In 2005, Cincinnati Children's had a serious patient safety event every 21 days on average. Now, there are hundreds of days between safety events.
Stephen Muething, MD, chief quality officer at Cincinnati Children's Hospital Medical Center, credits this success to the culture of safety it has built in the last 20 years.
"Patient safety has long become the way we operate, the way we believe, and the way we think," Dr. Muething, MD, told Becker's. "The main thing we've done is focus on predicting harm, and predicting risk across a team. This predictive nature is key to high reliability because we can either prevent harm from happening or minimize it as quickly and effectively as possible."
Dr. Muething pointed to two unique strategies the hospital has taken to build its safety culture.
Safety coaches
Cincinnati Children's offers an unusual volunteer opportunity for employees: Become a safety coach.
The safety coach program launched over 15 years ago to a mixed response. Dozens of staff volunteered right from the start, but others worried about being watched so closely. However, safety coaches are not "safety police." Instead, they give feedback to colleagues when they notice a possible concern. Dr. Muething said this ranges from patient safety concerns in the operating room to employees walking while texting in the hallways and even jaywalking outside the hospital.
"The most common events are strains, sprains, trips, and bloodborne pathogen exposures," Dr. Meuthing said. "We're constantly working on daily behaviors and activities to prevent these."
Over 300 nurses, physicians, unit secretaries, pharmacists and more employees volunteer as safety coaches today. Almost all of them have had personal experiences with harm or know someone who has.
Over the years, the program has expanded and adapted to fit the needs of the hospital. Some departments have even created programs specific to their units.
Transparency with employees
Cincinnati Children's has also embraced full transparency with employees when it comes to safety events.
After a safety event, the system completes a root cause analysis and action plan. Then employees are invited to come hear what went wrong and how leadership intends to fix it.
"This level of sharing is not very common at hospitals," he said. "These meetings are important because they keep up the continuous drum beat that we are always learning and always improving, and it is everyone's responsibility."
The meetings occur as needed, but average about once every other month.
The impact
The combination of these two programs has created a strong culture of safety in the system. Currently, they are on a 287-day streak of no serious patient harm events and have logged 25 days since the last lost-time injury for employees. These, Dr. Muething told Becker's, are pretty average streaks.
"We never truly achieve complete safety, which is why I always emphasize the word 'journey,'" he said. "You don't reach it; you have to constantly strive to get better every single day."