Susan Carroll since 2021 has served as president of Inova Loudoun Hospital, one of only 12 in the U.S. to achieve 26 consecutive "A" grades from Leapfrog Safety Group.
Infections are among the most significant factors driving safety ratings down, Ms. Carroll told Becker's. Fostering the right mindset and workplace culture has been key to developing solutions to address this and other challenges.
In March 2022, Ms. Carroll and the senior nursing team at the Leesburg, Va.-based hospital met to tackle rising hospital-acquired infections, which had reached six in the first two months of the year. While the team focused on maintaining proper line techniques, Ms. Carroll suggested a different approach: examining whether lines were even necessary for certain patients.
"It was a perfect example of a practice in healthcare that I'm sure all hospitals see: 'It's just the way we've always done it,'" she said.
This mindset shift led to the implementation of a "stop the line" program, encouraging medical staff to evaluate whether a line was truly needed. Over two years, Inova Loudoun's ICU reduced the number of lines from 245 per month to 42. So far in 2024, the hospital has reported six confirmed infections, including two central line-associated bloodstream infections — matching the total from just the first two months of 2022.
"If it wasn't for our culture and our nurses and team members being selfless about what is convenient for them and valuing the patient first, we wouldn't have been able to change this," Ms. Carroll said. "It's one example of many things in healthcare that we need to change our mindset about. Is this really what is best for our patients, or is this just something that we've always done and it's something that is convenient for us?"
A cornerstone of the hospital's culture is shifting the focus from associating infections with specific units or teams to viewing them as patient outcomes, reinforcing a patient-centered care approach. These principles extend to other metrics, including length of stay and readmissions, reflecting a system-wide commitment to a patient-first perspective, Ms. Carroll said.
Mortality rates have also been a key focus, with the hospital achieving a 47% reduction in the past two years, driven by the same principles.
"If we are happy with our outcomes, then our culture is perfect. If we are not happy with our outcomes, then we need to change the culture, because it 100% drives your outcomes," Ms. Carroll said. "That's really what we've been focused on. We want a culture of continuous improvement because we believe this is what we owe to our patients, and we're privileged to serve this community."