Based on evidence related to the science of safety, leadership training has focused on leading with safety; finding and fixing system problems; and building and reinforcing accountability. As part of leading with safety, each meeting begins with a safety topic or story. Leaders encourage, reward, and expect staff to report safety events; expect staff to ask safety questions; and recognize and support staff when they do. As part of finding and fixing system problems, each hospital conducts a daily safety huddle. Safety issues are identified and addressed immediately. As part of building and reinforcing accountability, leaders provide instant feedback and constant reinforcement; apply a just algorithm when errors occur; and conduct frequent rounds. Weekly inter-professional safety rounds include individuals from compliance, facilities, housekeeping, infection control, materials management, nursing, regulatory, accreditation, and safety. A member of Senior Staff meets regularly with staff to discuss the unit’s priorities for and concerns about patient safety.
The nursing vision and strategic plan reinforce HRO principles. Nursing’s involvement includes hourly rounding and bedside report. Inter-professional education is being planned for physicians, nurses, and all employees. The safety scorecard includes hospital acquired conditions and the serious safety event rate. The Culture of Safety Survey (Agency for Health Care Research and Quality) is being used to assess staff’s perspective of safety.