Implementing clinical best practices across a multihospital system to improve patient safety is one of the hardest things that Sandra Bruce has had to do as a health system executive.
Ms. Bruce, president and CEO of Chicago-based Presence Health, noted this during a panel at the Becker's Hospital Review 6th Annual Meeting May 7 in Chicago.
Other panel participants were Ruth Brinkley, president and CEO of Louisville-based KentuckyOne Health, Thomas Stover, MD, MBA, president and CEO of Akron (Ohio) General Health System, and Steve Little, president and CEO of Agnesian HealthCare in Fond du Lac, Wis. The panel was moderated by Molly Gamble, editor-in-chief of Becker's Hospital Review.
The panelists discussed various aspects of what makes a health system high-performing, and narrowed it into two buckets: excelling at patient safety and adjusting to new methods of payment.
"We've made patient safety and quality our No. 1 priority," Ms. Brinkley said, a sentiment shared by her three colleagues. Below are two best practices discussed that have helped drive out variation in medical practice and move the needle on patient safety.
1. Engage the physicians. Dr. Stover put it simply: "Embrace physician leadership." At Akron General, Dr. Stover and the rest of the executive team let physicians "lead the charge" of improving patient safety and limiting variability in medicine. Developing and training physicians to use approaches like Lean and Six Sigma has been successful at Akron General in getting physicians to solve problems and decrease variation in practice.
But it is important to note that this is easier said than done, as integrating various groups of physicians and bringing them to agree on one way of doing things is never easy. "Convincing providers to [deliver healthcare] in all the same way is a difficult thing," Mr. Little said.
Ms. Bruce agreed, saying, "it's going to be an interesting journey" to get everyone on the same page and agree on a set of clinical pathways. But Presence has already been successful in this area, as it implemented common sepsis protocols across the system and saw a large decrease in sepsis mortality and in cost per case.
2. Build a patient safety-centered culture. While they may not be treating patients directly, CEOs are largely responsible for creating cultures that support and contribute to patient safety. "Invest in culture-shaping and in talking about those who we serve," says Ms. Brinkley. When leaders can connect everything back to the patient, it makes it easier to bring clinicians on-board to change practices and improve patient safety.
On a similar cultural note, Mr. Little and the leadership at Agnesian HealthCare attribute some patient safety success to one change: moving to an environment that's not punitive when reporting on near misses or adverse events. "It has had a massive impact on improving safety and quality," he said. "Everyone has immunity." By removing penalties for reporting near misses, frontline workers at Agnesian can come forward with problems that can then result in positive change. He said that the system receives thousands of near miss notices in a year, which boil down to about 100 items that can drive change and prevent the system from having a negative event occur.