When The Leapfrog Group released its latest round of safety grades and designations for the nation's hospitals, Swedish Covenant Hospital President and CEO Mark Newton said he was rather surprised.
Not because SCH received an "A" grade — this was the fourth year in a row his hospital has received the top mark — but because it was the only hospital in Chicago, and one of just 55 urban hospitals, to be named a Top Hospital by Leapfrog.
Top Hospitals are evaluated based on their ability to meet or surpass a variety of safety and quality standards.
"We really are pleased that we've established this long track record," Mr. Newton says. But the string of great safety grades isn't a coincidence: SCH has had a "relentless focus" on constant improvements in patient safety.
"[Hospitals] only have two directions — you can get better or get worse, but you will not be the same," he says. "You really have to be relentless in the focus."
Here, Mr. Newton discusses specific areas of patient safety in which SCH has made strides and what contributed to the hospital's success in the arena. SCH has focused on and improved in the following patient safety areas recently:
• Hospital-acquired infections. This was one of the main focuses for SCH in 2013. The hospital was able to improve its HAI rates partially through use of its integrated electronic medical record system. "We were able to…hardwire in protocols aimed at reducing HAIs," Mr. Newton says.
• Central-line infections. SCH has gone 18 months without a central-line infection. The improvement in this area "is attributed to a very robust clinical documentation system," Mr. Newton explains.
• Reduced surgical site infections. SCH reduced SSIs to having just four recorded at the hospital in the course of a year. This was achieved through a modified protocol for antibiotic use.
• Catheter-associated UTIs. The hospital found an overuse of catheters, so a new protocol was put in place: "We basically say clinical staff has to justify why they need to use a catheter before they use it," Mr. Newton says.
After making strides in four areas to achieve an "A" from Leapfrog in 2013, SCH has one main patient safety focus this year: falls. "When people fall, it's a fairly dramatic and high-risk issue," Mr. Newton explains. "That's what we're going to focus on as an organization this year."
Culture of safety
While SCH has made great improvements in those four areas, the hospital has worked on developing a broader culture of safety to keep employees' focus on patient safety at all times. "I place a large premium on our culture of safety, and it's driven from the board level down," Mr. Newton says.
One aspect of SCH's culture of safety is making sure every employee knows they have permission to ask why something is being done "and they will not be criticized for that," he explains. "If something's not right, we want people to bring it forward and don't want them to be abused or intimidated when they do."
This specifically applies to the catheter program, for example — if a clinician feels a catheter is not needed, and another clinician wants to put a catheter in, the first needs to feel comfortable speaking up.
Role playing
SCH keeps a continual focus on safety through role playing. "If we hear about a situation that occurs at another hospital, we role play that through our organization from a risk and quality management standpoint," Mr. Newton says. "We constantly test our systems."
Walking through various real-life situations at SCH helps the hospital identify gaps in the system, or where a change in process or reeducation of staff is necessary. And, according to Mr. Newton, the staff appreciates the chance to learn from real-life situations.
"The clinicians become very excited and motivated about that because they're here to protect patients' safety and don't have to deal with the aftermath of doing harm to a patient" to learn, he says.