The Evolving Culture of Safety

1. The Evolving Culture of Safety Dr. Ami Hiatt Keatts MD, FACOG, CPPS

2. Why do we care about safety? • It affects our institution’s reputation and referral patterns • It improves outcomes for patients • It improves worker satisfaction • It affects payment • It is the right thing to do 2

3. Goals of this talk: • Review history of the patient safety movement • Present quality metrics facing physicians • Teach systems thinking for healthcare • Review ways to assess providers safety attitudes (when recruiting to your institution) • Answer questions 3

4. Quality Measures for Physicians • Medicare: readmission, acute and chronic prevention • Commercial insurers also have forms (Anthem Q-HIP) • These will impact payment • Shift from volume to value • Transparent outcomes on the internet (check out vhi.org for my cesarean rate) 4

5. “Humans will always make mistakes…the universal constant is that human infallibility is impossible” Why Hospitals Should Fly, by John Nance, J.D. 5

6. Swiss Cheese Model, by James Reason 6

7. Traditional Medical Model vs Aviation • Senior knows best • Individual interactions • Savior model • Blame individuals • Secretive • Everyone has input • Team-based interactions • All work for goal • Accountability • Transparency 7

8. What is your institution doing to become safer? • Safety Training • Pre-procedure Time-outs • Computerized Physician Order Entry • Handwashing • Bedside Barcode Medication Verification • Fall prevention • Pharmacists makes rounds too 8

9. A word about the Generations http://www.careerplanner.com/Career-Articles/Generations.cfm 9

10. Things to look for: • Awareness of safety in healthcare (ask!) • Team player • Good listener • Values communication, even if not perfect at it • Accountable • Looking for JOY and Meaning at work Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care (Download at www.npsf.org/lli) 10

11. Questions? 11