Nobl Insights

Tackling Patient Safety with Safety Huddles

Nobl is proud to have collaborated authorship with Charlene Sanders, VP of Quality at Mary Lanning Healthcare, to produce this blog post.

As we begin this year’s Patient Safety Week, we reflect upon the path our organizations have taken in our journey to provide safe care to patients, and we celebrate the advances in safety initiatives that have created a better patient experience.

Many acute-care initiatives have been introduced over the years to enhance Mary Lanning Healthcare’s culture of safety while hardwiring best practice care to benefit our patients. One life-saving safety initiative we’ve implemented is the Rapid Response Team. This low-budget initiative is directed toward developing an organization’s culture to create an impetus to recognizing early signs of clinical deterioration in patients, and to develop a team of experts who work together towards assessing a patient’s condition. Positively, Rapid Response Teams enable our staff to feel empowered to take action when they see deterioration in their patients. As a result, we’re able to save more lives than we could otherwise.

Several years later, we implemented what I believe to be one of the most significant patient safety initiatives an organization can—the daily Safety Huddle.

Our data affirms an improvement in quality of care and in the transformation of a fear-based culture to an open culture of patient safety in a relatively short period of time.

Safety Huddles provide a structured method for learning both from safety occurrences and from near-miss safety events. The huddle process encourages open communication between members of the leadership team to raise awareness of any occurrence that could be considered a safety event. The Safety Huddle is an informal process in which there is no recrimination, and it promotes transparent discussion regarding potential safety issues. Identified Issues are usually resolved within 24 hours.

Our daily fifteen (15) minute safety huddle is led by the CEO or an executive team leader every weekday at a set time, and attended by directors. We’ve seen our teamwork enhanced by the daily interaction, with the expectation that issues or problems are resolved in a timely fashion.

The typical Safety Huddle agenda addresses the following:

- Safety success stories, announcements, and/or introductions
- Number of days since last serious safety event
- Number of says since last employee injury
- Departmental reports concerning events or variances to care

Examples of issues brought forward:

- Security issues or risks
- Medication issues
- Falls
- Restraints
- Environment of Care issues

Organizations that haven’t implemented a daily safety huddle can begin the process in a short period of time, with minimal to no expense aside from the fifteen (15) minutes required of each Director or Manager to attend the daily meeting. In the long run, I’ve seen that this dedicated time actually reduces the time that it would normally take for issues to come to resolution. Similar to the Rapid Response Team initiative, the daily Safety Huddle is fairly easy to implement and is extremely impactful to patient and organizational outcomes.

Since meeting for our first Safety Huddle in September of 2013, Mary Lanning Healthcare has seen an improvement in reporting concerns and a decrease in the time that it routinely takes to address patient safety issues. Our data affirms an improvement in quality of care and in the transformation of a fear-based culture to an open culture of patient safety in a relatively short period of time. The daily Safety Huddle champions transparent leadership and fosters communication that not only moves the organization toward achieving goals established for the quality and safety strategic plan, but has dramatically changed the culture of safety within our organization. Results of the 2015 patient safety culture survey, when compared to 2013 results, provide quantitative evidence that Mary Lanning Healthcare’s culture is evolving into world class performance status with respect to patient safety, while demonstrating noteworthy improvement in quality measures.

Without strong leadership, and a passion toward creating a safer environment for our patients, none of this would have been possible! At the end of the day, Safety Huddles are just one way that Mary Lanning Healthcare aligns with the 2016 Patient Safety Awareness Week mission to make every day a patient safety day.

For more info

Charlene Sanders joined Mary Lanning Healthcare as VP of Quality in September 2013. She has over 30 years of leadership experience, working with hospitals, health systems, and academic medical centers to improve patient outcomes, patient safety, and overall quality performance.

Built on a tradition of caring, Mary Lanning Healthcare is in its 100th year of providing quality healthcare for residents of the central Nebraska area. We continue to grow and expand, working to provide patient-centered care in a positive environment, while implementing some of the newest technologies available. In addition, the recent Century Project construction propelled your hospital into the future. The project is just another example of how Mary Lanning Healthcare strives to provide the best care possible for central Nebraska now and into the future.

The Untapped Potential of the Electronic Health Record

A few months ago I wrote a blog post regarding the changing tides of healthcare, and the effect that those changes were having on our country’s nurses. Higher patient acuity, electronic health records (EHR), and budget cuts are all contributing to increased burnout amongst nurses, increased turnover, and less time nurses are able to spend actually caring for patients.

Out of that blog post, there’s one topic in particular that I’ve become increasingly passionate about over the months, and that’s the effect EHRs are having on our hospitals and healthcare providers.

The Medicare and Medicaid EHR Incentive Programs were created in 2009 to provide incentives for eligible hospitals to adopt, implement, or upgrade their EHR technology. For hospitals, these incentive payments can total as much as $2 million or more. As a result, hospitals have spent the last 5+ years implementing, dropping, and re-implementing various EHR systems throughout their organizations. Of the hospitals we talk to, I think one trend remains: few hospitals are satisfied with their EMR vendor, so they’respending multi-millions—if not hundreds of millions— of dollars to try and solve the problem.

One of the greatest challenges hospitals face is this false assumption that EHRs were created to solve the interoperability issues that seem to be so prevalent in healthcare today. The reality of the matter is that these tools were created to coordinate patient care within the hospital and replace the paper records that had become the standard over the years. While it makes sense for hospitals to seek ancillary solutions with integration capabilities, it also puts a major hinderance on the hospital’s ability to solve a plethora of other cost saving and quality improvement problems. The question, I beg, is at what point do the human and financial resources required to implement these systems begin producing negated returns for the hospital or health system? My assumption: most hospitals began seeing negative returns shortly after contracts with the EHR vendors were signed.

One of the greatest challenges hospitals face is this false assumption that EHRs were created to solve the interoperability issues that seem to be so prevalent in healthcare today.

This isn’t to say that hospitals shouldn’t be investing in Electronic Health Records or that the incentive programs are failing. These tools have amazing potential to help providers better manage and coordinate care. For the first time, hospitals have the ability to exchange health information electronically, all while providing higher quality and safer care for patients. Concern is risen only when hospitals are overextending their IT and clinical staff for these 12-24 month implementations, as it puts a gratuitous freeze on all other clinical and IT initiatives.

It doesn’t have to be this way.

Quite the contrary, the right initiatives are capable of dramatically enhancing the impact EHRs are able to have on managing and coordinating care. It’s the reason why companies like Cerner are establishing initiatives to make 3rd party integrations easier to actualize. Up until this point, most EHR vendors have had a starkly definitive attitude towards 3rd party integrations—and plenty still do. The fact that this trend is beginning to break is an excellent indicator of great things to come not only for care providers, but also for their patients.

In summary, while we still have a long road to travel toward overcoming the resource and interoperability constraints imposed upon the providers, we’re getting closer. By working together and limiting resource requirements on the side of the provider, we truly begin to see the impact that we’re all working so hard to materialize: enhanced quality, safety, and coordination.

It certainly won’t happen overnight, but we shouldn’t be afraid of making changes slowly. We should only be afraid of standing still.

Nobl is passionate about advancing collaboration between EHRs and Third-party applications. If you haven’t already, check out our rounding solutions.


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