/ en Fri, 25 Apr 2025 22:51:26 -0500 Wed, 26 Mar 25 15:28:00 -0500 /news/headline/2025-03-26-aha-podcast-great-catch-strategies-building-culture-safety-reporting <p>Mindy Estes, M.D., former CEO of Saint Luke’s Health System and former AHA board chair, and Nancy Howell Agee, CEO emeritus of Carilion Clinic and former AHA board chair, discuss the importance of bringing a culture of safety reporting to an organization and how technology cannot replace the human factor in a successful patient safety strategy. <a href="/advancing-health-podcast/2025-03-26-great-catch-strategies-building-culture-safety-reporting" title="March leadership dialogue"><strong>LISTEN NOW</strong></a><strong> </strong> </p><div></div> Wed, 26 Mar 2025 15:28:00 -0500 Safety culture /advancing-health-podcast/2025-03-26-great-catch-strategies-building-culture-safety-reporting <p>In this conversation, Mindy Estes, M.D., former CEO of Saint Luke’s Health System and former AHA board chair, and Nancy Howell Agee, CEO emeritus of Carilion Clinic and former AHA board chair, discuss the importance of bringing a culture of safety reporting to an organization, and how technology can’t replace the human factor in a successful patient safety strategy.</p><hr><div></div><div class="raw-html-embed"><details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br> </h2> </summary> <p> 00:00:01:03 - 00:00:26:14<br> Tom Haederle<br> Welcome to Advancing Health. Hospitals and health systems never stop working to advance patient safety and quality. It has been and always will be our field's top priority. In today's conversation, two former ���������� Association board chairs discuss the importance of bringing a culture of safety reporting to an organization, and how technology can't replace the human factor in a successful patient safety strategy. </p> <p> 00:00:26:16 - 00:00:41:04<br> Tom Haederle<br> Dr. Mindy Estes is the former CEO of Saint Luke's Health System in Kansas City and her guest, Nancy Howell Agee, is CEO emeritus of Carilion Clinic in Roanoke, Virginia. </p> <p> 00:00:41:06 - 00:01:06:23<br> Mindy Estes, M.D.<br> I'm Dr. Mindy Estes, and today we have the privilege of speaking with Nancy Howell Agee, CEO of Carilion Clinic. Nancy's remarkable journey began as a nurse when her commitment to patient care laid the foundation for an extraordinary leadership career. So let's just jump right in. You've had a remarkable career from nurse to CEO and long service in the field for AHA and other organizations </p> <p> 00:01:06:23 - 00:01:24:22<br> Mindy Estes, M.D.<br> and so, I think it really gives you a unique perspective on health care quality, safety, equity, workforce, all facets that go into a quality organization. So thinking back, what have been the most important actions you've taken as a leader to drive quality and patient safety? </p> <p> 00:01:24:25 - 00:02:09:21<br> Nancy Howell Agee<br> Well, you know, I'm glad you mentioned that I began my career as a nurse. And I treasure the fact that I am a nurse still. And, as one-on-one patient encounters are what have always driven me - the notion that you're caring for one person after another, and how you do that the very best of all. As I became a leader in health care about the time that I was moving as a chief operating officer and then the CEO, I was a representative from the ���������� Association to the Joint Commission, and I was on the Joint Commission Board. </p> <p> 00:02:09:24 - 00:02:34:07<br> Nancy Howell Agee<br> And at that time, you know, we were beginning to talk about zero harm. And so I was hearing from the AHA in one ear: patient safety, quality; and in the other ear from the Joint Commission, patient safety and quality. So in stereo, what's really important. And I pondered that quite a lot as a leader to look at our own organization, </p> <p> 00:02:34:07 - 00:03:00:07<br> Nancy Howell Agee<br> what could we do differently? Not just check the box, not just meet the regulations, but really understand fundamentally what it meant to improve health care, improve patient safety, and improve quality. It seemed to me that it needed to start with the board. And so sort of a bottom up, top down conversation of education about our highest priority and what that meant. </p> <p> 00:03:00:07 - 00:03:31:07<br> Nancy Howell Agee<br> And when we talk about statistics, it's really important to measure quality, of course. But a statistic represents a patient. And so we began to frame how we think about quality with the patient in mind. Not the patients, but a patient. And it seemed to make a difference. At that time we reorganized the board and the board committees. And while we had a quality committee, it wasn't perhaps as robust as the finance committee. </p> <p> 00:03:31:07 - 00:04:00:15<br> Nancy Howell Agee<br> And it seemed like the committee that got the most airtime at board meetings was the finance committee. And educating the board about what it meant to be an integral, high integrity, zero harm organization. So we renamed the Quality Committee for the board CAPS: Clinical Advancement and Patient Safety. And now the two most important board committees are CAPS and finance. </p> <p> 00:04:00:17 - 00:04:27:09<br> Nancy Howell Agee<br> And our board chair sits on both. In hindsight, it was really important that our board chair began to [see] patient safety and quality is the single most important thing. I'll tell you something else we've done, Mindy. We celebrate what we call the great catch. And so the more event reporting that we do, we think that's fantastic. And so we, you know, any little thing, any big thing. Was funny, </p> <p> 00:04:27:09 - 00:04:51:07<br> Nancy Howell Agee<br> I was waiting on the elevator, a gurney went by and it went a little too fast around the curve. And there was a resident standing there and he said, hey, I think we need to put that in the event report. And it was, you know, just kind of an everyday encounter, but it was a great focus. The other thing we did was create a new set of values. </p> <p> 00:04:51:09 - 00:05:25:17<br> Nancy Howell Agee<br> Our mission is to improve the health of the communities we serve. We focused on our values and our values include courage, compassion, curiosity, commitment. And by focusing on those values,  we use those to talk and to educate regularly for new employees, as well as every year the required education for all staff include focus on our values and what that means to patient safety and quality. </p> <p> 00:05:25:19 - 00:06:02:13<br> Nancy Howell Agee<br> And the last thing I'd mention is that we organized everything under one umbrella. So everything from risk management to honor reporting to all the sort of things we do for preparation, for Joint Commission, for surveys from our state, patient safety, patient advocacy and our human factors team and our sim lab are all under one umbrella. And creating that real focus that's both education metrics and celebrate the good work that we do. </p> <p> 00:06:02:15 - 00:06:37:27<br> Mindy Estes, M.D.<br> It's remarkable. There are a couple of things that have, that have struck me. One is your point about so much time spent in board meetings on finance. And one of the things that, we did at Saint Luke's was to reorder our board agenda and have a quality close, if you will, just like we have the financial close where we are presenting the quality metrics not only on a monthly basis, but year to date basis, so that we have time on the front end of the board meeting to talk about quality as opposed to whatever time we had left. </p> <p> 00:06:38:00 - 00:07:06:15<br> Mindy Estes, M.D.<br> The other thing I would mention is, as you know, I'm currently on the Joint Commission Board, and we talk about innovation and quality and patient safety. And the conversations when you were on the board beginning to talk about Do No Harm. You know, today Joint Commission is innovating and innovating rapidly. So I think it really is, organizations in the Joint Commission, in this instance, marching together from a foundation that's been created over a number of years. </p> <p> 00:07:06:18 - 00:07:31:02<br> Mindy Estes, M.D.<br> You helped develop Carilion's innovative care model. Undoubtedly - and I've heard you speak on how that evolved - and I know you have a lot of insights for other leaders. So if you were advising a new system leader and there certainly as we've seen, movement in health care, there are a lot of new system leaders in our field. What would you tell them to do first, to set the tone for an effective culture in the organization? </p> <p> 00:07:31:02 - 00:07:34:04<br> Mindy Estes, M.D.<br> I think you've already touched on that, but I know there's more. </p> <p> 00:07:34:06 - 00:08:19:07<br> Nancy Howell Agee<br> I think creating an environment of this is our highest priority means you're using every single meeting, every memo, your social media, we have an internal social activity. We focus on that with every single communication that we have. And I think that that's critically important. But I'm glad you mentioned technology because both existing technology and new technologies, again, we focus on why we're doing this for patient safety and how it improves quality and by having that as our key priority, I think it begins to permeate the organization. </p> <p> 00:08:19:15 - 00:08:45:00<br> Nancy Howell Agee<br> Technology is important. If you ask me, what doesn't work as well as you thought it would when you first started? You know, I'll say introducing an electronic health record. I remember when we did that and we did it big bang approach. And I remember these words probably came out of my mouth as much as anybody. We're going to eliminate medication errors by having this technology. </p> <p> 00:08:45:04 - 00:09:15:24<br> Nancy Howell Agee<br> And of course that's ridiculous in hindsight. There's nothing that can completely alter the human nature of our business, thank goodness. But because we are humans, mistakes can happen. And so doing everything you can to have a safe environment, to create a culture that's a permissive culture that encompasses patients taking quality and everything that you do, I think that makes all the difference. </p> <p> 00:09:15:27 - 00:09:43:27<br> Nancy Howell Agee<br> You know, Mindy, you and I go back a long time. We used to think about things like central line infections and catheter infections and I don't know. It wasn't that we were cavalier about those things. I think we were just as concerned about patient safety and quality. We didn't recognize the whole milieu that it took to care for every single patient, every time, in the way that a patient should be cared for. </p> <p> 00:09:43:29 - 00:10:02:28<br> Nancy Howell Agee<br> And when I look back and I think about some of the things that we perhaps took for granted or didn't realize that we could change, and now I look where we are as an industry. Our whole field has improved patient safety culture, and I think there's even more that we can do. </p> <p> 00:10:03:00 - 00:10:26:20<br> Mindy Estes, M.D.<br> You know, to your point of change. And, you know, I think organizations like ours, we test, we pilot, we retest, and, you know, we want consensus. And if we don't like the first pilot, we do another one. And I think Covid taught us very quickly that, you know, we can innovate and we can innovate quickly. And we can learn from that innovation </p> <p> 00:10:26:20 - 00:10:39:12<br> Mindy Estes, M.D.<br> and if we fail, we need to fail quickly. And you touched on the electronic record and my next question, it was just going to be, what did you learn from something that wasn't as effective as you might have hoped? </p> <p> 00:10:39:15 - 00:11:03:10<br> Nancy Howell Agee<br> Well, I'll just echo first of all that you're right. During Covid, we learned, and I hope we continue to learn that lesson - and that is innovate, innovate quickly. You know, I think we can be accused of being way too slow and thinking through things, which is important. We have a saying here. Take risks without being reckless. After all, you are talking about a patient's life. </p> <p> 00:11:03:12 - 00:11:44:00<br> Nancy Howell Agee<br> The notion that we can innovate, that we can recognize and do something about that and take ownership at multiple levels. So I think one of the real lessons that began before Covid, but what really came home during Covid was a necessity for focusing on the resilience of our staff and all the things that we can do, because, you know, as a CEO, you and I are not really important to that patient interaction, that precious moment between a caregiver and a patient. </p> <p> 00:11:44:03 - 00:11:54:07<br> Nancy Howell Agee<br> And so all the things that we can do to support our staff so that they can give the kind of high quality, safe care that we would expect. </p> <p> 00:11:54:09 - 00:12:17:21<br> Mindy Estes, M.D.<br> You know, resilience continues to be important. And I think in this day and age is something that we used to take for granted as well, that the mission and the privilege to do what we do would fuel internal resilience. And I think part of this whole patient safety, quality and quality of our workforce and our workforces experience as well - </p> <p> 00:12:17:27 - 00:12:57:04<br> Mindy Estes, M.D.<br> that resilience and how we take care of that has become increasingly important. And Nancy, I want to thank you as always for your time, for your sharing your insights and experiences and your journey from being a nurse to an award winning CEO and your successful transformation of Carilion Clinic. It really provides powerful lessons for all health care leaders at all levels, and your commitment to quality and safety innovation, combined with your dedication to mentoring future leaders, especially women in health care, truly exemplifies exceptional leadership. </p> <p> 00:12:57:04 - 00:13:25:04<br> Mindy Estes, M.D.<br> And, you know, we've seen through your examples, how health care organizations can navigate while maintaining an unwavering focus on quality and safety, Because at the end of the day, that is what we do to provide the highest quality patient care and safety to our patients, first and foremost. And I really think it's important for our listeners to realize that underlying all of the success you've had is the heart of a nurse. </p> <p> 00:13:25:06 - 00:13:27:11<br> Nancy Howell Agee<br> Thank you Mindy. </p> <p> 00:13:27:13 - 00:13:35:23<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details></div> Wed, 26 Mar 2025 02:25:11 -0500 Safety culture /guidesreports/2025-03-11-improvement-safety-culture-linked-better-patient-and-staff-outcomes <div class="container"> .container h2{ color:#003087; } <div class="row"><div class="col-md-4"><h3>Insights Report</h3><p>Every day, in every hospital across America, care teams work to provide safe, high-quality care to each and every patient. Part of that work includes continually identifying what drives better outcomes, and then implementing changes to improve patient care.</p><p>AHA’s insights report series features learnings gained in collaboration with data partners to better analyze hospital and health system progress on patient safety. In September 2024, AHA partnered with Vizient to release a <a href="/guidesreports/2024-09-12-new-analysis-shows-hospitals-performance-key-patient-safety-measures-surpassing-pre-pandemic-levels" title="View the report: New Analysis Shows Hospitals Improving Performance on Key Patient Safety Measures Surpassing Pre-pandemic Levels">report</a> showing that numerous outcome measures of health care quality and patient safety — including mortality and healthcare-associated infections — are improving while hospitals care for more patients with significant health care needs.</p><p>The latest insights report, created in collaboration with Press Ganey, highlights progress on additional outcome measures of patient safety including some that reflect the ongoing work nurses lead to protect patients. In addition, Press Ganey’s comprehensive data shows clear improvement on the experience of both patients and the health care workforce. It also shows improvements in safety culture, which is a leading indicator of better safety outcomes and better experiences for patients and staff.</p></div><div class="col-md-4"><div class="panel module-typeC"><div class="panel-heading"><h3 class="text-align-center panel-title">Key Insights</h3></div><div class="panel-body"><h4 class="text-align-center">Data in this report show that:</h4> ol.IRolNumBox li { counter-increment: list; list-style-type: none; position: relative; margin-bottom: 15px; } ol.IRolNumBox li:before { color: #fff; content: counter(list); left:-35px; position: absolute; text-align: center; width: 30px; height:30px; background-color:#69b3e7; padding:0px; border-radius: 5px; padding:0px 0px 0px 0px ; font-weight:700; font-size:20px; top:-5px; } <ol class="IRolNumBox"><li>Hospitals are performing at or better than pre-pandemic levels on multiple measures of quality and patient safety, including patient falls and pressure injuries (i.e., bed sores) that reflect work led by nurses to care for patients.</li><li>Millions of patients report that their overall care experience is improving.</li><li>Press Ganey data from more than 1 million members of the health care workforce show a rebound from pandemic lows in engagement, resilience and safety culture.</li><li>Patient safety, patient experience, workforce experience, and well-being are all tied together by a hospital or health system’s culture of safety. Across clinical settings — the single largest driver of a patient’s reported experience of care is how well their care team members work together. Better teamwork has long been shown to drive better outcomes.</li></ol></div></div></div><div class="col-md-4"><div><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/03/AHA-Insights-Report-Improvement-in-Safety-Culture.pdf" target="_blank" title="Download the print version of the Insights Report: Improvement in Safety Culture Linked to Better Patient and Staff Outcomes">Download the Report PDF</a></div><div><a class="btn btn-wide btn-primary" href="/press-releases/2025-03-12-report-reveals-link-between-health-care-workforce-well-being-patient-experience-and-safety-outcomes" title="View the Press Release: Report Reveals Link Between Health Care Workforce Well-being, Patient Experience and Safety Outcomes in Hospitals">View the Press Release</a></div><div><a class="btn btn-wide btn-primary" href="/aha-patient-safety-initiative" target="_blank" title="Click here to visit the AHA Patient Safety Initiative landing page.">Learn More about the AHA Patient Safety Initiative</a></div><div><a href="/system/files/media/file/2025/03/AHA-Insights-Report-Improvement-in-Safety-Culture.pdf" target="_blank" title="Download the print version of the Insights Report: Improvement in Safety Culture Linked to Better Patient and Staff Outcomes"><img src="/sites/default/files/2025-03/PSW-PG-Report-Cover-352x456.jpg" alt="Cover image of the Insights Report: Improvement in Safety Culture Linked to Better Patient and Staff Outcomes" width="352" height="456"></a></div></div></div><div class="row"><div class="col-md-12"><h2>Evidence in Key Areas Show Care is Getting Safer</h2><p>The Press Ganey National Database of Nursing Quality Indicators (NDNQI) dataset reflects quality measures reported by 25,652 units across 2,430 inpatient acute care hospitals. Analysis of four key measures in NDNQI data includes catheter-associated urinary tract infection (CAUTI), central lineassociated bloodstream infection (CLABSI), patient falls that result in harm, the number of patients who develop hospital-acquired pressure injuries (HAPI), also known as bed sores. The analysis shows the incidence of all measures have declined since their pandemic peaks, with nearly all measures across all units back to or better than pre-pandemic levels.</p><div class="col-md-12"><img src="/sites/default/files/2025-03/PSW-Evidence-in-Key-Areas-img1-1120x372.jpg" alt="Medical-surgical / Critical care; Fall Rate: Rate of Patient Falls from 2019 to 2024 between both | CLABSI: Rate of Infections from 2019 to 2024 between both" width="1120" height="372"></div><div class="col-md-12"><img src="/sites/default/files/2025-03/PSW-Evidence-in-Key-Areas-img2-1120x370.jpg" alt="Medical-surgical / Critical care; CAUTI Rate: Rate of Infections from 2019 to 2024 between both | HAPI: percentage of Patients from 2019 to 2024 between both" width="1120" height="370"></div><p><em><small><strong>Source:</strong> ©2025 Press Ganey. All rights reserved; a PG Forsta company.</small></em></p><p><em><small><strong>Note:</strong> Falls are measured as total patient falls per 1,000 patient days; CLASBI is measured as central line-associated bloodstream infections per 1,000 central line days; CAUTI is measured as catheter-associated urinary tract infections per 1,000 catheter days; and HAPI prevalence is measured as the percentage of surveyed patients with hospital-acquired pressure injuries.</small></em></p></div><div class="col-md-12"><h2>Patients Say Their Care Experience and Perception of Safety are Improving</h2><p>Press Ganey works on behalf of 75% of U.S. acute care hospitals and medical practices across the country to survey patients regarding their care experiences and gain insights into how hospitals are working to deliver safe and effective care. Included in the surveys are questions that explicitly ask patients about their perception of staff’s efforts to keep them safe, along with questions about other facets of care that contribute to greater safety, such as teamwork among staff, attention and responsiveness to patient needs, and communication between patients and members of the clinical care team. Importantly, the data for this report, based on responses from 13 million patients, show steady gains in their perceptions of both experience of care and safety of care after a drop due to the COVID-19 pandemic. Results show hospitals and health systems are on the path to returning to pre-pandemic levels of safety.</p><img src="/sites/default/files/2025-03/PSW-Patients-Say-img1-1120x486.jpg" alt="National trends in patient experience: Likelihood to Recommend | Ambulatory surgery, Medical Practice, Inpatient, Emergency department - data between 64.5 to 85.3 between 2019 and Q1 of 2024" width="1120" height="486"><p><em><small><strong>Source:</strong> ©2025 Press Ganey. All rights reserved; a PG Forsta company.</small></em></p><p>One of the key factors driving improvements in patients’ perceptions of care is the teamwork of their caregivers. Across clinical areas — inpatient and outpatient, surgical and medical, emergency and scheduled — the single largest driver of a patient’s likelihood to recommend a hospital, facility or provider is perception on how well their care team members work together. Better teamwork has long been shown to drive better outcomes.</p> .IRcallOut01 { border: solid 2px #003087; padding:0px; overflow: auto; } .IRcallOut01 h2, .IRcallOut01>p, .IRcallOut01 h3{ text-align:center; } .IRcallOut01 h3{ background-color: #003087; color:#fff; padding:15px; } .IRcallOut01Insert{ background-color:#f6f6f6; padding: 5px 0px; margin-bottom: 15px; } .IRcallOut01 h4{ border-radius: 5px; padding:10px 10px 5px 10px; color:#fff; display: inline-block; margin-top:5px; margin-left: 15px; } .IRcallOut01 h4.IRcallOut01Red{ background-color:#d50032; } .IRcallOut01 h4.IRcallOut01Blue{ background-color:#69b3e7; } .IRcallOut01 h4.IRcallOut01LBlue{ background-color:#307fe2; } .IRcallOut01 h4.IRcallOut01Green{ background-color:#005844; } .IRcallOut01 h4.IRcallOut01Yellow{ background-color:#eaaa00; } .IRcallOut01 h4.IRcallOut01DRed{ background-color:#651d32; } .IRcallOut01 ul li:nth-child(1){ font-weight:700; color:#003087; } <div class="col-md-12 IRcallOut01"><h2>What earns patients’ confidence and loyalty?</h2><p>Patients are attuned to team dynamics and interpersonal competencies.</p><h3>National analysis of key drivers of likely to recommend by setting</h3><div class="col-sm-6 col-md-4"><div class="IRcallOut01Insert"><h4 class="IRcallOut01Red">Emergency</h4><ul><li>Staff worked well together</li><li>Cared about you as a person</li><li>Attention to your needs</li><li>Treat with courtesy/respect</li></ul></div></div><div class="col-sm-6 col-md-4"><div class="IRcallOut01Insert"><h4 class="IRcallOut01LBlue">Inpatient</h4><ul><li>Staff worked well together</li><li>Response to concerns</li><li>Attention to your needs</li><li>Attitudes toward requests</li></ul></div></div><div class="col-sm-6 col-md-4"><div class="IRcallOut01Insert"><h4 class="IRcallOut01Blue">Med Practice</h4><ul><li>Staff worked well together</li><li>Concern for questions/worries</li><li>Explanation of condition/problem</li><li>Include in decisions</li></ul></div></div><div class="col-sm-6 col-md-4"><div class="IRcallOut01Insert"><h4 class="IRcallOut01Green">Clinic</h4><ul><li>Staff worked well together</li><li>Treat with respect/dignity</li><li>Response to concerns</li><li>Trust skill of staff</li></ul></div></div><div class="col-sm-6 col-md-4"><div class="IRcallOut01Insert"><h4 class="IRcallOut01Yellow">Amb. Surgery</h4><ul><li>Staff worked well together</li><li>Response to concerns</li><li>Nurses’ concern for comfort</li><li>Provider response to concerns/questions</li></ul></div></div><div class="col-sm-6 col-md-4"><div class="IRcallOut01Insert"><h4 class="IRcallOut01DRed">Urgent Care</h4><ul><li>Staff worked well together</li><li>Provider listened</li><li>Explanation of condition/problem</li><li>Include in decisions</li></ul></div></div></div><p><em><small><strong>Source:</strong> ©2025 Press Ganey. All rights reserved; a PG Forsta company.</small></em></p><p>Similarly, patients who perceive that their care was safe are 2.5 to 3 times more likely to recommend their hospital to others. Their perceptions of safety are based on their own interactions with hospital team members, their observations regarding practices such as handwashing and cleanliness, and how they see team members interacting with one another to deliver care. Specifically, when asked about their confidence in the care they received and their willingness to recommend a hospital to others, patients ranked hospitals more highly when they perceived the hospital team to be working well together and to be attentive to the patients’ needs and questions.</p></div><div class="col-md-12"><h2>Workforce Experience and Well-being are Improving</h2><p>At its core, health care is a uniquely human experience centered around people caring for other people. This is why hospitals and health systems pay close attention to and invest in the well-being of their workforce. An energized and engaged workforce improves the care provided to patients, the physical and psychological wellbeing of patients, and how patients perceive the work to keep them safe. As the enormous strain of the COVID-19 pandemic recedes, the health care workforce is beginning to rebound as well. Press Ganey data from 1.7 million members of the health care workforce show a rise in their reported experience and resiliency. A resilient workforce is essential in health care, given the complex and high stakes nature of the work.</p><div class="col-md-12"><img src="/sites/default/files/2025-03/PSW-Workforce-Experience-img1-1120x609.jpg" alt="Gaining ground in resilience: Resilience and its sub-components of activation (meaning in work) and decompression (ability to disconnect) are on an upward trend. | 3-year trending: Activation, Resilience, Decompression - Reported Satisfaction Score between 2022 and 2024 & Item-level change vs 2023 benchmark; Activation: Work makes a difference - +.03, Work is meaningful - +.03, Care for all patients equally - +.02, See patient as an indvidual person - .01 / Decompression: Able to free mind when away from work - +.08, Rarely lose slepp over work - +.07, Disconnect from comm's during free time - +.06, Enjoy personal time without focus on work - .05 " width="1120" height="609"></div><p><em><small><strong>Source:</strong> ©2025 Press Ganey. All rights reserved; a PG Forsta company.</small></em></p><p>Hospitals that score higher on team member engagement surveys also see higher patient experience scores reported from patients. This correlation gets more pronounced every year, with the top performing quartile of hospitals on staff engagement in 2023 scoring in the 80th percentile on patients’ likelihood to recommend.</p><div class="col-md-12"><img src="/sites/default/files/2025-03/PSW-Workforce-Experience-img2-1120x485.jpg" alt="Likelihood to recommend is correlated with team engagement and correlation is getting stronger: Inpatient Likelihood to Recommend (percentile rank); 2021 for Engagement Quartile, Engagement Quartile" width="1120" height="485"></div><p><em><small><strong>Source:</strong> ©2025 Press Ganey. All rights reserved; a PG Forsta company.</small></em></p></div><div class="col-md-12"><h2>Safety Culture is Essential</h2><p>A critical factor in generating both better patient outcomes and care teams’ engagement in their work is a strong safety culture. A strong safety culture supports the teams through the demanding tasks associated with care delivery and makes a noticeable difference in how patients experience their care, leading to safer care and a more resilient care delivery system.</p><p>A culture of safety is an environment in which everyone, including patients and families:</p><ul class="arrow"><li class="arrow">Can speak up when they see something that might not be right.</li><li class="arrow">Is confident that improvements occur when issues are reported.</li><li class="arrow">Is dealt with fairly and compassionately when an error occurs.</li><li class="arrow">Experiences effective teamwork and communication.</li></ul><p>An organization’s safety culture is assessed with evidence-based survey tools, such as the instrument Press Ganey developed, which gather responses from over 1 million hospital staff each year. The Press Ganey data show a positive relationship between the level of care team engagement in their work and the hospital scores for patient safety culture. When caregivers feel that they are supported, working with an effective team and doing meaningful work, they are more likely to be deeply engaged in their work.</p><div class="col-md-12"><img src="/sites/default/files/2025-03/PSW-Safety-Culture-img1-1120x322.jpg" alt="Engagement top performers have a strong Culture of Safety: All employees - Engagement 3.99 = path 51.5% with a high Saftey Vulture Score - 4.51 (97th), path 48.5% with a low Saftey Culture Score - 3.44 (2nd) | 95 percentile-rank difference in employee engagement" width="1120" height="322"></div><p><em><small><strong>Source:</strong> ©2025 Press Ganey. All rights reserved; a PG Forsta company.</small></em></p></div><div class="col-md-12"><h2>Opportunities to Enhance Safety Culture</h2><p>In the aftermath of the COVID-19 pandemic, hospitals’ performance in both safety culture and quality and safety metrics have rebounded and begun to plateau. Resources and teamwork remain areas with the greatest potential for growth. While prevention and reporting experienced an increase previously, the recent downward trend highlights the need for ongoing prioritization.</p><div class="col-md-12"><img src="/sites/default/files/2025-03/PSW-Opportunities-to-Enhance-img1-1120x479.jpg" alt="National Safety Culture Scores on the rebound; Saftey Culture Overall: Mean Score between 2019 and 2024 - average 4, Prevention & Reporting - average 4.14, Pride & Reputaion - average 4.15, Resources & Teamwork - average 3.7" width="1120" height="479"></div><p><em><small><strong>Source:</strong> ©2025 Press Ganey. All rights reserved; a PG Forsta company.</small></em></p><p>Press Ganey’s data establish how closely all of these outcomes — patient safety outcomes, patient experience, workforce engagement experience and resilience — are tied together by a hospital or health system’s culture of safety.</p></div><div class="col-md-12"><h2>A Continuous Journey to Improve</h2><p>Improvement is a continuous pursuit, and hospitals have been and will remain deeply committed to advancing the safety and quality of their care, the way in which patients experience care, and the wellbeing of their care teams. By improving the patient and workforce experience, identifying and addressing risks to patient or staff wellbeing, improving communications and understanding of what patients and their families value in their care experience, and implementing innovative strategies, hospitals will continue to demonstrate their commitment to patient safety.</p><p>One of the key goals of the <a href="/aha-patient-safety-initiative" title="Learn more about the AHA Patient Safety Initiative">���������� Association’s Patient Safety Initiative</a> is to help hospitals and health systems improve the culture of safety. Launched in 2023, AHA’s Patient Safety Initiative catalyzes hospitals’ and health systems’ collective expertise and momentum for improvement and focuses on 1) safety culture, 2) identifying and addressing disparities in health care outcomes, and 3) the wellbeing of the workforce.</p><p>Through the work of the Patient Safety Initiative, hospitals and health systems are using safety improvement strategies that have a history of success, as well as trying new and innovative approaches to further enhance their work.</p><p>To help leaders and boards learn from their counterparts in other hospitals and health systems, AHA has produced the Leading for Safety video series hosted by former Chair of the AHA Board of Trustees Mindy Estes, M.D., and featuring leaders from hospitals and health systems that have been recipients of AHA’s Quest for Quality award. The AHA’s Safety Speaks podcast series also features many quality and safety leaders talking about their innovative approaches to safety.</p></div></div></div> Tue, 11 Mar 2025 09:28:08 -0500 Safety culture /news/headline/2025-02-19-aha-podcast-tiered-system-safety-committing-zero-harm-wellspan-health <p>In this conversation, Carlos Roberts, M.D., urogynecologist, vice president and chief medical officer of the Women and Children service line at WellSpan Health, discusses the organization's commitment to zero harm, its innovative tier structure for daily safety huddles, and its fostered culture of continuous improvement and celebration of patient safety. <a href="/advancing-health-podcast/2025-02-19-tiered-system-safety-committing-zero-harm-wellspan-health" title="POD LINK"><strong>LISTEN NOW</strong></a><strong> </strong></p><div></div> Wed, 19 Feb 2025 14:48:56 -0600 Safety culture /education-events/layered-approach-addressing-workplace-violence <div class="raw-html-embed"> #block-mainpagecontent article > div > div > div.col-md-8{ width: 100%; } .panel-body { display: flex; flex-flow: row; flex-wrap: wrap; gap: 10px 10px; } .panel-body>div{ /*border:solid 1px red;*/ margin-bottom:10px } .page-header {order: 1; flex-basis:100%} .event-format {order: 2; flex-grow: 1} .event-dates {order: 3; flex-grow: 1;} .event-cost {order: 4; flex-grow: 1; flex-basis: 25%} .event-type {order: 5; flex-basis: 33%} .event-host {order: 8; flex-grow: 1;} .event-contact-info {order: 6; flex-grow: 2; flex-basis: 33%} .event-description {order: 3; flex-grow: 1} .event-sponsors {order: 9; flex-grow: 1;} .event-registration-link {order: 9;margin: auto 15%;} .page-header{ margin: 0px 0 10px; } h1{ margin:0px } h3{ margin:0px } h4{ color:#003087; font-size:27px; } </div><div class="row"><div class="col-lg-6 col-md-6 col-sm-6 center_body"><h4>AHA Affinity Forum Session One</h4><p>Workplace violence continues to threaten health care professionals, but mitigating the risk may come with complex challenges. In session one of the <a href="/affinity-forum/addressing-workplace-violence-health-care-2025" title="View the whole series">AHA Affinity Forum</a>, we’ll focus on how to analyze the unique needs of your organization and create a layered approach to violence mitigation. A layered and comprehensive safety plan can help you protect your organization and empower your teams to deliver exceptional patient care in a safe and supportive environment.</p><p>Elisa Arespacochaga, vice president of clinical affairs and workforce, AHA, and Andrea Greco, senior vice president of health care safety, CENTEGIX, will host Kala Bettis, MA, LSC, LAC, LPC, integrated behavioral health supervisor, Vail Health Behavioral Health, to discuss how to analyze the unique needs of your organization and create a layered approach to violence mitigation.</p><p>Each session will last 60 minutes to allow time for the panel discussion and interaction with attendees. Submit your questions ahead of time to contribute to the discussion and address issues that are unique to your organization, or role.</p><p><strong>Tuesday, December 3, 2024 at 12 - 1 p.m. Eastern; 11 a.m. - noon Central; 9 - 10 a.m. Pacific </strong></p></div><div class="col-lg-6 col-md-6 col-sm-6"><h4>Panel Discussion Replay</h4><div class="embed-responsive embed-responsive-16by9"></div><p><a class="btn btn-wide btn-primary ext" href="/system/files/media/file/2024/12/aha-affinity-forum_CENTEGIX_Session1_layered-approach.pdf" target="_blank" title="View the presentation/deck from the panel discussion" rel="noopener nofollow">Presentation / Deck</a></p></div> <div> <aside> <h3>Reserve Your Spot</h3> <div class="raw-html-embed">   MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 4218); MktoForms2.whenReady(function(form) { if(form.getId() == 4218) { form.onSuccess(function(values, followUpUrl) { form.getFormElem().hide(); document.getElementById("successAndErrorMessages").innerHTML = `<p>Thank you for your RSVP. Check your email for a save-the-date message to add to your calendar.<\/p>`; return false; }); }; }); <div id="successAndErrorMessages"> </div> </div> </aside> </div> </div>--></div><div class="row"><div class="col-sm-1"> </div><div class="col-sm-10"> /* people */ .people { margin-top: 50px; } .people img:nth-child(1) { border-radius: 200px; -moz-border-radius: 200px; -webkit-border-radius: 200px; margin-bottom: 10px } .people img:nth-child(1):hover { opacity: .7 } @media (max-width:991px) { .people { margin: auto; } .people p { text-align: center } } .ci_profile { margin-bottom: 30px; display: block; } @media (max-width:991px) { .ci_profile { text-align: center } } .ci_profile p { margin: 0 0 7px 0 } .ci_profile_name { font-weight: 700; font-size: 20px; } p.ci_profile_name { font-size: 1.5em; } .ci_profile_title { font-style: italic; line-height: 1.3em } .ci_profile_company { font-size: 1em; } p.ci_profile_award { font-size: .8em; text-align: center; color: #55555599; font-weight: 700 } .ci_profile_social { width: auto; } .ci_profile_social i { padding-right: 25px; font-size: 20px } .ci_profile_social a:last-of-type i { padding-right: 0px; } #ci_footer-social { font-size: 1.5em; padding-top: 0px; width: 100%; text-align: right; } @media (max-width:991px) { .ci_logo { margin-top: 25px } .ci_social p { text-align: center !important; } #ci_footer-social { text-align: center } } @media (min-width:540px) { .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .rowEqual_768>[class*='col'] { -ms-flex: 1; /* IE 10 */ flex: inherit; width: calc((100%/3) - 2px)/*Adjust % for the number per row, will override the bootstrap - Also needed for Safari*/ ; } } /* // */ <div class="row people people4"><h4 class="text-align-center">Speakers</h4><div class="row rowEqual_768"><div class="col-md-4 col-sm-6 ci_profile"><img src="/sites/default/files/2024-10/Kala-Bettis-VailHealth-affinity-forum-300x300.jpg " alt="Kala Bettis" width="300" height="300"><p class="ci_profile_name">Kala Bettis, MA, LSC, LAC, LPC</p><p class="ci_profile_title">Integrated Behavioral Health Supervisor</p><p class="ci_profile_company">Vail Health Behavioral Health</p><p class="ci_profile_award"> </p><div class="ci_profile_social"> </div></div><div class="col-md-4 col-sm-6 ci_profile"><img src="/sites/default/files/2024-10/elisa-arespacochaga_affinity-forum-300x300.jpg" alt="John Riggi" width="300" height="300"><p class="ci_profile_name">Elisa Arespacochaga</p><p class="ci_profile_title">Vice President of Clinical Affairs and Workforce</p><p class="ci_profile_company">���������� Association</p><p class="ci_profile_award"> </p><div class="ci_profile_social"> </div></div><div class="col-md-4 col-sm-6 ci_profile"><img src="/sites/default/files/2024-10/andrea-greco-centegix-affinity-forum-300x300.jpg" alt="Ed Gaudet" width="300" height="300"><p class="ci_profile_name">Andrea Greco</p><p class="ci_profile_title">Senior Vice President of Health Care Safety</p><p class="ci_profile_company">CENTEGIX</p><p class="ci_profile_award"> </p><div class="ci_profile_social"> </div></div> <img alt="" src="sssssssssss"> <p class="ci_profile_name">xxxx</p> <p class="ci_profile_title">vvvvv</p> <p class="ci_profile_company">ddddd</p> <p class="ci_profile_award">hhhhh</p> <p class="ci_profile_award"><a href="/center/next-generation-leaders-fellowship/scholarship">Age-Friendly Scholarship Recipient</a></p> <div class="ci_profile_social"></div> </div> --> <a href="/center/next-generation-leaders-fellowship/scholarship">Age-Friendly Scholarship Recipient</a> </p> --></div></div></div><div class="col-sm-1"> </div></div><div class="row" id=""><div class="col-md-10 col-md-offset-1"><div class="col-md-12"><h4>AHA Affinity Forum is brought to our members in collaboration with CENTEGIX</h4></div><div class="col-md-12"><p>Trusted by leading health care providers, CENTEGIX CrisisAlert™ offers all staff members a way to discreetly summon help in any emergency—anytime, anywhere on your campus. The wearable duress badge accelerates response times so your team can confidently begin de-escalation, knowing help is on the way.</p></div> <a href="xxxxxxxxxxxxx"> <img alt="CENTEGIX Logo" src="/sites/default/files/2024-10/CENTEGIX_LOGO_web-Horizontal-Recovered.png"> </a> </div>--></div></div> Fri, 06 Dec 2024 12:00:00 -0600 Safety culture /news/headline/2024-12-04-aha-podcast-mitigate-and-prevent-commonspirit-healths-transparent-culture-and-error-reporting-toolkit <p>In this “Safety Speaks” conversation, CommonSpirit Health's Beth Miller, system director, patient safety-performance improvement, and Austin Peterson, system director, patient harm prevention, discuss how safety transparency benefits both patients and providers, and how a CommonSpirit Health toolkit can help organizations lead the way in error reporting and patient safety. <a href="/advancing-health-podcast/2024-12-04-mitigate-and-prevent-commonspirit-healths-transparent-culture-and-error-reporting-toolkit"><strong>LISTEN NOW</strong></a></p><div></div> Wed, 04 Dec 2024 16:06:58 -0600 Safety culture /education-events/navigating-rising-tide-violence-ensuring-safety-health-care-environments <p><em><strong>AHA Leadership Scan: A Series of Virtual Panel Discussions</strong></em></p><p><strong>Navigating the Rising Tide of Violence: Ensuring Safety in Health Care Environments </strong><br><em>Updating your strategies to protect health care workers  </em></p><p><strong>Thursday, Dec. 12, 2024 </strong><br><em>1 - 2 p.m. Eastern; noon - 1 p.m. Central; 10 - 11 a.m. Pacific </em>   </p><div class="webreplay"> .webreplay{ border: solid 2px #777; padding: 15px 5px; margin: 0 0 10px 15px; } @media (min-width:360px){ .webreplay{ min-width: 290px; float: right; } } <h2 class="text-align-center"><small>On-demand Webinar</small></h2> MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 4247);</div><p>Health care and social services experience the highest rates of injuries caused by workplace violence, according to the Department of Labor, jeopardizing their ability to care for their communities.  </p><p>Hospitals and health system teams experienced violence well before the pandemic, from bullying and incivility to active shooters, intimate partner violence, homicides and suicides. The compounding trauma of the pandemic and violence against health care workers by patients, family members and visitors has heightened the need to create a safer workplace and a more resilient workforce.  </p><p>What does all this mean to your organization and how can you respond effectively to ensure the safety and security of your workforce?  </p><p>Join leaders in security and health care for a panel discussion on the increasing prevalence of workplace violence in health care settings. The panel will explore critical topics including the rise in violence, how to distinguish between violent and uncomfortable interactions, and the impact these incidents have on safety. Learn proven violence prevention techniques and discover strategies for building trust in safety protocols.</p><h3><small class="sm"><strong>Attendees Will Learn:</strong></small></h3><ul><li>To identify and respond to workplace violence threats inside and outside facility walls. </li><li>The difference between violence and uncomfortable interactions and how each relates to safety. </li><li>How to build trust in health care settings, including home care services to improve the safety of health care workers. </li><li>How to implement best practices in violence prevention techniques and reporting on increased workplace violence incidents.</li></ul><h3><small class="sm">Speakers:</small></h3><p>Betty Jo Rocchio, DNP, RN, CRNA, CENP, EBP-C <br><em>Executive Vice President and Chief Nurse Executive</em><br><strong>Advocate Health</strong></p><div><p lang="EN-US" lang="EN-US" paraid="2018905445" paraeid="{8c46086d-b5be-4ec6-890c-1e5d964c976f}{81}">Jason P. Stopyra, MD, MS <br><em>Enterprise Group VP, Public Safety & Emergency Management</em><br><em>Enterprise Director, Workplace Violence Mitigation</em><br><em>Professor, Department of Emergency Medicine</em><br><strong>Advocate Health </strong></p></div><p>Eric Sean Clay, MBA, MSc, CHPA, CPP, PSP, PCI <br><em>Vice President of Security Services, </em><strong>Memorial Hermann Health System </strong><br><em>President</em>, <strong>International Association for Healthcare Security and Safety  </strong></p><p>Jason J. Grellner  <br><em>Vice President and Head of Healthcare </em> <br><strong>Evolv Technology  </strong></p><p><strong>AHA Moderator:</strong></p><p>Jordan Steiger <br><em>Senior Program Manager of Clinical Affairs and Workforce </em><br><strong>The ���������� Association</strong></p><p><br>By attending the AHA Leadership virtual panel discussion "Navigating the Rising Tide of Violence: Ensuring Safety in Health Care Environments" offered by the AHA, participants may earn up to <strong>1 ACHE Qualified Education Hour </strong>toward initial certification or recertification of the Fellow of the American College of Healthcare Executives (FACHE) designation.  </p> Wed, 30 Oct 2024 08:48:58 -0500 Safety culture /education-events/understanding-origins-violence-health-care-facilities <p><strong>Understanding Origins of Violence in Health Care Facilities   </strong><br><em>Safety and Security Best Practices </em> </p><p><strong>Tuesday, October 15, 2024 </strong>   <br><em>1 - 2 p.m. Eastern; noon - 1 p.m. Central; 10 - 11 a.m. Pacific </em> </p><div class="webreplay"> .webreplay{ border: solid 2px #777; padding: 15px 5px; margin: 0 0 10px 15px; } @media (min-width:360px){ .webreplay{ min-width: 290px; float: right; } } <h2 class="text-align-center"><small>On-demand Webinar</small></h2> MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 4070);</div><p>Violence in health care facilities is an increasingly concerning trend in the United States. Health care workers are facing rising incidents of physical and verbal assaults, significantly impacting hospitals, staff, visitors and patients.  </p><p>Health care workers, particularly nurses, are now five times more likely to experience violence on the job than workers in other sectors. The ongoing rise in violent incidents was exacerbated by the pandemic, which led to higher stress levels among patients and their families. Safety concerns are not only affecting the mental and physical well-being of health care workers but can also compromise the quality of patient care. Fear of violence can lead to distracted care, increased burnout and higher turnover rates among staff, which in turn strains hospital resources and impacts patient outcomes.  </p><p>By implementing a comprehensive strategy combined of legislative support, robust safety protocols, investing in new technology and ongoing staff education, hospitals can better protect their employees and ensure a safer environment for everyone involved. Join both Jason Grellner, former executive director of Mercy Healthcare and current vice president and head of healthcare for Evolv Technology, and Drew Neckar, the president & principal consultant at Security Advisors Consulting Group LLC, in an insightful and interactive webinar dedicated to addressing violence in health care facilities.</p><h3><small class="sm">Attendees Will Learn:</small></h3><ul><li>More about the scope of violence in health care.  </li><li>The associated impact violence has on health care staff and patients.  </li><li>Best practices to identify future incidents of violence.  </li><li>Best practices for a wholistic approach to violence.  </li><li>More about targeted violence in health care and the importance of threat assessment and threat management.  </li></ul><h3><small class="sm">Speakers:</small></h3><p>Jason J. Grellner <br><em>Vice President and Head of Healthcare </em><br><strong>Evolv Technology</strong></p><p>Drew Neckar <br><em>Principal Consultant </em><br><strong>COSECURE Enterprise Risk Solutions </strong></p> Wed, 28 Aug 2024 11:19:38 -0500 Safety culture /advancing-health-podcast/2024-07-03-unifying-hospital-boards-quality-and-safety <p>In this new “Safety Speaks” conversation, Harry S. Smith, board chair of Valley Health System and member of the AHA Committee on Governance, discusses how their organization rearranged its governance system to ensure that quality and patient safety standards were being met across the board. </p><p>To learn more and sign up for the Patient Safety Initiative please visit <a href="/aha-patient-safety-initiative" target="_blank">/aha-patient-safety-initiative</a></p><hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00;00;00;14 - 00;00;31;10<br> Tom Haederle<br> E Pluribus Unum - that's Latin for "out of many, one" - is the traditional motto of the United States and printed on the dollar bill. Out of many, one is also the goal for independent hospitals and their boards who merge into larger health systems and may face the challenge of maintaining safety and quality standards that are no longer just their own. </p> <p> 00;00;31;13 - 00;01;06;07<br> Tom Haederle<br> Welcome to Advancing Health, a podcast from the ���������� Association. I'm Tom Haederle with AHA communications. Valley Health System serves a sizable patient population in Virginia. It was formerly six separate hospitals, all of which were governed independently by their boards. In this Safety Speak series podcast hosted by Sue Ellen Wagner, vice president of Trustee Engagement and Strategy with AHA, we hear how Valley Health System rearranged its governance system to overcome the hiccups of its growing pains and ensure that patient safety standards were kept up across the board.</p> <p> 00;01;06;09 - 00;01;18;26<br> Sue Ellen Wagner<br> Thank you Tom. Joining me for this podcast is Harry Smith, board chair of Valley Health System in Virginia, and member of the committee on Governance. Welcome, Harry, and thank you for joining me. </p> <p> 00;01;19;03 - 00;01;20;27<br> Harry S. Smith<br> Thank you, Sue Ellen. Happy to be here. </p> <p> 00;01;20;29 - 00;01;26;18<br> Sue Ellen Wagner<br> Great to have you. So can you tell us a high level overview of your health system? </p> <p> 00;01;26;21 - 00;01;58;29<br> Harry S. Smith<br> Be happy to. Valley Health System, and I've been involved with it and its largest subsidiary, Winchester Medical Center for 22 years. In two more years, I will retire. I will have termed out of Valley Health, and as a career banker, I have found health care to be - as a friend of mine said one time - you're performing God's mission. And I don't know of any organization in the world that does what hospitals and health care systems do to care for our population. </p> <p> 00;01;59;01 - 00;02;29;24<br> Harry S. Smith<br> So when I first started this journey 20 some years ago, I was on the Winchester Medical Center board, which is about 83% of the economic engine, the patient base of our system. We had five other hospitals. We did have a system, Valley Health System. We serve nine counties and a city in the northern part of Virginia. And some people will know it as the panhandle of West Virginia. </p> <p> 00;02;29;25 - 00;03;00;21<br> Harry S. Smith<br> So in addition to Virginia laws, rules and regulations, we also deal with West Virginia. So Valley Health System started back in the late 90s as starting to pull together a loose confederation of like-minded small hospitals to become a regional hospital. Over the years, 2 or 3 that we thought might come into that system actually sold to a for profit system, and that was their decision. </p> <p> 00;03;00;23 - 00;03;35;06<br> Harry S. Smith<br> So we ended up with the Winchester Medical Center, which is Level II trauma, to critical access hospitals and then three rural hospitals. It's been fun looking at this growth of this eclectic system of several different types of delivery in two different states. We realized early on, though, that we were somewhat disconnected, even though we had this holding company called Valley Health, we still had its board in six different hospital boards.</p> <p>00;03;35;08 - 00;04;04;06<br> Harry S. Smith<br> And principally they were responsible for their hospital, their operations. They had their own president. For the most part they did some of their financial and some of their accounting, but a lot of that was at the system level. But they were really principally responsible for quality. And so I became more involved and then was on the hospital board at Winchester Medical Center and the Health System Board, I started realizing how complex this was.</p> <p>00;04;04;09 - 00;04;39;01<br> Harry S. Smith<br> It should be more efficient, and we should be able to provide even better quality for our community. And how could we do that? And first is ask questions. One of the first questions I asked of our CEO was how many quality meetings? How many board meetings do you go to in a month? And it was astounding because remember, we had a quality hospital board meeting for each one of those, plus the system, and he was attending all of those, and each one was handling quality at a high level, but with its own standards.</p> <p>00;04;39;04 - 00;05;09;03<br> Harry S. Smith<br> You can't take six hospitals that used to be independent and overnight, put them all under one system and say to their executive team and to their board, you are no longer independent. So that took a process of moving more functions to the system, which we started really with finance and then audit. They then were principally quality. Then it was, we've got to standardize quality.</p> <p>00;05;09;03 - 00;05;41;12<br> Harry S. Smith<br> So Valley Health System hired its chief quality medical officer to system level. And then started working with the individual hospital presidents and their vice presidents of medical affairs to begin that process. As it started, we still were meeting a lot and I'm not sure really moving the needle as positively as we wanted with quality. So we then visited several systems, worked with consultants on how do we do this better?</p> <p>00;05;41;15 - 00;06;06;29<br> Harry S. Smith<br> And what we came up with, what we did was Valley Health System then became the sole member of all of these separate hospitals. So we then evolved into one board, Valley Health System, which is the sole member of the six hospitals with one board. So early when they were independent hospitals, you had a lot of attention to quality, because that's pretty much what they did.</p> <p>00;06;07;01 - 00;06;34;17<br> Harry S. Smith<br> Now it's one big board, not in each community, even though there's some community representation. How is it going to handle quality in a community that might be 70 miles away? That brought through the standardization process. And we did that at the Valley Health level, kind of just doing what we used to do, but now instead of 6 or 7 boards, it's one. Still wasn't working as well or as efficient as we thought.</p> <p>00;06;34;19 - 00;06;57;27<br> Harry S. Smith<br> We then decided to form what we call QMAC. It's the Quality Medical Affairs Committee, which has the full authority of the board. The system board meets six times a year. Credentialing occurs more than six times a year. And we said the hospitals have to exist for credentialing. You just can't disband a hospital. It has to have a board.</p> <p>00;06;57;28 - 00;07;37;20<br> Harry S. Smith<br> Well, its board is the Valley Health Board because it is a sole member-owned hospital. So representatives then of each hospital, their vice presidents of medical affairs, their lead administrators, their chief nursing officers, key physicians serve on the QMAC, Quality Medical Affairs Committee, which has the full authority of the board. And it meets monthly, and it has full authority to do credentialing to review all quality indices, KPIs and we then at the Valley Health Board, when we meet that six times a year, will open</p> <p>00;07;37;20 - 00;08;03;00<br> Harry S. Smith<br> our meeting, will have a consent agenda. And let me go back, if I might, because in one of this morning's presentations talked about the board's priorities as days and days and years and years ago, it may well have been finance. I think we all understand our number one priority is quality, and we have taken a lot of the normal duties and responsibilities.</p> <p>00;08;03;02 - 00;08;28;22<br> Harry S. Smith<br> Even the monthly financial report and the quarterly. And that's in a consent agenda now. So we don't have a long formal presentation on finance. So we save our time and our time is saved really at reviewing quality, educating the board on quality, but also taking time to educate. Our last meeting, we talked a lot about artificial intelligence and its impact on systems and quality and physicians</p> <p>00;08;28;22 - 00;08;58;02<br> Harry S. Smith<br> and don't be afraid of it because it's just a tool. You still will have humans making those decisions. So I then chair the board. We'll go through the consent agenda of those items that used to take an hour or more. We then open the sole member meetings, and that's where the quality report flows up to our system. The chair of our quality committee and the chief medical officer for the system will make that presentation.</p> <p>00;08;58;04 - 00;09;21;20<br> Harry S. Smith<br> And all this information is in our board package, and we have what we call an S-bar. You'll see the report. But then if you want literally the other 200 pages to go with that report, you can pull that up. That committee is populated, as I mentioned, from all of our hospitals are critical care. Our clinical administrators, our physicians assistants, nurse practitioners, chief nursing officers.</p> <p>00;09;21;22 - 00;09;52;22<br> Harry S. Smith<br> So it's very well represented. And that's where the deep dive occurs. That's where the sausage is made. We at the system level who aren't on that committee have to have a very high level of trust, which we do, and have given that committee, again, full authority to act on the board for our quality initiatives, including credentialing. So I know I'm rambling, but just to give you an idea of what this committee does and then how we review it.</p> <p>00;09;52;23 - 00;10;28;25<br> Harry S. Smith<br> So our QMAC committee reviews credentials. Our staff executive committee, which some would call their medical executive: committee minutes and reviews. Our performance improvement committee: harm scorecard quality scores, patient experience scores. They'll have special reports. They'll hear from our VHMG, which is our Valley Health medical group. That's the employed physicians. We have our entity presidents. There will have information that comes at a little bit of recruiting, is epic working as we would sentinel events, serious safety events.</p> <p>00;10;29;01 - 00;10;59;21<br> Harry S. Smith<br> Again, this is for all six hospitals coming to one group. As I mentioned credentialing, we have advanced practice providers involved in that. We hear a report from each department: cardiology, emergency medicine, family, etc. Review in depth the Performance Improvement Committee which again includes harm patient experience. The annual quality plan which they review first recommend to the board. The board will review it, discuss it,</p> <p>00;10;59;21 - 00;11;31;11<br> Harry S. Smith<br> at times we tweak it. That will become the annual plan of quality for our system. They look at falls, wrong site surgeries, lab issues, patient access, wound care. All of this happens on a monthly basis. You couldn't expect a board of 14 to 16 to really have that depth and level of knowledge to review every month, the thousands of hours that go into the details to come to that committee on a monthly basis, which typically meets for two to 2.5 hours.</p> <p>00;11;31;14 - 00;11;40;23<br> Harry S. Smith<br> So they have figured out how to get this information. And what underlies that information is a tremendous amount of detail.</p> <p>00;11;40;25 - 00;12;08;18<br> Chris DeRienzo, M.D.<br> Thank you for tuning in to this episode of Safety Speaks, the podcast series dedicated to patient safety, brought to you by the ���������� Association. I'm Dr. Chris DeRienzo, the AHA’s chief physician executive and a champion of the AHA Patient Safety Initiative. AHA’s Patient Safety Initiative is a collaborative, data driven effort that lifts up the voices of individual hospitals and health systems into the national patient safety conversation.</p> <p>00;12;08;21 - 00;12;40;18<br> Chris DeRienzo, M.D.<br> We strive to catalyze and connect health care professionals like you across America in your efforts to innovate and improve, and to bolster public trust in hospitals and health systems by helping you share your successes. For more information and to join the 1500 other hospitals already involved, visit aha.org/patientsafety or click on the link in the podcast description. Stay tuned to hear more about the incredible work of members of the AHA's Patient Safety Initiative.</p> <p>00;12;40;20 - 00;12;47;13<br> Chris DeRienzo, M.D.<br> Remember, together, we can make health care safer for everyone.</p> <p>00;12;47;15 - 00;12;56;00<br> Sue Ellen Wagner<br> So that QMAC is a way to keep quality at that local community hospital level, and then weave it right up to the top to the system.</p> <p>00;12;56;06 - 00;13;29;09<br> Harry S. Smith<br> Absolutely. I'm not sure I'll say it's our challenge, but our opportunity now and this has been a ten year endeavor. But QMAC really in the last four years has come of its own to where the data, the conversation, the presentation, that's all very, very good. We still have some pockets though, where we could have better standardization of delivery of quality throughout our various entities, including our employed physicians.</p> <p>00;13;29;11 - 00;14;02;12<br> Harry S. Smith<br> That's really the drive right now. We started in 2017 on a journey called High Reliability Organization, which is comprehensive, expensive in the short run, but will be very beneficial in the long run. And it's a journey that never ends. I think I've mentioned to you before, this really came from the Navy. And what does that mean? It means what happens 100% of the time should happen, and what shouldn't happen 100% of the time doesn't happen.</p> <p>00;14;02;14 - 00;14;24;12<br> Harry S. Smith<br> And that's not easy to do. But if that is your goal, if that is your mission, if you know that you want to do everything right. If you don't, you correct it, you learn from it, and then you have to have those standards across the system that everybody is operating in the same manner. And that's where we're finding still a little bit of some variables.</p> <p>00;14;24;15 - 00;14;49;26<br> Harry S. Smith<br> The last thing they look at, and the most important thing that QMAC back presents to our board then would be our dashboard, our KPIs. This is approved. Our quality plan annually originates from this committee representing all of those constituents I mentioned earlier. Comes up to the board and is presented twice. Once - okay, here's what we think. You all chew on this for a month or two.</p> <p>00;14;49;27 - 00;15;14;26<br> Harry S. Smith<br> We're going to come back and then receive formal board approval for our quality plan. In the last three years, the board has made a few tweaks. They never have just blindly accepted the QMAC report and quality plan. An example would be the mortality index. We were doing really, really very well on that. Because we were doing so well</p> <p>00;15;14;28 - 00;15;33;22<br> Harry S. Smith<br> QMAC folks in executive management recommended, because the hurdle was already pretty high, that we should continue that for the next year. Board members said, we think you need to raise that. You've already obtained this level. And they go, yeah, but this is a great level when you look at peer. Yeah, but we think you can do better.</p> <p>00;15;33;25 - 00;15;35;06<br> Harry S. Smith<br> And they exceeded that.</p> <p>00;15;35;11 - 00;15;37;11<br> Sue Ellen Wagner<br> Commend you for that. That's amazing.</p> <p>00;15;37;14 - 00;15;58;23<br> Harry S. Smith<br> Thank you. And they did accept us. So currently we are looking at and this is where we had to tweak the mortality index. We look at whole house infection. We used to just look at sepsis. They made the change. I asked our quality medical officer, tell me what this whole house infection is. And he goes, well it's a new indices that CMS is looking at.</p> <p>00;15;58;25 - 00;16;21;07<br> Harry S. Smith<br> And sepsis. We've got a pretty good handle on that in our system now. So we're now looking across the whole system i.e. the whole house at all infections not just sepsis. If we would see sepsis crop up, then we certainly would put a shining light on that and give that more attention. We are looking average length of stay.</p> <p>00;16;21;08 - 00;16;48;04<br> Harry S. Smith<br> We think that is important, which ties a little bit into and we still have operating margin. And then last is engagement. Employee, outpatient, inpatient, ED - critically important to us. What people think about us, how do they feel about our quality. And we take that seriously. These are our major dashboard KPIs. And really only 20% of that is finance.</p> <p>00;16;48;06 - 00;16;59;23<br> Harry S. Smith<br> You might say a little bit of length of stay is tied to finance. And I will tell you, a decade ago, 60% would have been financial indicators. Now it's 20%.</p> <p>00;16;59;25 - 00;17;02;10<br> Sue Ellen Wagner<br> And the rest is quality or most of it.</p> <p>00;17;02;13 - 00;17;27;15<br> Harry S. Smith<br> Most is quality. And again, working through that socially, politically and again when you're realigning boards and duties and we're wanting to get to a point where you never will get. And that's 100% perfection. But if that's your goal and if you can continue to improve on that goal, tweak it as you get there, then I think we've done our job. </p> <p>00;17;27;17 - 00;17;47;15<br> Sue Ellen Wagner<br> Absolutely. Wow. So you've really described a great case example for other systems to follow and other hospitals. You're still keeping that quality local, but your reduced the number of meetings that boards have to go to. And that system is still seeing what's going on across all of your six hospitals. That's great.</p> <p>00;17;47;17 - 00;18;12;27<br> Harry S. Smith<br> We are. We have independent trustees. The chair of QMAC has to be a trustee. Now we're lucky this happens to be a physician. So that's great. We have a trustee who is a nurse, actually dean of a nursing school who had been a practicing nurse. She is on that. So we have independent nursing validation. We then have several independent trustees who do not have a medical background.</p> <p>00;18;13;00 - 00;18;33;08<br> Harry S. Smith<br> And we now require that members of the board who are not members of QMAC mandatorily have to attend at least one meeting a year. Because in one of our surveys a couple of years ago, members said they weren't sure that we were meeting our quality commitment. Those on the committee were going, what?</p> <p>00;18;33;10 - 00;18;37;05<br> Sue Ellen Wagner<br> So you just weren't transferring the information more broadly.</p> <p>00;18;37;08 - 00;19;13;20<br> Harry S. Smith<br> And we were bringing it up to the system board, but we were bringing it up through, you know, a monthly meeting report, but some probably weren't going to that S-bar or reviewing those 100 or so pages. Nor should they. They were newer learning how to trust this. Is it really working as we think it should? One way to get that is to have the experience of attending that meeting at least once during the year, to really see what these very dedicated professionals are committing to and doing, to continue to strive to improve quality, to again that 100% level.</p> <p>00;19;13;22 - 00;19;37;27<br> Sue Ellen Wagner<br> It's a very important step to make sure that all your board members are knowledgeable about what's going on and understand. And I also think it's pretty phenomenal that you've modified the way your consent agenda is done, and you're talking more about quality. We talked earlier at the AHA Annual Meeting at our Age Friendly and Quality and Patient Safety program, how it's so important to have quality be front and center of your board members.</p> <p>00;19;38;00 - 00;19;52;06<br> Sue Ellen Wagner<br> Any other words of wisdom for other boards in terms of what they should be focusing on, on quality and patient safety, or how they get buy in to make some changes to their board structure and how they should be talking about quality and patient safety.</p> <p>00;19;52;08 - 00;20;19;27<br> Harry S. Smith<br> I think the first is don't be shy that you don't know everything. You may not have a background in health care. That's where I think most of the apprehension might be. You have to be comfortable in giving up the perceived local control. You have to develop what your community, what your structure that will work for you and it.</p> <p>00;20;19;29 - 00;20;49;01<br> Harry S. Smith<br> And I would say this would be more for those trustees that don't have that quality level of background. It's okay to ask a question. I mean, I'm a banker and I've started this years ago going, how many meetings do you attend and why are we spending so much time on this and why are we doing that? Getting involved in organizations like the ���������� Association, attending meetings, listening to peers best practices.</p> <p>00;20;49;03 - 00;21;14;08<br> Harry S. Smith<br> It really does help with efficiency, effectiveness. And it's okay to ask that question. It might not work for everyone. That's okay, but you can improve what you're doing in every single instance and circumstance in every part of this country if you just aren't comfortable with the status quo and just ask why, how, and maybe we can do things better, we found that you can.</p> <p>00;21;14;10 - 00;21;19;06<br> Sue Ellen Wagner<br> Well, I think you've provided some great insights for our listeners, and I want to thank you for joining me.</p> <p>00;21;19;13 - 00;21;20;24<br> Harry S. Smith<br> Thank you, Sue Ellen.</p> <p>00;21;20;26 - 00;21;29;05<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Wed, 03 Jul 2024 16:56:02 -0500 Safety culture /education-events/health-care-safety-and-security-best-practices-your-questions-answered <p><strong>Health Care Safety and Security Best Practices – Your Questions Answered </strong><br><em>Protecting Health Care Professionals</em></p><p><strong>Tuesday, August 6, 2024 </strong><br><em>1 - 2 p.m. Eastern; noon - 1 p.m. Central; 10 - 11 a.m. Pacific    </em></p><div class="webreplay"> .webreplay{ border: solid 2px #777; padding: 15px 5px; margin: 0 0 10px 15px; } @media (min-width:360px){ .webreplay{ min-width: 290px; float: right; } } <h2 class="text-align-center"><small>On-demand Webinar</small></h2> MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 3978);</div><p>In recent years, there has been a notable escalation in incidents of workplace violence within health care facilities across the United States. Approximately 50% of members belonging to the American College of Emergency Physicians and the Emergency Nurses Association have reported encountering some form of violence in their professional environments. This figure surges to 70% among emergency nurses.</p><p>Given these compelling statistics, it is imperative to strategize on safeguarding the work environment of our health care professionals. Join Jason Grellner, former executive director of Mercy Healthcare and current vice president and head of healthcare for Evolv Technology, in an insightful and interactive webinar dedicated to exploring safety and security best practices in a health care setting. This webinar will get your questions answered, as it is a follow-up from the April 23rd webinar that explored steps security professionals are taking to protect the health care environment.</p><p>Join us to learn how to elevate security measures and enhance emergency response protocols, leverage effective situational awareness techniques, harness the potential of artificial intelligence in preparing and responding to active threats, and evaluate the substantial impact of comprehensive safety training for your hospitals.  </p><p><strong>Attendees Will Learn:</strong></p><ul><li>The scope of workplace violence in health care. </li><li>How to implement security and emergency response best practices.  </li><li>To better harness technology and training for improved safety.</li></ul><p><strong>Speaker:</strong></p><p>Jason J. Grellner <br><em>Vice President and Head of Healthcare </em><br><strong>Evolv Technology</strong> </p> Fri, 14 Jun 2024 14:17:42 -0500 Safety culture