At the Becker's Hospital Review Annual Meeting in Chicago on May 17, Charles "Chuck" D. Stokes, MHA, COO, and Michael Shabot, MD, CMO of Houston-based Memorial Hermann Healthcare System, discussed developing a high reliability healthcare organization.
A high reliability organization requires a commitment of everyone in the organization to patient safety and transparency. For example, Memorial Hermann shares the system's incidence of adverse events with the board of directors. Memorial Hermann also instituted senior leadership rounding, hourly nurse rounding and a "just culture" — an environment in which people can speak out about patient safety mistakes without being penalized. "You have to have a culture where employees can say 'We made a mistake' so you can take proactive steps [to improve safety]," Mr. Stokes said. One of the ways the health system promotes a just culture is through intensive training in which clinicians and staff learn, among other tools, CUSS words: phrases that clinicians and staff can use to confidently communicate a patient safety risk. The phrases are "I am Concerned," "I am Uncomfortable," "This is for Safety" and "Stand up and stand together." Learning key phrases empowers staff to speak up when a clinician or fellow staff member puts patient safety at risk.
Memorial Hermann also created a high reliability organization by borrowing strategies from other industries, such as commercial aviation and U.S. Navy submarines. Dr. Shabot said the submarine teams have a mission, but that it is secondary to safety. Similarly, Memorial Hermann established one core value: patient safety. The training and standardized practices enforced this value. By fully committing to safety, the health system improved several safety measures, including the rate of pressure ulcers, retained foreign bodies and ventilator-associated pneumonia.
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A high reliability organization requires a commitment of everyone in the organization to patient safety and transparency. For example, Memorial Hermann shares the system's incidence of adverse events with the board of directors. Memorial Hermann also instituted senior leadership rounding, hourly nurse rounding and a "just culture" — an environment in which people can speak out about patient safety mistakes without being penalized. "You have to have a culture where employees can say 'We made a mistake' so you can take proactive steps [to improve safety]," Mr. Stokes said. One of the ways the health system promotes a just culture is through intensive training in which clinicians and staff learn, among other tools, CUSS words: phrases that clinicians and staff can use to confidently communicate a patient safety risk. The phrases are "I am Concerned," "I am Uncomfortable," "This is for Safety" and "Stand up and stand together." Learning key phrases empowers staff to speak up when a clinician or fellow staff member puts patient safety at risk.
Memorial Hermann also created a high reliability organization by borrowing strategies from other industries, such as commercial aviation and U.S. Navy submarines. Dr. Shabot said the submarine teams have a mission, but that it is secondary to safety. Similarly, Memorial Hermann established one core value: patient safety. The training and standardized practices enforced this value. By fully committing to safety, the health system improved several safety measures, including the rate of pressure ulcers, retained foreign bodies and ventilator-associated pneumonia.
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