical staff to make sure they are following safety procedures. Godambe envisions a similar technology being implemented into its hand hygiene systems to make sure families are washing their hands properly before visiting vulnerable patients.
Share and Share Some More
One of the biggest success factors throughout both organizations’ patient safety journeys is the shared learnings that drive safer care for all patients across the healthcare continuum. In addition to citing the benefits of sharing information about safety challenges and successes organizationwide, Capouya and Godambe underscore the value of collaborating with partners, such as patient safety organizations and healthcare associations, to share learnings and resources more widely.
Solutions for Patient Safety, The Children’s Hospital Association and Patient Safety Organizations, including the RLDatix Safety Institute, serve as “connectors,” Capouya says, to facilitate information sharing.
“I can reach out to any number of children’s hospitals today, and they would gladly share with me their strategies and tactics around what they’re doing to prevent harm, and we would as well,” he says. “That atmosphere has accelerated our journey.”
CHOC considers Solutions for Patient Safety, RLDatix and BETA Healthcare Group, the host organization of the BETA HEART program, among its collaborative partners in creating sustainable patient safety cultures. The hospital is also part of a patient safety organization of around 60 children’s hospitals that meets every Wednesday.
“In real time you get to hear, ‘Hey, we have this issue, does anyone else have this problem?’ It’s a phenomenal amount of learning that goes on,” Godambe says.
There are no quick fixes in patient safety—it is an ongoing journey. That’s why organizations like Nemours Children’s Health and CHOC make continuous learning a core pillar of their safety initiatives.
“Sustaining improvement is not a one and done,” Godambe says. “It takes persistence. We have to focus on what every health system has learned and collaborate. At its most basic, it is about what did you learn today, and how can you share it?”
For more information, please contact Fathma Rahman, global brand and marketing communications manager, Marketing, RLDatix, at fathma.rahman@rldatix.com.