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The Intersection of Safety, Quality, and Operations

ACHEMT Starts its 2019 Educational Programming With “The Intersection of Safety, Quality, and Operations”

Prepared by Sharon Stewart, MSHCAD, FACHE, Sr. Director, Information Systems, Quorum Health Corporation

ACHE of Middle Tennessee held its first educational program of 2019 on March 19th at THA.  The keynote speaker was Dr. Kenneth Sands, Vice President, Chief Epidemiologist, and Chief Patient Safety Officer for HCA Healthcare who focused on the intersection of safety, quality, and operations in healthcare organizations.  His call to action referenced a recent Navy disaster corrective action plan that emphasized the danger to organizations that stop being a “questioning culture” and thus miss significant risk factors that lead to bad outcomes.

Dr. Sands drove home the need for healthcare organizations to build on the traditional approach to safety which emphasizes standardization by adding a systems approach to mitigate the impact of unanticipated events.  The expanded approach acknowledges that the entire environment cannot be controlled and accidents are prevented by people being able to adapt to changing conditions.  He recommended using the ACHE Blueprint for Safety to guide organizations through an assessment of their safety culture.  Additionally, he reiterated the need for senior leadership to establish and support a questioning culture.

Dawn Fitzgerald, CEO of QSource moderated a panel discussion that included  perspectives from Pam Womack, CEO of the Mental Health Cooperative; Rachael Kurzer Givens, Chief Quality and Compliance Officer with BrightSpring Health Services; Dr. Jim Geraughty, Chief Medical Officer for Unity Physician Partners; and Jenny Slayton, Vice President, Quality, Safety and Risk Prevention for Vanderbilt University Medical Center. 

Ms. Fitzgerald invited the panelists to discuss how their organizations give priority to quality and safety.  Ms. Givens reported that the first topic on the board meeting agenda for their newly-merged organization was quality and safety everywhere they deliver services.  Ms. Slayton noted that, “attention is the currency of leadership” and shared that her organization has leadership rounds on the clinical units that are intentional and focused on meaningful dialogue.

Ms. Womack works with an organization where she, staff, and clients with behavioral health and substance abuse issues are all working together in one large area. She noted that all their staff is trained in therapeutic options so they can comfortably respond to unexpected needs.  Dr. Geraughty presented the view of quality and safety from the perspective of population health based on his years of experience with managed care and payer organizations.

The panel tackled the question of how to address quality and safety concerns in specialty populations like behavioral health.  One of the key factors they consider is that working with behavioral health and substance abuse clients creates a safety risk for employees as well as other clients.  OSHA is becoming more active with investigations of organizations where workplace violence includes patient to employee encounters.  Proper training and protocols are essential. The panel agreed that in addition to traditional investigation and improvement activities, celebrating success is key to sustaining a culture of safety.  Meetings should begin with discussion of success stories.  The key when working to motivate health care workers is to humanize the discussion as much as possible.  Instead of discussing only rates for example, they recommended telling a specific patient story, or a specific accomplishment like 30 days without a single CLABSI infection.

The day’s event ended with the attendees having the opportunity to welcome our new National ACHE Chairman, Heather J. Rohan, FACHE.  Ms. Rohan is a member of ACHEMT and is President, HCA TriStar Division.  Ms. Rohan reiterated the opportunity for healthcare leaders to take advantage of the Safety Blueprint made available by ACHE at http://safety.ache.org/blueprint.